Jennifer Duncombe

South Sudan’s conflict began as a political crisis in the capital, Juba, in December 2013 but rapidly spread throughout the country, involving various armed groups and militias. Civilians have also been repeatedly targeted and subjected to extreme levels of violence, including rape, abduction and murder. Unity state, in the central north of the country, is one of the worst affected areas. Almost 600,000 people are displaced in the state, with many seeking safety in the UN Protection of Civilians camp in Bentiu, and others simply hiding in the bush or swamplands. Médecins Sans Frontières provides the only hospital for the 110,000 people in the camp – a 170-bed facility providing everything from maternity care to surgery.

Jennifer Duncombe, Epidemiologist, shares her experiences from Bentiu:

Médecins Sans Frontières medical staff work to bring down the fever of a young boy with malaria in Bentiu camp before they can give him a blood transfusion. © Brendan Bannon
Jennifer Duncombe, Epidemiologist
“I worked as an epidemiologist in the camp, following a surge in fighting in Unity State that resulted in a considerable influx of people. As a result, the risk of disease outbreaks due to overcrowding, poor water and sanitation conditions, and strained health facilities increased dramatically.
We saw many cases of malnutrition, measles and Hepatitis E, as well as other tropical illnesses such as Kala Azar, however our biggest concern was malaria. During my three month assignment, Médecins Sans Frontières treated more than 40,000 children aged under five for malaria. Indeed, in August, the camp was so overwhelmed by the malaria outbreak that, together with other organisations, we conducted a community-based malaria treatment campaign. In eight days, 250 outreach workers screened 30,000 children aged six months to five years old for malaria and, of those, treated more than 16,000. It was a colossal effort and something I will never forget! In the following weeks when fewer severely sick children were seen at the hospital, and the number of deaths decreased, we all sighed with relief. Although the outbreak was not yet over, we could at least see some improvement and there was a light at the end of the tunnel.

"We also saw many indirect impacts of the conflict, such as children who came in missing limbs because they were playing with grenades that they found."

We had many patients who were directly affected by the war: for instance people with gunshot wounds. We also saw many indirect impacts of the conflict, such as children who came in missing limbs because they were playing with grenades that they found. At one stage, we had three children come to the hospital with shrapnel wounds and missing limbs from a grenade explosion. Unfortunately, within a few days, all had died. A few weeks later, we had two more children injured by grenades. Thankfully, our surgeon worked his magic and this time they both survived.
Life inside Bentiu camp, although relatively peaceful, is difficult. People are reluctant to come to the camp because they fear disease outbreaks, like malaria, but they are fleeing for their lives and can see no other option. Working in Bentiu was also extremely challenging, both physically and emotionally. It was incredibly hot but also very muddy, so we trudged around in gumboots, sweaty and sunburnt and desperately seeking shade. And yet, it was impossible to feel sorry for ourselves when we came face-to-face with such seemingly unnecessary suffering in the camp each day. What is the point of this war? Why are these people killing each other? When will it be over?”
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