South Sudan: Health, Protection Risks At Overcrowded UN Bases in South Sudan

Juba — Since fighting broke out across nearly half of South Sudan in mid-December, at least 75,000 people have fled to UN compounds, desperate for security and shelter. More than four months later, as battles between government troops and forces loyal to former vice-president Riek Machar continue, the displaced are still arriving at the UN gates.

As many as 20,000 people streamed into the base in the Unity State capital, Bentiu, this month after opposition forces allegedly carried out ethnically targeted killings after taking control of the town.

"So many people are saying there is nowhere else for them to go," Toby Lanzer, the UN humanitarian coordinator in South Sudan, told IRIN after a recent trip to Bentiu. The opportunity to shelter in the camps is "giving civilians who are just stuck in the wrong place at the wrong time, a sense of hope."

But the fear is they may have exchanged the dangers of the frontline for new risks: The start of the rainy season could speed disease outbreaks within the congested camps, while a civilian attack on one UN compound this month left dozens of people dead and signalled that the bases cannot necessarily shield people from the fighting they moved there to escape.

Aid agencies have lashed out at the UN Mission in South Sudan (UNMISS), accusing its leaders of not working fast enough to improve conditions in existing camps or build new ones, even as UNMISS officials promise new sites will finally be ready next month. At the same time, some UNMISS officials are calling for the military reinforcements the UN Security Council authorized in December so they can simply secure the sites they already have.

The safety of the UN camps - now known as protection of civilians (POC) sites - was called into question in the early days of the fighting when armed youth stormed the base in Akobo, in eastern South Sudan, on 19 December. They killed two Indian peacekeepers and at least 20 civilians.

In the days after the Akobo attack, the Security Council unanimously approved an increase in the number of UNMISS peacekeepers from 7,000 to 12,500. So far, about 650 of the promised peacekeepers have arrived or are on the way, according to acting UNMISS spokesperson Joe Contreras.

Despite the slow deployment, there were no major security incidents at the camps for nearly four months, though aid workers reported some bases had been caught in the crossfire of some battles, and residents had been hit by stray bullets. Then, on 17 April, a group of youth armed with rocket-propelled grenades and other weapons breached the Bor compound.

Bor, the capital of Jonglei State, has changed hands four times since the fighting started. While tens of thousands of people crossed the Nile to escape the area completely, 5,000 are still holed up at the UNMISS base.

After the rebels emerged from days of fighting with control of Bentiu on 16 April, some of the Bor camp residents held noisy celebrations, angering local youth loyal to President Salva Kiir's government. They marched on the compound - allegedly to deliver a petition to UNMISS. Instead, gunfire erupted and the youth managed to enter the base. Nearly 60 people were killed before peacekeepers were able to drive them out.

William Koang, who has been living in the Bor base since December, said the youth are still moving around the outside the camp and "the thing we're fearing is another attack."

New level of brutality?

The assault on the Bor POC site points to a new level of brutality in South Sudan's conflict, especially in the wake of the Bentiu massacre. The UN has accused rebel fighters of systematically killing people sheltering at a mosque, church and hospital based on their ethnic origins. In an echo of the Rwandan genocide, they allegedly used a local FM station to incite the population, including "calling on men from one community to commit vengeful sexual violence against women from another community," according to the UN report on the killings. The opposition has denied all of the charges, but that did not stop people from fleeing to the UNMISS base.

In the aftermath of the two incidents, acting UNMISS Unity State Coordinator Mary Cummins issued a press statement calling for a promised battalion of Ghanian soldiers to arrive "soon" and help protect the influx of people into the Bentiu camp. Days later Hervé Ladsous, the UN peacekeeping chief, called the violence in Bor "an extremely dangerous precedent" that "cannot happen again". Still, no date has been set for the arrival of the nearly 5,000 additional peacekeepers.

Filthy floodwater

Not all of the dangers are waiting outside the POC sites. Nyabuok Dup is one of the more than 20,000 people crowded into the Tomping camp, in the shadow of Juba's airport. The UN has reported that the space available for each person is less than a tenth of what is recommended by minimum humanitarian standards. When it rains, dirty streams of water flood the makeshift home she has built from plastic sheets and jagged pieces of plywood.

"When the rain comes, immediately houses fall down," she told IRIN. Médecins Sans Frontières (MSF), which is running both in-patient and outpatient clinics at the compound, reported that during the first heavy rainfall after the camp was established, 150 latrines collapsed, "mixing [effluent] with floodwater". Every time it rains, Dup has to hold her two infant children to prevent them from drowning in the filthy floodwater.

Earlier this month, MSF accused UNMISS of a "shocking display of indifference" for "refus[ing] to improve living conditions" for people like Dup at the POC site. Stefan Liljegren, MSF's field coordinator, told IRIN already more than half of the 200 patients they treat per day are suffering from diarrhoeal diseases, respiratory infections and skin diseases that are either caused or exacerbated by the water that courses through the camps. And as the months-long rainy season continues, it raises the risk of an outbreak of cholera, measles or some other infectious disease.

(In response, Toby Lanzer, the Humanitarian Coordinator in South Sudan, said, "I think that what [MSF] said was said in a spirit of trying to make sure that before the rains really set in for the next few months, that the conditions of people are as good as they can be. I think that was MSF's main message and we share that message.")

"People here still have a major problem and a big, big, big health risk," Liljegren said. "They need a lot of attention to prevent an outbreak here."

"Death traps" warning

Overcrowding is also in evidence at the UN base in Upper Nile State's capital, Malakal. It has 18,000 people. Oxfam spokesperson Grace Cahill said the Malakal population is particularly vulnerable, with at least half of the families there headed by women. "Everything suggests that these people are too afraid to leave the POC and that they're really the poorest of the poor," she said.

While acknowledging that the bases "weren't ever prepared to be places where people could live", Cahill said unless peace returns to South Sudan soon, tens of thousands of people are likely to remain at the camps indefinitely, which means UNMISS needs to work faster to make them habitable. Even UNMISS head Hilde Johnson has acknowledged Malakal and Tomping are at "imminent risk of turning into death traps."

Work is under way in both Juba and Malakal on new sites to take the people living in the most dangerous areas of the camp. International Organization for Migration head of operations John McCue said in both cases they should be able to start moving people by the end of May - ahead of the heaviest rains - at the very latest. About 2,000 people in Tomping can be moved even sooner to land that was recently opened within the UNMISS base, while teams work on installing new latrines in the current camp.

The new camps come more than a month behind earlier deadlines UNMISS had set, but McCue pointed to a host of logistical difficulties in getting them built - including gaining access to land to build the sites and to the peacekeepers necessary to secure it. Officials must also deal with rapidly shifting events on the ground, where an outbreak of fighting can delay attempts to transport heavy equipment.

And even as teams build fences and dig latrines for the new sites in Juba and Malakal, McCue warned that the international community will probably now need to divert attention and resources to Bentiu. Until two weeks ago, "everything was relatively OK," he said. But that changed quickly when thousands of people decided that despite the threats from both within and without, the UN base was still their best chance for safety.

[ This report does not necessarily reflect the views of the United Nations. ]

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