In Old Fangak, Jonglei State, communities have been immensely impacted by recurrent floods and have had to learn to live surrounded by water, completely cut-off from basic healthcare. Villages have become islands and people have no choice but to use canoes to go from one place to another, forcing many people to stay in their villages discouraged by the cost of transport and duration of the journey. MSF teams in Old Fangak are seeing a concerning rise of malaria cases in the area, with an average of 75% of admissions being positive malaria cases since the beginning of August 2023. Many are severe malaria cases, usually combined with malnutrition, pneumonia and anaemia conditions, and especially among children and pregnant women. While malaria peaks used to occur during the rainy season from June to October, this year despite the rainy season and expected floods seeming to be delayed, malaria cases are already high: receding waters from last year are breeding grounds for mosquitos, putting communities at continuous risk.