South Sudan was engulfed by severe instability throughout 2022 and into early 2023, with eight out of its ten states being rocked by violence. This upheaval triggered extensive population displacements, predominantly in the Abyei Special Administrative Area (ASAA) and regions such as Twic County. These mass displacements have been aggravated by a historical backdrop of conflict, an increasing climate crisis, economic hardships, and lack of access to life-saving healthcare.

Since 1997, Médecins Sans Frontières/Doctors Without Borders (MSF) has been steadfastly committed to providing medical assistance in the Abyei Special Administrative Area (ASAA), a region claimed by both South Sudan and Sudan and for which, there is no final status, and it remains a contentious issue. MSF intensified its efforts in 2006 by rendering crucial medical services within ASAA. Moreover, in 2008, MSF inaugurated a hospital in Agok, which availed an overabundance of services encompassing emergency care, surgical procedures, maternal and pediatric care, vaccinations, and treatments for diseases such as HIV, tuberculosis, diabetes, and malaria, along with therapeutic feeding, among other services. In the aftermath of the violent armed conflicts in Agok in February and March 2022, which caused the displacement of approximately 70,000 individuals, MSF reallocated its operations to Abyei town (ASAA) and Mayen Abun (Twic/Warrap State) to maintain support for the displaced people.

At present, MSF supports the Ministry of Health in ensuring access to secondary healthcare at Ameth Bek Hospital, providing an array of services including inpatient care, round-the-clock emergency room access, surgical care, comprehensive maternal and neonatal care, treatment for chronic illnesses, and mental health support. MSF is also providing health promotion and integrated community case management, in seventeen sites around ASAA in collaboration with local healthcare authorities.

The crucial role of Ameth Bek Hospital, supported by MSF, is underscored by its status as the sole secondary healthcare facility in ASAA catering to both the displaced people and the hosting communities. However, there is a conspicuous void in primary healthcare (PHC) services. Between November 2022 and January 2023, an overwhelming majority - over 50% - of patients at Ameth Bek Hospital required referrals to PHC facilities, indicative of the profound challenges in accessing elementary health services. In tandem, shortages in essential medicines were reported, attributed to delays in international procurement, thereby worsening the already critical dearth of quality PHC.

Furthermore, ASAA is beleaguered by issues of food shortages. MSF has observed that fish constitute the mainstay, and often the only source of nutrition for many residing near water bodies. Communities have been observed drying fish as a means to stockpile for the lean season.

In summary, ASAA is ensnared in a double bind of healthcare crisis and food shortages, with the population being heavily dependent on the healthcare support provided by MSF at Ameth Bek Hospital. The gaps in primary healthcare infrastructure, coupled with the challenges in food accessibility, are aggravating the difficulties faced by the communities in this area.

With a highly anticipated increase in humanitarian needs due to the ongoing crisis in Sudan, there has been a significant influx of individuals into South Sudan since the fighting outbreak on April 15. As of end of October, over 335,000 individuals, predominantly South Sudanese returnees, as well as refugees and third-country nationals, have crossed the border. The large number of arrivals, particularly women and children, presents challenges for transit sites. The combination of floods and the Sudan crisis further strains response capacity. Rising market prices have contributed to worsening food insecurity.