As fighting rages around South Sudan's northern city of Malakal, overcrowding at the United Nations base there is so severe that 2,000 bags of human waste have been collected to limit the risk of disease, the Danish Refugee Council (DRC) said on Tuesday.
Some 20,000 people are seeking protection inside the base of the United Nations Mission in South Sudan (UNMISS) in Malakal, capital of Upper Nile State, the nation's second biggest oil state, double the number on Friday, putting pressure on limited water supplies and overwhelming camp latrines.
The world's youngest state is experiencing its worst crisis since independence two years ago, with 487,000 displaced and thousands killed since fighting between government and rebel forces broke out on Dec. 15.
"Our team report fighting in and around Malakal town from around 7.30 am today, specifically with fighting around the airport," Heather Blackwell, DRC's country director, said in an email.
"This huge increase of people further strains the limited water and sanitation facilities inside the camp and availability of food," Blackwell said.
"DRC has undertaken an immediate camp clean-up operation designating areas for defecation (as latrines are limited) and paying for bags of human solid waste to improve general conditions and reduce spread of disease."
The DRC has paid residents $1 per bag to collect the waste, and 2,000 bags are being loaded on to trucks to be burned, though it is not safe to do so now because of the fighting, she said.
Those at the Malakal base are getting eight litres of water per day, just over half the international standard for such situations of 15 litres. Aid agencies at the base have increased their ability to provide surgical care for injured patients, but inadequate sanitation for such large numbers remains a subject of concern.
The oil regions have been the focus of fierce battles between government forces and rebels.
"Everyone who could left Malakal in the past few days. There were rumours that the opposition forces from Bentiu were moving eastwards towards Malakal," Oxfam country director Jose Barahona said in a telephone interview from Juba.
"Yesterday, a lot of civilians in Malakal went to the U.N. base or left the city."
Bentiu, west of Malakal, is the capital of South Sudan's main oil producing region, Unity State. There was a similar exodus from Bentiu last week ahead of the government's recapture of the town on Friday.
On Sunday, more than 200 people fleeing Malakal drowned in a ferry accident on the River Nile, the BBC reported.
The upsurge in fighting around Malakal has made it impossible for more humanitarian workers to get in to improve conditions at the U.N. base, which was built to house U.N. peacekeepers.
Oxfam was planning to send sanitation experts to Malakal on Wednesday but this now looks unlikely. Tuesday's daily U.N. flight to Malakal was suspended because of the fighting.
Since the start of the crisis, almost 200 latrines have been built for those sheltering inside the Malakal base, Barahona said. This falls far short of humanitarian standards, which recommend one latrine for 20 people.
"We were still struggling to provide enough latrines and water for 10,000 people," he said. "The open defecation areas will be very crowded and there is the risk of people getting sick."