"Only Water": Flooding across east Africa

04 Nov 2020

Severe flooding is affecting an estimated 1.3 million people across South Sudan and Ethiopia, inundating homes and leaving many without adequate food, water or shelter. Heavy summer rains have seen many areas flooded since July, with river levels continuing to rise.

Médecins Sans Frontières (MSF) is providing medical care in the flood-affected areas of Pibor, Jonglei and Upper Nile in South Sudan, and in the remote southern region of Dasenech in Ethiopia. With the lack of clean water or appropriate sanitation and the increase of water-borne diseases, access to medical care for those in affected areas is critical.


Crossing floodwaters, a woman carries tree branches to construct a new house in Pibor, South Sudan. This year’s floods are the latest in a number of simultaneous emergencies in the region, including COVID-19, increased violence and fighting, a growing economic crisis, and high levels of food insecurity. © Tetiana Gaviuk/MSF

Pibor, South Sudan

The flooding in Pibor, South Sudan is only the latest in a string of crises to hit the region. Following massive flooding in Pibor in 2019during which the MSF clinic was flooded—ongoing conflict in the region has caused large-scale displacement, loss of life, and a significant lack of resources. The current flooding, occurring during the COVID-19 pandemic, has made the need for medical care in the region even greater. 

“This has been a hard 12 months for this community,” says Josh Rosenstein, MSF’s Deputy Head of Mission. “Once again our latest emergency response to conflict-related displacement is transforming into a flood response.

“This emergency is having a compounded effect on the local community. The worst of the flooding is yet to happen, and the community is already feeling the strains of food insecurity. Lack of access to healthcare will only get worse over the coming weeks and months, and conditions will only grow more precarious for people.”

MSF has opened a clinic in the only location in town that was not under water during the floods in 2019, in the hopes that this clinic can remain open throughout the flooding. A mobile MSF team has been delivering medical care to prevent and treat the most serious health conditions in hard-to-reach areas. 

With many areas underwater across the region, those without a mobile clinic attempting to access care face a perilous journey. When 13-year-old Yoel fell ill, his father, a widower and father of five, carried him through chest-high waters for two hours to reach the MSF clinic. 

"There are no roads to the hospital,” Yoel’s father said. “Only water.”


Yoel recovers after surgery at MSF’s hospital in Bentiu Protection of Civilians site. His father Stephen Manyang Chan, a widower and father of five, saved his son’s life by carrying him to the MSF clinic, walking through chest-high waters for two hours. © Tetiana Gaviuk/MSF

Upper Nile, South Sudan

For the second year in a row, flood waters from swollen rivers are sweeping through communities in the Greater Upper Nile region at an alarming speed. Since July, the floods have displaced hundreds of thousands of people and left many more without reliable access to food and clean water. 

"The water rose surprisingly fast," said 39-year-old Tbisa Willion from Canal town, Upper Nile state. "We left without thinking to save our lives. We took a canoe to return to our house and tried to save some belongings, but we found only a few plates. I have nowhere to live."

In areas where floodwaters are too high to walk through, people use makeshift rafts constructed from plastic sheeting or reshape large plastic water tanks into canoes, with shovel for oars. Those who stay to protect their houses use sandbags or mud walls to try to stop the water. In these high-risk areas, they are exposed to malaria, waterborne diseases, snakebites and food insecurity as floodwaters overwhelm their homes and farms. 

In Upper Nile State, MSF has set up an emergency clinic serving the towns of Canal and Khorfulus, which can only be reached by boat. MSF team members are treating patients with malaria and diarrhoea, conducting rapid nutrition screening, providing psychosocial support, and distributing essential household items. 


Flooding in Pibor, South Sudan. Those unable to leave flooded areas are exposed to malaria, waterborne diseases, snakebites and food insecurity as floodwaters overwhelm their homes and farms. © Tetiana Gaviuk/MSF

Jonglei, South Sudan

Flooding began in July in Old Fangak, a town of about 30,000 people in a wetland area of Jonglei state, South Sudan. In late September an additional 3,000 people from surrounding villages arrived in Old Fangak after heavy rains flooded their homes. Most of the town's latrines have flooded, raising the risk of waterborne diseases. The water levels continue to rise.
"Many houses are affected on a daily basis," said Dorothy Esonwune, MSF project coordinator in Old Fangak. "The focus of everybody is on scooping out water from around their homes and building up flood dikes out of the mud."
At the MSF hospital in Lankien, high floodwaters have made it nearly impossible for people to travel from surrounding areas for care, leading to a reduction in patients. The local airstrip has flooded, making it more difficult to deliver medical supplies or refer patients to other medical facilities when needed. 
As the floods continue to impact people across South Sudan, MSF teams are conducting a series of aerial and ground assessments to identify the most-affected communities.

Dasenech, Ethiopia


MSF’s team in Dasenech, Ethiopia, distributing kits of jerry cans, soap, water purification tablets and cooking pots to households displaced by the floodwaters. © MSF

Torrential rains continue in Ethiopia, where major floods have left parts of Dasenech, in the south of the country, under water. More than 60 per cent of the region’s population has been displaced. MSF is currently responding in nine sites in southern Ethiopia, where around 46,000 displaced people have sought refuge. Three of these sites are only accessible by boat. 

Safe, clean water is the most urgent need. MSF teams are assisting local authorities in providing 45,000 litres of water each day to those affected by the floods, as well as distributing jerry cans, soap, water purification tablets and cooking utensils. 

The floods have destroyed food supplies, leading to increases in malnutrition, especially among children. Of the 3,685 children our teams have screened in the area, 95 were severely malnourished and joined our feeding program, with 11 needing hospitalisation. 

The communities that have been displaced are mostly nomadic, relying heavily on their livestock. Floodwaters are preventing their migration to the locations they would usually be occupying at this time of year. This displacement has led to even more crowded living conditions for those in the area, and the lack of functioning latrines is causing an increased risk of disease. Malaria and cholera cases are on the rise. 

Against the backdrop of the COVID-19 pandemic, and with the nearest secondary health facilities out of reach, access to healthcare is crucial for those displaced. 


A convoy of supply trucks carries essentials to MSF’s distribution points in Dasenech, Ethiopia, where more than 60 per cent of the population has been displaced by flooding. © MSF


Can you help support our crisis response work?

As an independent, impartial medical humanitarian organisation, Médecins Sans Frontières can respond rapidly to emergency situations and deliver urgent medical treatment to people in need – no matter who they are.
By making a donation, you can help ensure that we can be there to provide medical assistance during times of crisis.