Source: IRIN News
Under the sweltering sun, women at Jamam refugee camp, in South Sudan's Upper Nile State, dig through the clay of a dried up waterhole in their search for water.

Scooping up muddy water to fill one jerry-can takes three hours, but is better than returning home with nothing after a day waiting at a camp water-point and risking getting involved in a fight, says 19-year-old Macda Doka Waka.

Aid agencies are struggling to keep up with the food and water needs of over 37,000 people in the camp who have fled bombardment and violence across the border in Sudan's Blue Nile State.

"It takes a long time to get water. I went this morning to put my jerry-can there [at a camp water point]; I will have to fetch it tomorrow as there is not enough water," said Entisar Abas Elmak, whose normally healthy child has been sick four times in two months with diarrhoea and vomiting. 

Small children intercept cupfuls of muddy water headed for the buckets and gulp them down greedily in temperatures over 45 degrees, but the poor quality water is causing health problems.

"There are already a lot of diarrhoea cases - children, men, the elderly - everyone's getting diarrhoea, and rain will make it worse," said Sheikh Osman Alamin, a 43-year-old farmer who has been in the camp for three months.

Daudi Makamba, a water expert with Oxfam, says the agency faces a huge challenge to provide enough water as boreholes have collapsed, waterholes are dry, and it lacks the means to truck more than the current 160,000 litres from the remaining three boreholes around 30km away.

"For the moment we have an average of 5-6 litres per person per day. For survival it’s 3-7 litres, but for basic water needs such as drinking, bathing and washing we need at least 7.5-15 litres per person per day," he said at a water point where one man with a pad and pen, and another with a whip, shout at an angry crowd of women vying for the water.

"Water, that is a huge challenge - the biggest we are facing here in Jamam," said Andrew Omale, Oxfam's emergency coordinator at the camp, which he referred to as “forgotten”. "The current situation is that this area doesn't have ground water. We have tried our best. So far we have drilled over 10 boreholes and these have not yielded any result."

Oxfam hopes that a larger drill from aid agency CARE International and the International Organization for Migration arrives before the rains start and make drilling even more complicated.

"This is one of the huge worries we have currently, because this area has a very bad history. Once it comes to rainy season, the roads are cut off," he added.

Appeals for more support

Oxfam is urging donors to ramp up support now, warning that it will be three times more expensive when the rains come and block off roads; shortages could endanger people's lives.

"This is going to cause a lot of health problems and I'm afraid that we will lose a lot of people, especially if rains flood this black cotton soil,” Omale said.

"The international community has not done enough... it has not focused on this emergency. These people started coming here in November. Up to now we have not received enough support to help the refugees here in Jamam," he said.

Médecins Sans Frontières (MSF) which is providing over 130,000 litres of water a day to the camp, has also appealed for aid to be ramped up, and more water and sanitation partners. 

"In its clinics MSF witnesses the direct consequences of the lack of water, with cases of diarrhoea rising continuously, now constituting one in four of all consultations," the organization said in a recent statement.

In addition to an increase in respiratory infections and malaria that look set to worsen during the six-month rainy season, the current lack of water is set to cause other health problems.

"We're also seeing a lot of skin infections and eye infections which again goes with when there's conditions of poor sanitation… and we are having at least two to three children a week coming with severe dehydration, and in need of urgent fluids,” said MSF’s Kirrily de Polnay.

Insufficient food

Camp resident Alamin's flimsy shelter - made of straw and two plastic sheets - lies on the vast floodplain called "Jamam Zero" where most of the refugees have set up camp.

"We are not yet settled. We were told this place will be flooded when the rains come... Food is very difficult, getting water is very difficult, so we don't know what next," he told IRIN.

His family of 10 dodged bombs in Blue Nile for months before coming here. According to Alamin, the only source of food in Blue Nile State is small quantities of sorghum in abandoned farms - families can't even find salt to cook it with as markets no longer exist.

In Jamam, time is running out to pre-position enough food for 80,000 people, as aid agencies expect another 40,000 when food and water in Blue Nile runs out.

Many camp residents say they are not receiving enough food, and that children are becoming malnourished.

"We are being given food, but it's not enough... A 25kg sack of sorghum is supposed to last five people for one and a half months, said Elmak. "You also get a gallon of oil and lentils, and if you try to make it last the month it doesn't stretch…

"Also, when you arrive here, they don't give you food immediately. You have to stay for one month or a month and a half and then you will be given food," she said, adding that her family had had to survive on tree leaves until they received sorghum and cooking oil rations.

Twenty-six-year-old Khamis Kueba, who walked for five days with the family livestock and arrived in Jamam three days ago, can barely speak from exhaustion and hunger, but will have to wait for the next distribution.

Bombings in Blue Nile State

Across the border, the situation is even worse, said Sheikh El Rathi Rajab, a Blue Nile MP.

He said bombs were being dropped day and night and people had fled to the bush, to Ethiopia, or were trying to get to South Sudan but are being blocked by Sudan Armed Forces.

The USA has warned of a “potential famine” in Blue Nile and neighbouring South Kordofan, where Sudan has been battling rebels.

If the blockade on aid is not lifted soon, "they will lose their lives because the situation is getting worse and it will continue to get worse," said Rajab.

• Sudan