During the first two weeks of December, Watchlist conducted field research in Juba, South Sudan, with health and humanitarian workers and administrators regarding attacks on medical facilities and personnel and denial of humanitarian access. The research will be published in a Field Monitor report in 2018. It will be the third in a series of Watchlist reports focused on this issue.

Many of those interviewed detailed the ways in which parties to the conflict, including the Sudan People’s Liberation Army (SPLA) and the Sudan People’s Liberation Movement in Opposition (SPLA-IO) have damaged or destroyed medical facilities through arson and looting; occupied medical facilities; threatened, intimidated, detained, abducted, and killed medical personnel and humanitarian workers; shot at and stolen ambulances; looted humanitarian convoys filled with lifesaving medicines and nutrition supplements; detained, extorted, or denied passage at checkpoints to persons attempting to reach medical facilities to receive lifesaving treatment or deliver essential medicines or humanitarian aid; and suspended airdrops of food aid to areas unreachable by road. Parties to the conflict have also forced the suspension of water, sanitation, and hygiene activities for varying lengths of time; prevented access to humanitarian missions seeking to conduct assessments for famine and cholera in various areas; and imposed a range of bureaucratic impediments, including escalating fees for work permits required for foreign staff, taxing humanitarian organizations, and requiring clearance by multiple government agencies at national and local levels for transportation and delivery of humanitarian aid.

Representatives of several health and humanitarian organizations in separate interviews drew the same conclusion in various ways—that parties to the conflict see humanitarian aid as a weapon in the conflict. One representative explained: “First, yes there’s SPLA and SPLA-IO, but really there are multiple, competing factions that occasionally align under these two umbrellas. This is a country of multiple warlords and you’re not going to be a warlord of an area if you can’t get humanitarian assistance there.” Another stated further that: “Having an NGO in your area provides legitimacy, but having an NGO in a neighboring area is a threat. There are big power dynamics constantly at play with humanitarian aid at the center.” A third representative summed it up: “Humanitarian aid is being used as a pawn in a Machiavellian game. Humanitarians are playing by the rules of international humanitarian law and parties to the conflict are playing a game by an entirely different set of rules.”

In this context, South Sudanese children’s needs for health care and humanitarian aid have risen, but their access to the resources needed to treat them has dropped dramatically, partially due to targeted attacks on medical facilities and personnel and denial of humanitarian access. “Everyone and everything is a target here,” said a humanitarian worker interviewed for the report. “Everything is collateral damage.”

To learn more about Watchlist’s thematic research examining the impact on children of attacks on health care, click here: https://watchlist.org/about/report/