South Sudan health system struggles despite aid

South Sudan’s health sector remains heavily dependent on international aid as renewed fighting between rival political factions raises concerns about the country’s already fragile medical services, Africanews and agencies reported on 9 March.

Much of the country’s healthcare is delivered by international organisations rather than the government, with many clinics and hospitals run by aid groups providing basic treatment and emergency care.

South Sudan is also among the most dangerous countries for health workers. Medical facilities run by Médecins Sans Frontières were attacked 11 times in the past year.

At the International Committee of the Red Cross surgical unit in Juba, blast doors protect the facility and emergency food and water are stored on site in case of a siege.

A soldier treated at the hospital said he had expected to die after being shot but was flown to the facility for treatment. He said many wounded fighters receive little medical care.

Medical staff say many of the wounded fighters treated at the hospital are likely to return to combat linked to the country’s overlapping conflicts.

Angeth Jervas Majok, the ICRC’s head physiotherapist, said some patients return repeatedly after being injured in the fighting. “I have actually had one patient who came back four times,” Majok said. “On the fifth time, unfortunately we lost him.”

Staff at the facility receive payments described as “incentives” because the organisation is not permitted to pay salaries. Government wages for medical workers, typically about $10 to $50 a month, have not been paid for months.

Years of conflict and underinvestment have left the country with limited healthcare infrastructure and a shortage of trained medical staff. In many areas, aid organisations provide services where state facilities are absent or unable to operate.

South Sudan received about $1.4 billion in foreign aid in 2024, the largest amount globally as a share of GDP. Despite this, health outcomes in the country remain among the worst in the world.

Life expectancy in South Sudan is estimated at around 58 years, while maternal and child mortality remain high. Access to healthcare is limited and many communities lack functioning clinics.

Poor infrastructure further complicates access to treatment. With only about 300 kilometres of paved roads in the country, many patients must travel long distances to reach medical care.

The United States has warned it could withdraw funding if governance does not improve, while some aid organisations are scaling back operations as donations decline. The International Committee of the Red Cross said it plans to reduce activity at one of its facilities.

Information Minister Ateny Wek Ateny acknowledged financial difficulties but said the government was working to address them.

South Sudan gained independence in 2011 but has faced repeated cycles of violence since then.

The United Nations says more than 5,100 civilians have been killed and hundreds of thousands displaced in recent violence, warning the country could be nearing another civil war.

Africanews, Maghrebi.org