"They Killed Them While We Were Running"

Since the escalation of violence at the beginning of 2025, MSF teams in various locations have been witnessing the impact of violence on civilians, including both indiscriminate and targeted attacks on civilians and civilian infrastructure. We also witnessed the use of incendiary weapons, forced recruitment (our staff and patients), increasing numbers of people injured in conflict (often referred to in our project as ‘war-wounded’) and a sharp escalation in conflict-related sexual violence (CRSV) - all of which are compounded by a breakdown in access to healthcare and protection mechanisms.

Civilians are bearing the brunt of conflict escalation through increasing violence casualties, including gunshot wounds, sexual and gender-based violence (SGBV), including conflict related sexual violence (CRSV), large-scale displacement, attacks on healthcare, and a significant loss of access to lifesaving services.

As a medical humanitarian organization that has worked in South Sudan for more than 40 years, including in violence-affected hotspots, MSF is directly witnessing the human consequences of escalating violence. Through medical data and testimonies from patients and staff, MSF has evidence of increasing civilian harm, barriers to accessing care, and gaps in healthcare services. ​

Our long-standing presence provides a unique perspective on the situation of violence and access constraints. Our advocacy therefore seeks to highlight the protection risks facing civilians and to promote stronger guarantees of safe, unimpeded access to both healthcare and survivor support services.

MSF has compiled medical data, testimonies, and field observations in a new report "They killed them while they were running: escalating violence in South Sudan", documenting the types and consequences of violence across its project areas from January 2025 to April 2026. The report draws on violence-related medical data, alongside qualitative interviews, including testimonies, focus group discussions, and semi-structured interviews with staff, patients, and community members across eight locations including Pieri, Malakal, and Yei. ​ ​