MSF PRESS RELEASE

MEDICAL CARE UNDER FIRE IN SOUTH SUDAN



JUBA/AMSTERDAM/BARCELONA/NEW YORK, FEBRUARY 26, 2014 - As entire towns in
South  Sudan suffer devastating attacks, medical care has also come under
fire, with patients shot in their beds, wards burned to the ground, medical
equipment looted, and, in one case, an entire hospital destroyed, the
international medical humanitarian organisation Médecins Sans Frontières
(MSF) announced today.  Hundreds of thousands of people have been
effectively denied life-saving assistance.



MSF staff witnessed the gruesome aftermath of recent armed attacks and
clashes in Malakal in Upper Nile State, discovering patients murdered
inside the town's Teaching Hospital. In another disturbing violation of
medical structures since conflict erupted in mid-December 2013, an MSF team
returned to Leer, in Unity State, and discovered the hospital thoroughly
looted, burned and vandalised.  Vast parts of the town appear to have been
razed to the ground.



"Assaults on medical facilities and patients are part of a broader backdrop
of brutal attacks on towns, markets and public facilities," said Raphael
Gorgeu, MSF head of mission. "These attacks show a complete lack of respect
for medical care and deprive the most vulnerable of life-saving assistance
just when they need it most."



Scenes of horror in Malakal

On February 22, MSF teams discovered at least 14 dead bodies throughout the
Malakal Teaching Hospital compound, scattered among 50 to 75 patients who
remained in the facility, too weak or elderly to flee for safety. Several
patients showed signs they had been shot dead while lying in their beds.
Many of the hospital wards, including the therapeutic feeding center for
malnourished children, had been burned, and general looting had clearly
taken place throughout the hospital. MSF has evacuated several of the most
severely ill patients to the United Nations Mission in South Sudan (UNMISS)
base in Malakal for treatment, 13 of whom were gunshot victims.



"Malakal is deserted, with houses burned throughout and countless dead
bodies strewn in the streets, said Carlos Francisco, MSF's emergency
coordinator in Malakal. "I can find no words to describe the brutality in
Malakal, which has left in its wake a ransacked city and a thoroughly
traumatized people."


Some of the patients MSF evacuated to the UNMISS base recounted that armed
groups entered the hospital on February 19 and shot dead people who had no
money or mobile phones to hand over.  Later that afternoon, armed men
returned and killed patients in their beds and others who had fled to the
operating theatre for safety, according to survivor testimonies. They also
reportedly raped women and young girls.



Hundreds of thousands deprived of care in Leer

Hundreds of thousands of people have been cut off from critical, lifesaving
medical care after Leer Hospital was ransacked and destroyed between the
final days of January and early February.



When MSF staff were able to assess Leer Hospital following weeks of
insecurity in the area, they discovered a horrific scene of equipment and
buildings reduced to ash, drug vials smashed and strewn throughout the
grounds, and sterilized surgical equipment broken and discarded everywhere.
Drugs, patient beds, and other supplies were thoroughly looted.  Not a
single hospital bed remains in the facility compound (see interactive guide
displaying hospital destruction).



"The people of Leer and throughout southern Unity State knew they could
count upon MSF for critical medical care, and now that assurance is simply
gone," said Gorgeu.  "The trust that is essential for us to carry out our
work has been shattered, and the ultimate victims are the countless people
who will suffer-and likely die-for want of medical care."



The hospital in Leer, opened 25 years ago, was the only secondary
healthcare facility in the region, constituting a critical lifeline for
nearly 300,000 people in the surrounding area. In 2013 alone, more than
68,000 medical consultations were carried out, nearly 400 people underwent
surgical care and 2,100 children were treated for malnutrition. Since
December 15, when fighting erupted in South Sudan, and up to January 15,
2014, more than 4,000 consultations were carried out and nearly 170
surgeries were performed until the forced closure in late January.



"Leer is now empty of civilians who have fled continued insecurity and are
living in terrible conditions in the bush, too terrified to return home,"
said Sarah Maynard, MSF project coordinator for Leer.  "But even if they
were to come back tomorrow, or a month from now, they would return to ruins
of their former home and no healthcare. This is catastrophic for the
population."



MSF's 240 locally-hired staff remain hidden in the bush, struggling to
treat patients with rapidly dwindling supplies. The staff report they are
reusing wound dressings and trying desperately to assist the displaced who
have grown more ill from drinking dirty river water and from eating water
lilies for lack of food. MSF is exploring every avenue to provide
healthcare to the displaced and resupply its staff.



"We must seriously consider if we can return to work in Leer Hospital,"
said Gorgeu. "That will not only require significant investment of
resources, but it will depend upon on unconditional respect from all
parties for our medical facilities, staff, and patients, not only in
southern Unity State but everywhere in the country."



Disturbing pattern of medical care under fire in South Sudan

The atrocities in the hospital in Malakal and the destruction of Leer
Hospital take place amidst a disturbing pattern of incidents affecting
medical staff, patients, and MSF-supported facilities in South Sudan:



.        In mid-January, armed men robbed and threatened staff at the MSF
compound in Malakal, leading to a temporary suspension of MSF's medical
activities in the town.

.        In mid January, the MSF compound in Bentiu, capital of Unity
State, was looted amidst chaotic fighting in the town, which forced MSF
staff to vacate Bentiu State Hospital and leave drugs and supplies with
patients and their caretakers. Thousands of people had no access to
healthcare for weeks in Bentiu town.

.        Patients were reportedly killed in their beds in the hospital in
Bor, capital of Jonglei State, during fighting in December 2013. In early
February, MSF staff visited the hospital and discovered the decomposed
corpses of a mother and child dumped in the facility's water tank. While
the hospital is today functional and well supplied, there are few patients
in the wards since most of the town is empty.



"Medical care has come under fire in South Sudan," said Gorgeu. "Rather
than safe havens for treatment, hospitals are now targets of attack and
brutality.  They are places to fear rather than trust, a complete inversion
of their purpose and role.  Hundreds of thousands of people are in
desperate need of shelter, food, water, and healthcare in South Sudan.  The
question is, how can effective, neutral aid be provided in a climate of
utter disrespect and fear?"



MSF has been working in the region that today constitutes the Republic of
South Sudan since 1983, and currently runs 17 projects in nine of the
country's ten states, with regular projects in Agok, Aweil, Bentiu,
Gogrial, Maban, Malakal, Nasir, Yambio, Lankien, Yuai, Pamat, and Yida and
four additional emergency operations in Juba, Awerial, Malakal, Melut, and
Nimule. MSF responds to emergencies, including large-scale displacement,
refugee influxes, alarming nutrition situations and peaks of disease such
as measles , malaria, acute watery diarrhea and kala azar, in addition to
providing basic and specialist healthcare services. MSF is also providing
medical and humanitarian to refugees from South Sudan in Kenya, Uganda and
Ethiopia.

In the first ten weeks of the current crisis, MSF carried out 103,614
consultations (including 40,925 of children under five), 3,767
hospitalizations (including 2,282 of children under five), treated  1,393
war wounded, performed 755 major surgeries, and 2,157 deliveries. MSF
currently has 333 international staff working in its projects alongside
3,330 South Sudanese staff.

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