For leverage, Helen grips the rungs on the side of the rusting hospital bed with her toes. “Sindika!” encourages Aisha Ayikoriu. “Sindika! Sindika!” In Luganda, the Bantu language widely spoken in Uganda, Sindika means “push”.
Built in the early 1990s to serve 10,000 local Ugandans, Ocea Centre Two is now the biggest of four clinics serving Rhino, a settlement of some 85,000 South Sudanese refugees. As the UN makes repeated statements about ethnic cleansing and budding genocide in South Sudan, Uganda can barely open camps fast enough to accommodate the influx of refugees. An average of 2,500 have been arriving every day since July, with that figure as high as 7,000 earlier this month.
A massive settlement for 100,000 has just opened in Moyo district in the tip of the north. With dry season offensives expected to begin any day now, it could be overflowing before mid-January.
In its most recent update, on 19 December, the UN’s refugee agency, UNHCR, says 584,573 South Sudanese refugees have arrived in Uganda since the civil war broke out in December 2013. Almost 400,000 of them have come since July, fleeing an upsurge in fighting and indiscriminate bloodletting in the southern Equatoria region. Related stories:South Sudan refugee influx overwhelms Ugandan reception centresSouth Sudan: “This fighting will continue to our children”The genocidal logic of South Sudan’s “gun class”
The lack of resources for the refugees is evident. There isn’t enough water, let alone sanitary pads for women, and schools for children. It may be safer in Uganda, but the conditions here are inhumane.
At Ocea Centre Two, there are two beds for women in labour. On the other side of the green fabric that serves as a curtain are five mothers with newborns. They share cots and use cloths to cushion themselves and their little ones on the concrete floor. Mothers fuss over the babies. Though the situation is grim, the scene isn’t sad.
The “inpatient” unit is 14 beds in a tent. It is the only clinic at Rhino equipped to do minor surgical procedures. The beds in the tent are always full and often overrun, with patients sharing beds or staying on the floor. For any major operations, patients must be sent to the nearest hospital, 72 nauseatingly bumpy kilometres to the west, in Arua, the closest main town. There is only one ambulance available. Vincent Debo, a clinical officer, looks embarrassed when he shares these statistics. Frontline Equatoria
The fight that has ruined the world’s newest nation turned three on 15 December. South Sudan itself is just five, having celebrated its independence in July 2011.
The conflict is an ethnically tinged power wrangle between the SPLA (government forces made up mostly of President Salva Kiir’s Dinka tribe) and the SPLA-IO (opposition forces – initially mostly Nuer people loyal to former vice president Riek Machar, but now increasingly mixed with members of South Sudan’s 63 other tribes). Equatoria had remained a bastion of relative calm while war over resources and power infected the rest of the country, but the seat of the conflict has shifted. A failed, internationally-brokered August 2015 peace agreement positioned IO troops alongside the SPLA in these states, priming the place for a bloodbath. In July, fighting broke out in the capital Juba, located in the south, in the middle of the Equatoria region. A chase down country for the ousted Machar was followed by massacres that have yet to stop.
South Sudan refugee flows to Uganda since July 2016Refugees from Equatoria say they left because staying at home was untenable. If it weren’t for the gunshots every night, the bodies in the streets, the families burned alive in their homes, and the women gang raped by the side of the road, they would have stayed. “Fear made me come here,” Peter Dada, originally from Laniya in central Equatoria, tells IRIN at Rhino settlement. “There is killing, continuously. No compromise.”Dada says if the government soldiers see you, they kill you. If IO soldiers see you, expect the same. He blames the SPLA alone though for the massive levels of rape, saying: “That one is being done by the government soldiers.” Most refugees say both sides are complicit in the sexual assault that has reached “epic” levels in South Sudan. It is less violent across the border, but the living conditions are dreadful.Shortages
The largest encampment in Uganda opened on 3 August, at Bidi Bidi. A small village a few months ago, it is now the world’s second largest refugee settlement, with a population of more than 260,000. Like Rhino, it is spread out across unforgiving terrain.
The majority of the refugees at Bidi Bidi and Rhino are from a mixture of South Sudan’s smaller, marginalised tribes, like the Kakwa and the Acholi. In the northeast of Uganda, the settlement at Adjumani hosts another 60,000 South Sudanese, but they are mostly of Kiir’s Dinka tribe.
Of the 100,000 school-age children in Bidi Bidi, only 10,000 attend classes.