Escalating Crisis in Gambella Refugee Camps
The living conditions for refugees in Ethiopia’s Gambella region are worsening rapidly, driven by significant reductions in humanitarian aid. This decline is largely attributed to global cuts in support from major donors such as USAID, which has placed immense pressure on basic services like food distribution, healthcare, clean water access, and sanitation.
Gambella, located in southwestern Ethiopia near the South Sudanese border, has been home to a large number of mostly South Sudanese refugees since 2014. Today, over 395,000 refugees reside in seven camps, including Kule Refugee Camp, where Doctors Without Borders/Médecins Sans Frontières (MSF) has provided healthcare services for more than a decade.
Essential Services on the Brink of Collapse
Humanitarian funding cuts have led to the suspension of nutrition services in four out of the seven refugee camps, putting around 80,000 children under five at risk of life-threatening malnutrition. Nyauahial Puoch, a mother from Tierkidi Refugee Camp, shared her concerns: “We receive food once a month—maize, wheat, and sorghum—but it always runs out before the month ends.” She traveled eight kilometers to seek treatment for her 17-month-old daughter at MSF’s facility in Kule Camp, where she was diagnosed with malnutrition.
Since October 2024, refugees in Kule Camp have received only 600 calories per day—less than 30 percent of the recommended daily minimum of 2,100 calories. Other camps are also facing similar challenges, with food distribution sometimes halting for months due to supply chain disruptions and funding shortages.
In 2025, MSF reported a 55 percent increase in child admissions to its therapeutic feeding center compared to the previous year, with half of these children coming from other camps in the region. Kuoth, whose one-year-old child received treatment at MSF’s hospital in Kule, said, “We walked three hours from our home in Akula Camp to get to the MSF hospital. Our child had a cough, diarrhea, and severe malnutrition and had to be hospitalized for 15 days until she recovered.”
Access to Healthcare Becoming More Difficult
Access to healthcare is becoming increasingly challenging for refugees in the region. MSF’s outpatient department (OPD) has seen a 58 percent rise in patient visits compared to the same period last year, with many patients coming from surrounding camps. The number of women attending antenatal care sessions has also increased by 72 percent compared to 2024, highlighting the growing demand for maternal health care services.
Armand Dirks, MSF’s project coordinator in Gambella, noted, “We’re receiving more patients from other camps because these services are no longer available locally due to many NGOs withdrawing from the region due to funding cuts.” He added that MSF is overwhelmed by the increased patient load and fears this number will continue to rise in the coming months.
Disease Prevention Activities Reduced
Funding cuts have also impacted disease prevention activities, such as malaria prevention programs. With malaria being endemic in the region, MSF anticipates a sharp increase in malaria cases during the current rainy season, which runs from May to October.
In July 2025, the number of malaria patients coming to MSF’s facility rose by approximately 125 percent compared to June 2025. Since January, MSF has treated over 23,800 cases, with more than half of these patients coming from neighboring refugee camps. Birhanu Sahile, MSF’s deputy medical coordinator, warned, “Cases are expected to rise sharply during this peak transmission period. This poses a serious threat to already vulnerable refugees who face heightened exposure to malaria-infected mosquitoes due to overcrowded living conditions and limited sanitation.”
To address this situation, MSF is enhancing its malaria treatment services and plans to establish a dedicated Malaria Health Post in Tierkidi Refugee Camp, which houses over 74,000 refugees. The organization is also distributing bed nets and supporting vector control and preventative measures in Kule Camp.
A Call for Urgent Action
Dirks emphasized the urgency of the situation, stating, “Walking through the camp, you’ll see many empty buildings—spaces once used by NGOs that have now withdrawn. Their absence is deeply felt. Services that once supported this community have now disappeared.”
Despite MSF’s efforts, the scale of needs in Kule far exceeds what the organization can address alone. Birhanu urged the Government of Ethiopia to take decisive steps in Gambella to advance refugee integration into local services. This includes strengthening the current healthcare system for everyone and enhancing its capacity to withstand future cuts.
Without urgent support and interventions from other actors, the crisis will continue to escalate, putting thousands of vulnerable lives at even greater risk.