Fierce fighting in South Sudan’s northern Unity State have caused tens of thousands of people to flee for their lives according to reports from the International Committee of the Red Cross (ICRC) and other NGO groups on Saturday.

A late 2013 political crisis in South Sudan sparked fighting between forces loyal to President Salva Kiir and rebels allied with his former deputy Riek Machar. The conflict reopened ethnic divisions that pit Kiir’s Dinka people against Machar’s ethnic Nuer forces.

The result has been genocide, with entire villages massacred and survivors left starving and without water.

Philip Aguer, a government military spokesman, confirmed the fighting in Unity State.

Doctors without Borders shut down a hospital in the town of Leer after reports of an imminent attack with staff members fleeing on foot, carrying critically ill patients on their backs. They hid on the banks of swamps and survived by drinking swamp water, the group said in a statement.

“Today, we withdraw again with a heavy heart, because we know how civilians will suffer when they are cut off from critical, lifesaving medical care,” said Paul Critchley, who heads the mission.

The International Committee of the Red Cross (ICRC) has also been forced to withdraw from Leer and that it feared for the wellbeing of tens of thousands of people who have fled the area.

“These communities face a fight for survival, hiding in the bush in unimaginably harsh conditions,” said Franz Rauchenstein, the head of the ICRC’s delegation in South Sudan.

The fighting will also prevent farming communities from planting much-needed crops during the imminent rainy season, leading to famine later in the year. Food shortages are a key contributor to the genocide, as displaced people who survive attacks often die later due to malnutrition.

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