The civil war in Sudan has been raging for the past two decades, mainly in the southern part of the country. Aweil East County in Bahr El Ghazal province has been regularly raided by armed militia during the recent months. Among other groups, the Muraheleen, a horse-riding militia, regularly carry out raids in Aweil East County.

The last major attack by this group took place throughout Aweil East on Jan 21, 2001. Because of war and drought, several thousand internally displaced persons (IDPs) have been in search of food and grazing areas for cattle in the past months within Aweil East. In this context, we did a retrospective mortality survey that focused on IDP camps within the area.

The objective was to identify the main causes of deaths and prioritise and orient medical-related activities. War-related deaths as a result of continued and ongoing violence in the region, and disappearances, were also investigated. For logistical reasons, the survey was limited to Yed Akuem IDP camp.

In this camp, the majority comprised the Dinka population mainly originating from Titcok Mareng, a village of a few thousand, situated in the lowlands of East Aweil. The Dinka population has been specifically targeted by the militia groups during the civil war between northern and southern regions of Sudan and the majority of them have been forceably displaced as a result.

The survey, carried out among families over a period of 2 days each, was done between Jan 21 and April 8, 2001. We collected data on all deaths reported by the families. Information on family members lost or taken away by the militia was also collected.

A total of 270 families were surveyed, representing 1,027 individuals (three to four individuals per family), of which 201 (20%) were children younger than age five years.

During the period investigated, 168 deaths were reported (13% of the initial population [1314] under study) of which 24 (11%) were children younger than five years of age.
94% (158 of 168) of all deaths, and 79% (19 of 24) of under five deaths were due to violence, from mainly gun-shot wounds.

9% (119 of 1314) of the initial population had disappeared, the majority abducted by the militia as hostages, but others lost and separated during the displacement.

Analysis of sex distribution was possible for 121 families reporting 44 disappearances: women represented 21% (nine of 44) of the total, including one girl younger than five years old.
It was not possible for us to analyse sex distribution among reported deaths as the survey was done under difficult emergency conditions.

All violent deaths and disappearances we documented occurred on Jan 21, 2001. Although the proportion of deaths recorded may have been over-estimated, the situation we report clearly highlights an unacceptable level of killings perpetrated in part against civilians. In particular, the death of children is intolerable.

Families claimed that nearly all of the disappearances, and notably disappearances of women, were abductions. The secondary health effects of war such as malnutrition, population displacement, and disease outbreaks are often documented as an essential feature of programme planning of aid agencies. Less, however, is known about the primary impact of war through violence on civilians and data is often impossible to collect under such insecure circumstances.

Bahr El Ghazal has been severely affected by famine in the past years Creusvaux H, Brown V, Baquet S, et al. Famine in southern Sudan. Lancet 1999; 354: 832., but this should not obscure the dramatic impact of violence in this war-torn region. The example of violence among the displaced from Titcok Mareng village provides a small insight into some of the human rights abuses being perpetrated in southern Sudan. In the context of on-going war in Sudan and elsewhere, investigations to document and quantify violence among forcibly displaced civilians must be carried out.

Such data will have an impact on the prevention of abuses against vulnerable populations in the futureLegros D, Brown V. Documenting violence against refugees. Lancet 2001; 357: 1429. . Authors: Vincent Brown,*Pierrette Caron, Nathan Ford, Jean Clément Cabrol, Jean Pierre Tremblay, Richard Lepec *Epicentre, 8 rue Saint Sabin, 75 011 Paris, France; and Médecins Sans Frontières, Paris, France.