Canadian aid worker Tara Newell says she helped a mother dig a grave for her three-year-old child a few days ago after the infant died cradled in the woman's arms on the side of a road in violence-plagued South Sudan.
"We had to help the mother bury the child on the side of the road so she could continue on and get water for herself," said the Canadian aid worker, deployed with the group Doctors Without Borders in South Sudan these past six weeks.
The woman was among 35,000 Sudanese refugees forced to walk 25 kilometres to a new camp after a temporary gathering point ran out of water.
For Newell, the case is a stark example of the decisions aid agencies face as they deal with an onslaught of refugees fleeing violence in Sudan's Blue Nile state.
Newell's Doctors Without Borders emergency response team was travelling alongside the walking refugees, offering them oral rehydration salts and high-energy biscuits to help them survive the journey.
"That walk was exhausting and there was a handful of deaths that day," said Newell, who is working in the Jamam camp in South Sudan's Upper Nile state.
South Sudan, the world's newest country after seceding from Sudan a year ago, is struggling with an increasing influx of refugees from its northern neighbour.
Over the past three weeks, about 35,000 people crossed over the border from Sudan's Blue Nile state. Refugee camps were already overcrowded with 70,000 refugees and those fleeing cite bombing and fighting between Sudan's military and a rebel group associated with South Sudan, the SPLM-N.
Rainy season poses problem
Adding to the problem, the six-month-long rainy season is about to begin in this part of South Sudan.
South Sudan became an independent nation on July 9, 2011.
The secession came after a referendum promised in a 2005 peace deal between the government of Sudan and southern rebels that ended a decades-long civil war.
But the conflicts continue between rebel groups and Southern Sudanese forces, between Northern and Southern forces in the oil-rich border region of Abyei, and between the Sudanese army and a pro-Southern group in the Nuba mountains.
Nearly a year after secession, the two sides are still negotiating key issues such as oil rights and border demarcation.
While welcoming the extra water to refill reservoirs, aid workers say the rains will also make it difficult to relocate people or bring them food as roads often become impassable as a result of the usual downpours.
"We are certainly not praying for water, which is fairly unusual in Africa. We are praying for another week of dry weather so we can get everyone out," Peter Struijf, an Oxfam aid worker at the Jamam camp, said.
A report by the UN High Commission for Refugees released Monday said that 2011 was a record year for forced displacements, with more people becoming refugees than at any point since 2000.
The numbers were driven in part by crises in several countries, including Sudan, and the agency expressed concern for the country because no end appears in sight for the ongoing conflict there.
Eric Reeves, a Massachusetts-based professor who has studied Sudan for 14 years, says crops have been devastated because of continued indiscriminate bombing in Blue Nile and South Kordofan, two Sudanese states where a rebel group, seen as supportive of South Sudan, is operating.
"There is no food. Both last year’s and this year’s agricultural cycle have been destroyed by the relentless aerial bombardment," said Reeves.
"We know that tens of thousands of people are going to starve. It’s unavoidable. The question now is whether that will become hundreds of thousands."
Reeves says he worries the conflict is about to revert back to square one. "We are very, very close to war," he says.
Worries about an escalation in the conflict heightened in April when border fighting intensified to its worst level since South Sudan's secession in July.
The UN Security Council expressed "strong concern" about delayed talks between the long-time foes over a string of disputes, including the position of the border and how much the South should pay to transport its oil through Sudan.
The council members "reiterated their grave concern about the situation in Southern Kordofan and Blue Nile States of Sudan, especially the rapidly worsening humanitarian situation." The two countries are scheduled to resume talks on June 21.
Relations between the former civil war foes, however, remain tense. In a TV interview with BBC, Sudan's ambassador to Britain said South Sudan is "not a real state" and that the newly independent country lacks democracy and government administration.
The statement was in answer to a question about why the two countries were unable to agree on the demilitarized buffer zone.
"When you say two sides, you are comparing, you know, different things," Abdullahi Alazreg told the BBC's HARDtalk program.
"You are comparing our established government with an entity that is in the process of prevailing. Southern Sudan is not a real country, is not a real state," said Alazreg. "It's a metaphorical state."
Sudan authorities, however, have shut out many international agencies and media outlets from parts of Sudan, making it difficult to access information about the situation and help those in need.
Fears of new influx
Newell notes that there are positive signs on the horizon. Doctors Without Borders' "biggest achievement" has been to increase the supply of water in the region since arriving six weeks ago, she says.
At the Jamam refugee camp, where Newell is stationed, the agency has secured enough water to give each of the 35,000 refugees about six litres per day. Five litres are necessary to prevent death, while 20 litres are required to also wash clothes and the body to prevent disease.
"Given where they came from — where there was no water — six litres of water a day is enough to sustain the population and reduce deaths," said Newell.
But that success could be nullified if a prediction by the UNHCR that up to 40,000 more people could be en route to South Sudan proves true.
"Water is still the most important thing to sustaining life and it’s in vast shortage here," said Newell.