The 20 seater plane touches down on the gravel airstrip at Rubkona, Unity State South Sudan. It has been a long journey over a few days and four different flights to get here and it really feels a little like the end of the world. There is not even a single building at the airstrip just a gate behind which are the jeeps of a few different NGOs and UN agencies here to collect their passengers from the World Food Programme flight that has brought us from the capital Juba to here. I spot the MSF vehicle amongst them and know that at least I have arrived.
On the short journey from Rubkona airstrip back to the MSF compound in Bentiu we cross the bridge over the Bahr el Ghazal River which links the two towns. Along the way we pass the area that was hit by aerial bombardments a few weeks ago, I see the power station that produces no power to feed the network of electricity cables in the two towns, many donkeys pulling improvised carts of oil barrels filled with water from the pumping station at the bridge, the street lights along the main road in Bentiu which have reportedly not operated in quite a long time. Most of all I see a lot of people, going from place to place on foot, in minibuses or tuk-tuk, buying items at the various markets, chatting at the side of the road, going about their daily business. The lights may not be on but people are at home here.
Nobody is quite sure what the population is here. Estimates range from 30,000 to 50,000. These people face many challenges in the current context. Following a referendum in 2011 South Sudan’s became independent from Sudan. The world’s newest country relies on oil revenue for 98% of its income; however oil extraction has been halted since January. The World Food Programme estimates that over 2.5 million people will be in need of food assistance in South Sudan this year and many more may be at risk.
The rains are just starting and it will be a few months before this years crops are ready for harvest. The markets are open but as in any supply and demand economy prices are high and many believe that in 6-8 weeks there may be little or no food left in these markets. In addition here near the border in Unity state the people are vulnerable to insecurity. Isolation is also a big problem, we are far from Juba in the South and the coming rains will make road transport difficult to impossible.
As in many such situations children stand to suffer the most. MSF has operated a therapeutic feeding programme in Bentiu since 2010. The most severely malnourished and unwell are admitted to the inpatient therapeutic feeding centre (ITFC) for medical and nutritional care. Other children attend the ambulatory clinic here in Bentiu or mobile clinics in the surrounding areas. A small number of expats and a team of national staff deliver basic care comprising therapeutic milk and food, medications, vaccinations and health education. It’s not high tech but it works, most of the time at least. Last year more than 5,000 children received treatment.
Over my first few days I get to meet my colleagues, pick up my first few Nuer words, learn that no fewer than four snakes have been found outside our house, shed copious amounts of sweat in the sometimes barely tolerable heat and most importantly try to get settled into my work which as the project’s doctor which will mostly involve medical supervision of the ITFC.
This will be my home and my work over the next nine months and is sure to be quite a challenge.