For some people in South Sudan, reaching a healthcare facility means walking for nights and days through difficult and unsafe conditions. Once there, they may find they need further treatment at a hospital hundreds of kilometres away. During the rainy season, flooding cuts off roads and isolates entire communities, while insecurity makes reaching healthcare even more dangerous.
“I have seen patients with serious health conditions who had to walk for days before arriving at an MSF facility,” says Rock Bopioko Molanga, Médecins Sans Frontières/Doctors Without Borders (MSF) flight coordinator in South Sudan. “When we refer them by air for further treatment, I feel relief because I understand what they've been through.”
Rock recalls helping organise the evacuation of five patients to Bentiu, in Unity State, after they had already struggled to reach medical care. “For me, what stays in my mind is not the flight itself, but the patients. They had already faced so many difficulties trying to reach medical care and knowing that we could help them continue their journey towards the treatment they needed was a moment of real relief,” Rock said.
For Christian Mopipi, MSF flight coordinator supporting South Sudan, the challenges become especially clear when patients urgently need care, but weather conditions prevent aircraft from reaching them. “We had a patient with a serious gunshot injury who urgently needed medical care, but heavy rain prevented our aircraft from landing. We couldn't reach him by air, so we arranged for him to travel by boat to Malakal, where we could fly him to Juba for treatment,” Christian said. The patient was in Toch, where heavy rainfall had made the airstrip inaccessible. His journey by boat and aircraft illustrates how teams must find alternative ways to help patients reach essential treatment.
In Pieri, Jonglei State, people also arrive from distant communities seeking medical assistance, sometimes requiring referral to another hospital. Rock recalls a flight from Chuil that had to abandon its landing just three minutes before touching down because heavy rain had made the airstrip unusable.
“The most difficult part is knowing that people are waiting for us, but there is nothing we can do until it is safe to land. You want to reach them, especially when medical care is needed, but the weather doesn't always give you that chance,” Rock said.
Weather is not the only obstacle. Christian recalls another emergency when a critically ill patient needed urgent evacuation, but all available aircraft were already scheduled for other destinations. “That day, all our aircraft were already scheduled, but we received an urgent request to evacuate a critically ill patient. We had to change and cancel some flights to make the evacuation possible. For us, the patient always comes first,” Christian said.
Between January and September 2026, MSF aircraft in South Sudan flew more than 3,300 hours across 700 flights and carried nearly 5,000 passengers and 469 tonnes of medical and logistical supplies to some of the country's hardest-to-reach places. During this period, MSF flights also supported 913 patient transfers, averaging more than 100 every month.
For Rock and Christian, the importance of these flights goes far beyond flight schedules and the number of passengers transported. Behind each medical referral is a person who needs care, often after an exhausting journey, and a medical team working to ensure that distance does not become another barrier to treatment.
For Christian, some of the most meaningful moments come when an aircraft finally reaches a remote location, where patients and medical teams have been waiting for its arrival.
“When we land, we see the joy on the faces of patients and medical staff, because it gives them new hope of receiving treatment,” Christian said.
For Rock, each referral is about ensuring that people are not left without options simply because they live far from a hospital.
“Behind MSF air operations there is a simple yet important objective: ensuring that people facing medical emergencies are not left without options simply because they live far from a hospital,” he said.
For patients facing floods, insecurity and long distances, aircraft can offer the only chance to reach the treatment they urgently need. Behind every flight is a person waiting for care, and a team working to help them reach it.
“Here, aviation is a lifeline” said Rock and Christian.
--------------------
Across six states and two administrative areas in South Sudan, MSF provides medical care to people affected by conflict, displacement and disease outbreaks, including in areas where hospitals are difficult to reach. Aircraft help patients access referral facilities and deliver medicines, equipment and essential supplies to healthcare teams working in isolated locations. MSF has been present in what is today South Sudan since 1983 and remains one of the largest medical humanitarian agencies in the country. From January to October 2026, MSF provided more than 719,349 outpatient consultations (including children under five), inpatient care for over 99,658 patients, including 8,771 surgeries, and screened 303,063 children for malnutrition.