"We thought there would be no survivors": the MSF Old Fangak hospital bombing

The pharmacy was the first to burn on 3 May 2025, when just before dawn two helicopter gunships fired on the Médecins Sans Frontières (MSF) hospital in Old Fangak, Jonglei State, South Sudan.  

Shooting continued across the town for 30 minutes. A drone bombed the market. When the smoke cleared, seven people were dead, 27 injured, among them four MSF staff and two patients who had been receiving care when the attack began. One year later, the hospital remains closed. The town is almost empty. 

"We thought there would be no survivors. Old Fangak is a small island, only protected by a levee," said Peter, an MSF Nursing Team Supervisor who was inside the hospital when the attack began. "After the bombardment, all I could see were bullet holes, blood, and a burning pharmacy." Peter had worked in difficult environments before, but nothing had prepared him for what he saw that morning. 

Based on all available information, the only military forces with the capacity to carry out such aerial attacks were under the control of the Government of South Sudan and its allies.  

Joseph, MSF Clinical Officer, had been with MSF since the Old Fangak hospital's earliest days, from the first two tents to a fully equipped facility with an operating theatre, pharmacy, and supplies stocked for months. "We lost it in just a few minutes," he says. "I was in shock. I cried." 

The bombing destroyed a way of life 

For the people of Old Fangak, the bombing destroyed not only the hospital, but everything that made life in the town possible. The market was gone. The dyke that protected the island broke during severe flooding in August 2025. With no hospital, no market, and no flood defences, there was nothing left to stay for. 

Nyaruon, a mother of three, fled with her children the days after the attack. "We had a good life there, housing, and supplies in the market. But after the helicopter bombed us, we lost everything. People had to run for their lives." 

Thousands fled to Paguir, a small village that almost overnight became one of the most populated areas in the county, and to surrounding locations including Toch. MSF relocated its activities to both sites, providing basic outpatient and inpatient care to displaced and host populations under extremely constrained conditions, outdoors, with limited infrastructure, far from where a fully equipped hospital once stood. 

Health care has been under continuous attack  

The bombing of Old Fangak was not the first attack on healthcare in South Sudan, and it was not the last. Since January 2025, MSF has suffered 12 attacks on its staff and facilities, forcing the closure of four hospitals, Ulang, Old Fangak, Lankien, and Akobo, and the suspension of medical activities across Upper Nile, Jonglei, and Central Equatoria states. At least 760,000 people have lost access to MSF-supported healthcare as a result. 

Today, in the conflict-affected areas of Jonglei State, only two hospitals remain. Both are run by MSF, in Chuil and Paguir.  

Nyakuok was displaced from Old Fangak and now lives in Paguir. A year on, she is still waiting for an answer that has not come. 

"What good came out of the bombardment? They wanted to kill our children. What about the people that actually died that morning? What about our medicine and the hospital? We are only paying the cost now because medicine is expensive." 

MSF calls on the South Sudanese authorities to provide clear and transparent explanations for the bombing of Old Fangak, ensure that those responsible are held accountable, and make a formal, public commitment that such attacks will never happen again. The two health facilities that remain in Jonglei State must be protected. For the people who have already lost everything once, there is nothing left to lose a second time.