Scores of people have been killed in hospitals in South Sudan since the country plunged into conflict in December, and attacks on medical facilities have helped to crush the already fragile health care system, medical charity Doctors Without Borders (MSF) said Tuesday.
"Patients have been shot in their beds, medical and humanitarian staff have been killed, and hospitals, ambulances and medical equipment have been burnt, looted and otherwise destroyed," MSF said in a report entitled South Sudan Conflict: Violence Against Healthcare.
"An already fragile healthcare system has been destroyed in areas affected by conflict and largely neglected in other areas, leaving hundreds of thousands of people without medical care at a time when it is critically needed," the report says.
Patients, including women and children, were shot in their hospital beds, and medical and humanitarian staff were killed, MSF said.
Raphael Gorgeu, the MSF head of mission in South Sudan, listed the total fatalities: 25 of the people killed in attacks on hospitals were patients, 27 were people seeking shelter in the hospitals, two of them were ministry of health staff and 4 were unidentified people.
He said the attacks have had devastating consequences on local populations.
"Hundreds of thousands of people became cut off from health care at a time they actually needed it most," Gorgeu said.
"One health facility destroyed, one ambulance burned, one health worker killed means no access to health care for thousands of people,” he said.
MSF project coordinator in Unity State Sarah Maynard said entire buildings in the town of Leer were reduced to ash and rubble, and life-saving surgical equipment was destroyed in an attack in January.
MSF staff were pulled out of Leer after the attack, and when they returned in May, Maynard said she was shocked to see the extent of the destruction.
“One of the things that really struck me the most was the absence of life and movement," she said.
"I had never seen a hospital without patients in it, with no staff, no noise -- not even babies crying," she said.
Before the attack, the MSF health facility in Leer provided preventive care and treatment for chronic diseases like HIV and tuberculosis to more than a quarter of a million people.
The patients kept on coming, desperate for our help, and although we had no delivery beds, the mothers were coming and giving birth on the floor because they wanted to be close to the medical teams...
Months afterwards, when MSF returned to Leer, people in the town were desperate for medical attention, Maynard said.
MSF did what it could to help them, often working in deplorable conditions.
"We had no power and no water," Maynard said.
"The patients kept on coming, desperate for our help, and although we had no delivery beds, the mothers were coming and giving birth on the floor because they wanted to be close to the medical teams, at least,” she said.
Maynard said she was also overwhelmed by the number of malnourished children she and MSF staff treated during their first week back in Leer.
“We started a feeding program for severely malnourished children under five. Hundreds of mothers were bringing their kids for weighing and measuring and I remember thinking in the first week that maybe we will admit 500 children in the program. In the end, it was 900,” she said.
Gorgeu said both government and opposition leaders have assured MSF that the violence against health care facilities and staff will stop, but there was little evidence that those promises are being kept.
“We do have, at the highest level from all sides, positive messages when it comes to protection for health care, protection of MSF. But the difficulty is that these messages are not always translated into reality in the field,” he said.
Government health officials were tied up in a meetings and were unavailable for comment about the MSF report.