United Nations aid chief Tom Fletcher has sounded a grave warning over the rapidly deteriorating humanitarian situation in South Sudan, after witnessing the human cost of the conflict at a hospital in Akobo, near the front lines.

Walking through crowded wards, Fletcher described scenes of profound suffering driven by renewed fighting and shrinking international assistance. He spoke of survivors of gunshot wounds lying on thin mattresses, including a 70-year-old grandmother and a small boy named Kol, who has lost his parents and siblings and is fighting for his life.

Akobo lies in eastern Jonglei state, one of the epicentres of the conflict. United Nations figures indicate that hundreds of thousands of people have been displaced there since the latest surge in violence, many fleeing with nothing but the clothes they were wearing. Aid workers report that families are sheltering in makeshift camps or under trees, with limited access to food, clean water or medical care.

Doctors at the hospital say they are overwhelmed. Operating theatres and emergency rooms are filled with patients suffering from gunshot injuries, shrapnel wounds and complications from delayed treatment. Dr Kenneth Ozollo, a surgeon with the International Committee of the Red Cross, said his team has been forced to work around the clock to cope with a sudden influx of wounded people as clashes intensified.

The conflict has largely pitted fighters aligned with President Salva Kiir, who draws most of his support from the Dinka community, against forces loyal to former vice president Riek Machar, backed mainly by the Nuer. Cycles of revenge attacks, cattle raids and armed confrontations have devastated villages, destroyed livelihoods and deepened ethnic mistrust.

Humanitarian agencies warn that the combination of violence, displacement, flooding in some regions and economic collapse has pushed millions toward acute food insecurity. Many health facilities have been looted or abandoned, and aid groups face insecurity, bureaucratic obstacles and funding shortfalls that limit their ability to respond.

Fletcher’s visit was intended to galvanize international attention and resources. He stressed that without urgent, sustained support, the fragile population of South Sudan risks sliding further into catastrophe, with children, the elderly and the wounded paying the highest price.