Refugee camps in Ethiopia's Gambella region are facing a deepening humanitarian crisis following significant international aid cuts that have crippled essential services, including food distribution, health care, and disease prevention.
The region, which hosts more than 395,000 refugees--mostly from South Sudan across seven camps--is witnessing a surge in child malnutrition, malaria cases, and patient admissions, according to Médecins Sans Frontières (MSF), which has operated in Kule refugee camp for over a decade.
The sharp decline in humanitarian assistance, driven by global funding reductions from key donors such as USAID, has already forced the suspension of nutrition programs in four of the seven camps, placing an estimated 80,000 children under five at risk of life-threatening malnutrition.
"We receive food once a month--maize, wheat, and sorghum--but it always runs out before the month ends," said Nyauahial Puoch, a mother of five whose 17-month-old daughter was admitted to MSF's inpatient therapeutic feeding center in Kule. "Some of the items we used to get are no longer provided at all."
Since October 2024, refugees in Kule camp have reportedly received as little as 600 calories a day--less than 30 percent of the recommended minimum. Food distributions across other camps have also been disrupted, with some going months without deliveries due to supply chain issues and funding shortfalls.
The impact on child nutrition is stark. MSF reported a 55 percent increase in child admissions to its therapeutic feeding program this year compared to 2024. Half of those cases came from outside Kule camp, underscoring the scale of the regional deterioration.
"We walked for three hours from our home in Akula camp to reach the hospital," said a father whose one-year-old daughter received emergency treatment for malnutrition. "She had a cough and diarrhea and was very weak. We were afraid she wouldn't survive."
In Nguenyyiel camp, Nyamuon Machar, the mother of a seven-month-old patient, said her family sometimes goes an entire day without food. "What we get now barely lasts a week or two," she said, describing a 50 percent reduction in rations over the past four months.
Access to health care has also become increasingly difficult as several NGOs have withdrawn from the region. MSF's outpatient department in Kule recorded a 58 percent rise in patient visits this year, while antenatal care visits increased by 72 percent compared to the same period last year.
"We're receiving more patients from other camps because many health services are no longer available locally," said Armand Dirks, MSF's project coordinator in Gambella. "MSF is overwhelmed, and we fear the numbers will continue to rise."
Malaria cases have also surged, exacerbated by the downsizing of disease prevention efforts. The organization has treated more than 23,800 malaria cases since January, with a 125 percent increase in July alone compared to the previous month.
"Cases are expected to rise sharply during this peak transmission period," said Birhanu Sahile, MSF's deputy medical coordinator. He warned that overcrowded shelters and declining sanitation make it harder to prevent infections. "This poses a serious threat to already vulnerable refugees."
In response, MSF has begun scaling up its malaria treatment capacity, including the establishment of a dedicated health post in Tierkidi camp, home to over 74,000 refugees.
"Walking through the camp, you'll see many empty buildings--spaces once used by NGOs that have now been withdrawn," Dirks said. "Their absence is deeply felt. Services that once supported this community have now disappeared."
Despite running at full capacity, MSF said its resources remain insufficient to meet the growing needs. It is urging the government to take steps toward integrating refugee populations into national health systems and reinforcing public services to withstand future aid reductions.
"Without urgent action from both national authorities and international partners, this crisis will continue to escalate, putting thousands of lives at greater risk," said Birhanu.
In February, a cholera outbreak in Ethiopia's Gambella region claimed 14 lives, with over 200 cases reported, according to regional health officials cited by DW. By April, the number of reported cases had surged to 2,016, with 32 deaths.
The region was simultaneously grappling with malaria, recording the highest incidence rate nationwide in April -- 462 cases per 100,000 people -- according to the Ethiopian Health Cluster.
Meanwhile, in June, more than 1,000 people fleeing violence in South Sudan were crossing into Gambella daily, with over 35,000 arrivals recorded since April, according to the European Union in Ethiopia.
Amid the influx, Médecins Sans Frontières (MSF) warned of a worsening humanitarian crisis in border camps, where thousands of South Sudanese refugees face a "public health catastrophe" driven by cholera and severe malnutrition. MSF said the local health system is overwhelmed and reported treating over 1,200 cholera patients, noting that the disease can be fatal in up to 20 percent of untreated cases.
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Tagged: Malaria, Ethiopia, Refugees and Displacement, Health and Medicine, East Africa, Conflict, Peace and Security
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