Indiscriminate attacks on civilians, sexual violence, forced recruitment, hunger, and shrinking humanitarian access are pushing South Sudan into a worsening humanitarian crisis, according to a new report by Médecins Sans Frontières (MSF).

In a report titled “They Killed Them While We Were Running”, MSF says civilians across multiple states are facing repeated attacks on villages, displacement, and destruction of essential infrastructure, including health facilities.

The report states that between January 2025 and April 2026, at least 12 attacks targeted MSF staff and medical facilities, leaving an estimated 762,000 people without access to healthcare services.

MSF says civilians are being exposed to airstrikes, ground assaults, abductions, forced recruitment, and widespread sexual and gender-based violence across Jonglei, Upper Nile, Central Equatoria, Lakes, Warrap, Western Equatoria, Abyei, and Greater Pibor.

According to the organization, healthcare services have also come under attack, including the bombing of hospitals and looting of medical facilities. It says MSF-supported hospitals in Old Fangak and Lankien were struck by air attacks in separate incidents, while other facilities were looted by unidentified armed groups.

The report further notes that humanitarian space is shrinking, with access restrictions and insecurity preventing aid agencies from reaching populations in urgent need.

MSF Head of Mission in South Sudan, Zakaria Mwatia, said civilians are increasingly trapped between fighting forces, with populated areas being directly affected.

“Across these areas, civilians are facing airstrikes and ground attacks, forced recruitment, abductions, and widespread sexual and gender-based violence,” Mwatia said.

“Populated towns and villages are being hit, resulting in civilian casualties, mass displacement, and the destruction of civilian infrastructure.”

The report also highlights a sharp rise in violence-related injuries treated by MSF. The organization says it treated over 6,000 people in 2025 alone for injuries including gunshot wounds, blast injuries, and sexual violence—an increase compared to the previous year.

In one account included in the report, MSF staff described survivors of sexual violence repeatedly attacked even after seeking medical care, underscoring what the organization calls a cycle of vulnerability and insecurity.

MSF warns that humanitarian assistance is increasingly being restricted or manipulated for political and military purposes, limiting aid delivery in some areas, particularly opposition-controlled regions.

The organization is calling on all parties to the conflict—including government forces and opposition groups—to respect international humanitarian law and protect civilians, healthcare workers, and humanitarian infrastructure.

MSF says civilians must never be targeted, and humanitarian access must be guaranteed to ensure lifesaving assistance reaches all people in need.