The Médecins Sans Frontières (MSF) hospital in Lankien, a town in South Sudan’s Jonglei state, was hit by an airstrike in February, although the medical charity’s bright red logo was painted on the roof of the building.
Lucy Lau, an MSF project coordinator based in the east African nation, said she believed the February 3 airstrike was not a coincidence.
It was a tactical attack targeting the hospital’s main warehouse, destroying not only the building but most of the critical supplies stored inside, she said in early April.
Before the airstrike, MSF received information about a possible attack in Lankien and decided to evacuate the hospital. Lau and other staff members were able to escape unharmed, but one worker was injured in the strike, which MSF blamed on the South Sudanese army.
She and her team were forced to cut short their six-month mission and leave the country that same evening.
Lankien is an opposition stronghold in South Sudan, a country that has been hit by political instability since a civil war broke out in 2013. Despite a peace deal in 2018, armed conflict has continued between President Salva Kiir’s government troops and rebel forces loyal to former Vice President Riek Machar.
Citing the UN, MSF said renewed conflict killed 2,000 people and displaced 320,000 in 2025.
The humanitarian aid NGO also said its health facility in Pieri, another town in Jonglei, was robbed by unknown assailants on February 3, hours before the Lankien airstrike.
In one STATEMENT released a day later, MSF criticized the attacks. “While we are aware of the great needs in the country, we find it unacceptable to be a target for attacks,” said MSF operations manager Gul Badshah.
MSF suffered eight targeted attacks in 2025, forcing the charity to close two hospitals and suspend medical activities in the states of Upper Nile, Jonglei and Central Equatoria. The UN said an airline BOMBING of an MSF hospital in Old Fangak, also located in Jonglei, in May last year “could amount to a war crime”.
Lau said the attacks were aimed at damaging health care systems in an area controlled by political opponents, without considering the effect on civilians.
Lau, an engineer by training, joined MSF’s logistics team in 2011. She said she had noticed an increased willingness in recent years to target civilian infrastructure and aid organizations in armed conflicts, resulting in greater difficulties in the delivery of humanitarian aid.
“It feels like a growing trend around the world,” the 46-year-old said.
Underfunded
Lau moved to Jonglei state in October, four months before the airstrike, to work as a project coordinator.
She was responsible for managing MSF’s emergency medical projects, coordinating operations between different departments: medicine, human resources, finance and logistics.
MSF’s hospital in Lankien treated cases of pediatric and maternity malnutrition and provided treatment for infectious diseases, including cholera, tuberculosis and HIV.
The disease outbreaks “are indirect impacts of the civil war,” especially in a country whose budget has largely gone to the military while health care is chronically underfunded, Lau said.
“The officials told me that only 1 percent of the 2026 national team bUDGET was assigned to the Ministry of Health”.
Those requiring treatment included civilians with explosive and gunshot wounds. The hospital also organized programs for survivors of intimate partner violence.
The Hongkonger, who arrived in South Sudan with a small MSF team, worked mainly with local health care workers and engineers. “These people spend most of their lives around this civil war. They are tired,” she said.
“Classic Dilemma”
Despite the threat to their safety, healthcare workers still feel responsible for their patients.
Lau recalled how a member of the team, who took refuge in a nearby safe house after the bombing, asked if they could go back to the hospital to treat wounded patients who had just arrived.
“Our job is to help (patients), but we also have to consider our own well-being… they were concerned about their safety, then they turned their attention to how they could help the injured,” Lau said. “It’s a classic dilemma.”
Because of the air strike, tens of thousands of South Sudanese were displaced. Some fled into the bush and eventually to nearby villages, such as Chuil and Minkaman in Lakes State. Some with more means fled to neighboring countries such as Ethiopia or Uganda, Lau said.
The growing violence means local communities will be left without any health care in a country where the government’s budget for health care is almost non-existent, Lau said.
Despite the attacks, MSF teams still in the country have increased medical and humanitarian support for displaced people. Since the end of February, they have provided 2,200 consultations, admitted 172 patients to the Chuil health care center and referred 16 patients for further treatment.
US President Donald Trump’s cuts to USAID have affected the ability of other international organizations to provide aid in South Sudan, leaving MSF, which does not accept US funding, as one of the few NGOs offering some semblance of a functioning health care system in the country, Lau said.
Space for help
After years of working in conflict zones, including Ukraine and Afghanistan, MSF logistics has noticed an increasing trend of targeting civilian infrastructure, particularly healthcare facilities.
In February, four years after Russia’s war in Ukraine began, the World Health Organization (WHO) said it had registered More than 2,800 attacks on Ukrainian healthcare, with the highest number recorded in 2025.
Meanwhile, United Nations experts CALLED Israel’s destruction of Gaza’s health system, including the bombing of hospitals, “medicine”. Amid ongoing US-Israeli attacks on Iran, the WHO said in early April it had verified more than 20 attacks on health care facilities in the Islamic Republic since March 1.
Attacks on facilities such as hospitals are no longer an unknown sight, Lau said.
According to to MSF, the government, opposition forces and non-state armed groups have all openly violated international humanitarian law by repeatedly attacking its medical facilities and staff.
In August, gunmen intercepted an MSF convoy and kidnapped a team leader just four days after abducting health ministry staff. The MSF team leader was released a few hours later.
During her deployment to South Sudan, Lau was responsible for negotiating with various factions, including the government and opposition, to protect MSF staff, clinics and patients within conflict zones.
Although MSF maintains a neutral stance in the conflict, the government questioned why Lau’s team was operating in opposition territory. “But we had teams providing services in government territory as well; it just wasn’t my team,” she said.
MSF said that since December, the government had ordered blockades barring humanitarian access exclusively to parts of opposition-held areas of Jonglei state, in an attempt to put pressure on opposition territory, including the civilian population living there.
The international charity warned that the restrictions could have “dangerous consequences for children, pregnant women and people living with chronic or life-threatening conditions”.
Lau and her team had to consider whether certain actions, such as operating in an opposition stronghold, would cause them to lose access to other parts of the state.
“We felt guaranteed that we would be protected working in a hospital. We can no longer think like that,” she said.
“The space for our work has become much smaller. Now there are a lot more risks that we have to consider, and we have to consider whether those risks are worth taking, and that’s a fine line.”
MSF, as an impartial provider of humanitarian aid, “cannot really help improve the situation under war conditions,” Lau said.
“But we can have an effect on the lives of individuals, and for them, that’s what’s important,” especially while international attention and support is limited, she added.
