“I arrived with nothing but my life”: Women in South Sudan describe harrowing escape from violence

JONGLEI STATE, South Sudan - "I left at night, crawling to avoid the crossfire," said Rachiel, a mother of seven from Baidit, in South Sudan's Jonglei State. "It took me two days to reach safety - I arrived with nothing but my life."

After fleeing an upsurge in violence that has broken out in recent months, Rachiel, 55, and her family are staying with relatives in Pagook.

Since the start of the year, some 370,000 people in South Sudan have been forced to leave their homes, more than 280,000 in Jonglei alone. Most fled with only the clothes they were wearing and have no food, shelter or healthcare access; over the past week, at least 16 health facilities have been looted, destroyed or forced to close, making it even harder to reach critical support.

Grace, a 45-year-old mother of five, described the terror as chaos erupted around her home. "We escaped with nothing," she told UNFPA, the United Nations Population Fund, which is the UN's sexual and reproductive health agency.

"Without this centre, many families would have nowhere else to turn" - Nyalueth

Rachiel, a 55-year-old mother of seven, fled her home amid the violence in Jonglei State and is now living with her relatives in Pagook. © UNFPA South Sudan/Levi Edward Lubari

Both women were waiting to be seen at the Pagook healthcare centre in Baidit, where UNFPA is working with partners to provide essential sexual and reproductive health services and life-saving medical supplies.

UNFPA estimates there are over 440,000 pregnant women in South Sudan, who for the most part cannot reach any antenatal or child birth assistance. This puts them and their newborns at greater risk of death, disease and complications, especially as living conditions deteriorate.

Outside the clinic, the queue kept growing. "Without this centre, many families would have nowhere else to turn," said Nyalueth, 30, a mother of six also waiting to see a health worker.

Health services brought to the brink

Mothers wait to be attended to at Pagook primary healthcare unit. As the number of women and girls seeking care continues to grow, women and newborns are forced to wait ever longer for support. © UNFPA South Sudan/Levi Edward Lubari

As the crisis continues to spiral, some 26,000 people have also arrived in Mingkaman, in the neighbouring Lakes State, in search of refuge.

"I don't have soap, milk for my baby, a mosquito net or sleeping mat," said a 30-year-old new mother who had fled from Twic East County in Jonglei State. "My child is not feeling well, but I don't know where the health facility is."

Three quarters of the population of South Sudan already live below the poverty line, and two thirds are in need of humanitarian assistance. In addition to severe hunger and the cholera outbreaks, severe floods frequently cut off entire communities, meaning pregnant women must wade through waterlogged terrain to reach care. Now in the latest fighting, ambulances and medical equipment have been seized and humanitarians prevented from reaching people in need, while ongoing arrivals of refugees and returnees from neighbouring Sudan are further stressing a struggling healthcare network.

"We have supplies to last maybe not even two months" - Health worker, Mingkaman

"Currently we are seeing about 80 to 90 pregnant women per day at the antenatal clinic, with up to eight deliveries per day," said one health worker in Mingkaman.

"This was not the case before the crisis in Jonglei - the increase has created a heavy workload on the few staff and strained our limited resources. We have supplies to last maybe not even two months."

Atong, a 28-year-old mother of four, holds her baby at the Pagook healthcare centre. © UNFPA South Sudan/Levi Edward Lubari

Martha* fled with her five children to Mingkaman and is currently camping on the premises of a primary school. "We escaped the terrible gunshots, but we are left with nothing in our hands. There is no food, no shelter, no hygiene - I am worried for my daughters' well-being," she told UNFPA.

"We are staying under trees. Children are starving and sick with coughs and fever."

UNFPA responding despite severe constraints

The growing number of women and girls seeking care at Pagook healthcare centre highlights the urgent need for continued humanitarian support. © UNFPA South Sudan/Levi Edward Lubari

UNFPA is assisting with airlifting medical supplies to Akobo, Bor, Pibor and Mingkaman, and all its supported health facilities in these areas are operational. Despite the danger and challenges, three mobile health teams are managing to reach remote communities with vital maternal and reproductive services, and seven women and girls' safe spaces offer survivors of violence a place to heal.

"Services don't stop for conflict" - John

There are mounting reports of gender-based violence against displaced women and girls, as they are cut off from support networks and protection mechanisms are crumbling. UNFPA is coordinating with partners to ensure response and protection across northern Jonglei, sending skilled health workers and providing post-rape treatment kits and other essential supplies.

"Services don't stop for conflict," said John, 45, a gender-based violence response officer at the clinic in Pagook. "We have not stopped working - even during the current conflict, we carry on."

South Sudan is one of the world's most underfunded humanitarian crises, with an immediate and long-lasting impact on the individual realities of the country's women and girls. As health centres and safe spaces close down, there are fewer options for safe deliveries and to ensure survivors' safety - and dwindling chances for girls to stay to decide their own futures.

UNFPA's response to the crisis has been possible thanks to support from the UN's Central Emergency Response Fund, the European Union, the Republic of Korea, and the South Sudan Humanitarian Fund led by OCHA.

*Name changed for privacy and protection