About 100,000 refugees fleeing the fighting in the Sudanese state of Blue Nile have taken refuge in Maban county in South Sudan. They are weak and exhausted after their long trip. In the camp of Batil, home to 34,000 people, the number of children with malnutrition is increasing but humanitarian response remains inadequate. More than 1,000 children have been admitted to the nutritional programs of Médecins Sans Frontières (MSF) and the number continues to rise. As MSF expands its teams and its medical activities, John Tzanos, MSF emergency coordinator in the region, provides an update.

In the Batil camp, the needs are wide-ranging – water, food and shelter but also soap and jerrycans to collect and stock clean water – but the most significant concern at this point is the nutritional situation. We admitted more than 1,000 young children suffering from severe malnutrition in three weeks. That's a very significant number and it continues to grow. 50 children – the most seriously malnourished – have been hospitalised and are being monitored closely around the clock. For the MSF teams, treating malnutrition in the camp is a race against time.

What are the causes of this situation?

These people have been on the move for months. Many fled because of attacks or bombings in their village. They often leave in the middle of the night and don't have time to get ready. We are dealing with entire families who are exhausted and extremely weak. Many arrived in a more or less advanced state of malnutrition. They now receive rations of rice, cereal and oil every 15 days, but it is not enough. Children, particularly the youngest ones, lack reserves of nutrients. As a result, the immune system cannot function properly and children can die from diarrhoea, fever or a respiratory infection. 

Can you tell us more about living conditions in the camps?

The situation we’re seeing in Batil is tragic. In addition to the lack of food, poor hygiene conditions – for example, the lack of soap – are aggravating the situation. There is a lot of diarrhoea. I'm also worried about malaria and the lack of mosquito nets. It's very upsetting to walk through the camp and see all these children who no longer have the energy to laugh or play. People are hungry. The weakest children die of malnutrition or diseases.

What is MSF doing in this region?

Today, in Batil camp, we spend most of our time and effort treating malnutrition. We currently have 150 beds in Batil. This number is constantly increasing because the needs are huge and growing. In the last few days, MSF has sent 70 tons of therapeutic foods by air and water from Nairobi and Dubai. As an emergency medical organisation, we also treat the sick. Diarrhoea, malaria and respiratory infections are the most common diseases. We also care for women during childbirth. Our teams are also providing 200,000 litres of drinking water every day to the refugees of Batil.

Is there sufficient international aid?

Clearly, the current amount of aid is inadequate to cope with such high needs. What we need now are more food distributions which are better-suited to the most vulnerable. In order to prevent the health of children, pregnant and lactating women from worsening rapidly, they need a rich and varied diet that contains protein and micronutrients. We are undertaking a nutritional and mortality survey right now, in order to better understand the needs and adapt our responses to them. We are very worried about this situation. We have to be ready for the worst. What we are facing is an extremely serious situation.

Are distributions possible despite the logistical problems?

MSF delivers aid primarily by air. We have expanded our teams significantly in the last few days and we've sent two vehicles, a tractor and 30 tons of energy biscuits for the malnourished children. Access is difficult in this region. Some roads have been cut off as a result of rising water now that the rainy season has begun. We are in a marshy area here. However, the airports and roads are open. Aid organisations cannot use logistical problems as an excuse. We've got to mobilise all resources immediately.