Ms Jane-Ann McKenna:

I thank the committee for inviting us to this meeting. As it is our first time to appear before the committee I will begin with a short overview of Médecins Sans Frontières, MSF, and the type of work it does. I will then discuss our current intervention in South Sudan and, in particular, the humanitarian crisis currently faced by the refugees who have fled the Blue Nile and South Kordofan states. I am joined by our chairman, Dr. Simon Collins, who have been with MSF for over eight years. He has spent over two and a half years in South Sudan.

Médecins Sans Frontières is an international emergency medical aid organisation that was established over 40 years ago. It has been established in Ireland since 2006. Our primary objective is providing emergency life-saving care to victims of war, conflict and any disease outbreaks. We often work in places where there are no other aid organisations or where organisations choose not to go. We are independent, non-political, non-religious and primarily privately funded. We received the Nobel Peace Prize in 1999 for our work. The key principle of MSF is to speak out on behalf of those who have no voice, particularly to speak about what we know and what we have witnessed on the ground. As we implement all the programmes ourselves we are in a key position to relay the messages we hear from our patients in the hospitals.

MSF is present in over 65 countries throughout the world, including places such as Syria, Somalia and South Sudan. Our annual budget is approximately €900 million per year. Thousands of Irish donors are funding our projects overseas and every year we send out Irish volunteers to the fields, including doctors, surgeons and nurses. Currently, there are two Irish expats working with us in South Sudan with this refugee crisis.

One of the reasons I mention the size of MSF operations is to put the refugee crisis in South Sudan into context. This is the largest MSF emergency intervention this year. We have allocated a budget of over €20 million for the camps in Upper Nile and Unity states alone. As members will see from the briefing paper I have circulated, there are almost 170,000 refugees scattered across five refugee camps in the region. Today, all of these refugees are 100% dependent on humanitarian aid for their survival. The health situation of the refugees has varied from poor to catastrophic over the last few months and it has been nearly a year since they first began to arrive. This is due to the difficulty of the situation, the insufficiency of the international aid effort and the fact that the camps have yet to provide adequate refuge for them. At present, we are running hospitals, mobile clinics and outreach services in all five camps treating malnutrition, infections and disease, as well as running vaccination campaigns. The gravity of the situation has pushed MSF to work in other areas including locating, treating and distributing water, which is not usually our key response.

In July, we conducted a mortality survey in Yida camp, which is in Unity state. This showed a mortality rate of four deaths per 10,000 people per day among children under five years of age. This is twice the emergency threshold. That means approximately five children were dying per day in Yida, mainly from diarrhoea and severe infections. These are treatable illnesses with the right care. A nutrition survey carried out in Batil camp at the same time found that nearly 50% of the children under three years old were malnourished. Both of these surveys indicate a catastrophic health situation in the camps. The camps are ill prepared and lack sufficient resources to deal with the high level of need that exists. In light of this, MSF, along with other organisations, has had to scale up its response immensely over the last two months to bring the situation back to what is now considered a normal emergency level. However, our medical teams continue to see the consequences of inadequate aid provision, particularly in water and infrastructure. This can be seen in the recent hepatitis E outbreak which happened in all the camps in the Upper Nile area.

For the refugee camps within South Sudan the only blockages to access are remoteness and logistical constraints. It is a notoriously difficult place in which to work. It is expensive and it is extremely difficult to get the right supplies and transport them in. All organisations, including MSF, have been taken by surprise by the sheer number of people crossing the border and the scale of the crisis. The response from the international community has been slow and inadequate. Relief operations must now be scaled up and maintained. Any reduction in the response or change in the situation on the ground could tip the conditions in the camps back to catastrophic levels again. Contingency plans must also be put in place to deal with new arrivals, which are highly anticipated at the end of the rainy season in the next month or two.

I have spoken mainly about the precarious situation within the camps in the Upper Nile and Unity states. However, the situation in the Blue Nile and South Kordofan must be mentioned as well. Unfortunately, we cannot say much about that situation. Essentially, we do not know what is happening on the other side of the border, particularly in the Blue Nile state. We are unable to work there. All we know is that 170,000 people have fled and have recounted harrowing stories about the level of violence and conflict they have encountered in their regions and homes. We must ask why independent humanitarian aid organisations are not allowed to work in this region and why nobody knows what is happening on the ground. MSF is deeply concerned about the health and safety of the people in both the Blue Nile and South Kordofan. More must be done to ensure that independent humanitarian relief is given to those who need it most.

I ask the committee to raise the current crisis in South Sudan, which I detailed in the briefing paper I circulated, and the need for independent humanitarian aid in the Blue Nile and South Kordofan states as a matter of priority for the Minister for Foreign Affairs and Trade.