World Refugee Day: Delivering malaria prevention to displaced people in South Sudan

Each year on 20 June, World Refugee Day offers the chance to reflect on the experiences of those forced to flee their homes because of war, violence or persecution. In South Sudan, renewed conflict in neighbouring Sudan in 2023 has led to a sharp increase in the number of people crossing the border, many of whom are now living in remote areas with limited access to essential services.  

These population movements present complex challenges for already overstretched health systems. Displaced people often face additional barriers to care, increasing their vulnerability to diseases such as malaria.  

To understand how health services are being delivered in these difficult circumstances, we spoke with Dr Aleu Pioth Akot, the former Director General in the State Ministry of Health in Northern Bahr el Ghazal State. He shares his perspective on the health needs of the displaced communities and the importance of agility and adaptation to ensure malaria prevention efforts can respond to evolving contexts. 

A long journey to care 

Dr Akot began by explaining how far many refugee settlements are from the capital, Juba. “It takes two days by road or an hour and a half by plane,” he said. “If there is something we need from the capital, it is hard to get it in time.” 

This distance affects how fast medicines and supplies arrive. Even though there are trained health workers on the ground, the lack of medical supplies makes it difficult to treat people. “Less medical supplies increase the burden of malaria and other diseases,” he said. “Delays are the most serious issue.” 

Despite these challenges, the Ministry of Health is committed to making sure that no one is left behind. “Health is for all,” Dr Akot said. “An individual has the right to health services.” 

To reach more people, the Ministry has worked with local leaders, international donors and organisations like Malaria Consortium, UNICEF, and the World Health Organization. “We mobilise what we have,” he explained. “We knock on doors and ask for help. We make sure the little we have is used well and shared fairly.” 

Protecting families from malaria 

Malaria remains one of the biggest threats to people in the region. In 2023, the Ministry distributed long-lasting insecticidal nets (LLINs) to five counties. But many people did not use the nets correctly at first. “We realised we had to teach people,” Dr Akot said. “So, we used radio and other media to explain how to use the nets properly.” 

When the conflict in Sudan brought more refugees into South Sudan, the Ministry had to adjust its plans. “At first, we had a strategy in place,” he said. “But when more people arrived, we worked with the federal government and partners to reach the camps.” 

In Wedwil refugee camp, the Ministry and Malaria Consortium, using funding from GiveWell,introduced seasonal malaria chemoprevention (SMC) to protect children under five, as well as handing out anti-malaria medicine to pregnant women. “We also carried out sanitation campaigns,” he said. “We encouraged communities to clear bushes, drain water and taught people about hygiene.” 

Communities lead the way 

One big challenge was the language barrier in the delivery of services. To solve this, the Ministry trained people from within the refugee community to deliver medicine, undertake peer-to-peer advocacy and sensitise their communities. “They are the ones who bring the message and services close to the people,” he said. “They understand the community, and the community trusts them.” 

Dr Akot stressed that including the community is key to success. “If people are not involved, they won’t accept the services,” he said. “Community involvement is most important.” 

The Ministry has also created a special team to make sure that no one is left out. “We include this in how we design our services,” he said. “It is not just a good idea. It is something we put into practice.” 

A call for peace 

On World Refugee Day, Dr Akot has one message for the world: the need for peace. “Peace makes it easier to provide services,” he said. “We all know how hard life is for refugees. They are far from home. They have left everything behind. They depend on others. They need support — but most of all, they need peace. We must stop the wars.” 

His message is a reminder that solidarity is not only about sympathy but also requires action. In South Sudan, that action is seen in every trained volunteer, every treated child. It is seen in the partnership between governments and NGOs, and in the voices of people like Akot, who work to bring health and hope to those who need it most. 

As part of this effort, Malaria Consortium has worked closely with the Ministry of Health and partners to support malaria prevention in hard-to-reach areas, including refugee and internally displaced person (IDP) settlements. In 2023, during a round of SMC in one of the implementing counties, adaptations were made to ensure 500 children in a refugee camp could safely receive life-saving antimalarial treatment. This included strengthened security measures, close collaboration with the National Malaria Control Programme, UNHCR and community leaders, and the use of community-based approaches to maintain trust and ensure safe, timely delivery. 

“Displaced communities face some of the highest risks of malaria, yet often the greatest barriers to prevention and care,” says Denis Mubiru, Country Director of Malaria Consortium, South Sudan. “On World Refugee Day, Malaria Consortium remains committed to ensuring no one is left behind, even in the most remote and fragile settings.” 

On this important day, we are reminded of the importance of action to ensure that those facing the greatest health inequities can access the services they need to prevent and treat disease, even in the most challenging and resource-constrained settings.