Bullet and blast injuries and blood needs in South Sudan trauma wards

By the Editorial Team · Friday, October 9, 2026

Dr. Slobodan Mirosavljev and medical staff at Juba Military Hospital are treating a surge of severe injuries caused by renewed fighting between South Sudan’s government forces and opposition groups, with the hospital operating at over 160% capacity and facing critical shortages in supplies like blood. This ongoing conflict, exacerbated by political tensions ahead of national elections, has resulted in hundreds of deaths, massive displacement, and a growing humanitarian crisis that strains healthcare resources and underscores the urgent need for expanded medical and rehabilitative care.

By mid-morning on a recent Thursday at Juba Military Hospital in South Sudan, Dr. Slobodan Mirosavljev, a Serbian surgeon, had already treated two critically wounded patients. The unpredictable nature of his work means he could remain at the hospital for an indefinite period, ready to respond to sudden arrivals of patients with severe injuries caused by ongoing conflict. Helicopters frequently deliver multiple casualties from distant regions, and mass casualty events can overwhelm the facility within hours.

Juba Military Hospital, supported by the International Committee of the Red Cross (ICRC), is a crucial center for the treatment of victims injured in the hostilities between the South Sudan People’s Defence Forces (SSPDF) and the Sudan People’s Liberation Movement-In Opposition (SPLM-IO). The SPLM-IO, aligned with former vice-president Riek Machar, opposes the government led by President Salva Kiir. Renewed fighting has intensified over the past year, especially in Jonglei state, a known stronghold of the opposition. The political crisis stems in part from Kiir’s sidelining of Machar, disrupting the fragile peace established in 2018.

Machar and Kiir were once comrades in the Sudan People’s Liberation Army, which fought for South Sudan’s independence from Sudan, achieved in 2011. After independence, Kiir became president and Machar vice-president until Kiir dismissed Machar in 2013, alleging a coup plot, which ignited a civil war that resulted in over 400,000 deaths and massive displacement along ethnic lines between the Dinka and Nuer communities.

Despite a peace deal in 2018 designed to unify their parties and reinstate Machar as vice-president, the agreement’s implementation has stalled amid continuing disputes. Renewed violence erupted in March 2025 following an attack by the White Army, a rebel faction allied with Machar during the civil war, on a government garrison in Upper Nile state. This led to legal charges against Machar, including murder and treason, and his suspension by Kiir, further escalating tensions ahead of upcoming national elections.

The resurgence of violence has killed hundreds and displaced more than 200,000 people. The UN Commission on Human Rights in South Sudan recently highlighted ongoing risks to civilians amid persistent violence and political instability, emphasizing the devastating humanitarian impact.

Within the hospital, medical staff face a daily challenge. Patients arrive with gunshot wounds, stab injuries, broken bones, and blast trauma requiring multiple surgeries and intensive care. Dr. Mirosavljev noted that severe head injuries are common, with about one in ten patients suffering bullet wounds to the skull. Blood supply is a critical concern; the hospital typically holds 15 to 20 units of blood, but a single patient may require several units, straining already limited resources. Staff work with patients' families and local blood banks to secure donations, but shortages remain frequent.

ICRC health coordinator Rose Ochieng reported that the facility is operating at over 160% capacity during peaks, with efforts underway to increase beds and expand physiotherapy support. However, demand continues to outpace available resources, and civilians caught in the conflict bear the brunt of the crisis.

Emergency room nurse Mubarak Jamal highlighted the uncertainty inherent in each day at the hospital. He described routine patient loads of 30 patients per day, with a significant share presenting weapon-related injuries. These numbers can spike dramatically during mass casualty events, sometimes exceeding 90 patients in a single day.

Rehabilitation is a vital component of care. Physiotherapist Lotto Charles, who has worked at the hospital since 2016, assists patients in recovering mobility and independence following severe injuries. He manages treatment ranging from broken limbs to extensive soft tissue damage. For Charles, the greatest reward is seeing patients progress from immobility to walking independently, underscoring the ongoing need for comprehensive medical and rehabilitative care amid the continuing conflict.

For Dr. Mirosavljev and his team, the unpredictable and often harrowing workload is balanced by the moments when patients survive and regain their independence—highlighting both the severity of South Sudan’s wounds and the resilience of those who endure them.

This article was reported by synthesizing coverage from multiple independent news outlets to present a balanced, unbiased account. Read about our editorial standards. Spotted an error? Let us know.