By Nora Boustany
Washington Post Foreign Service
Thursday, May 1, 2008; A12

Clashes between southern Sudanese troops and tribal militias in a contested oil-rich region of Sudan are intensifying, and the return of thousands of war refugees is fueling friction in the absence of adequate relief and basic services, according to the aid group Doctors Without Borders.

Dozens of people have been killed since Friday, as months of intensifying fighting threaten a 2005 peace agreement between the north and south. Calm was restored Tuesday after a truce was reached, according to news services.

A key part of the peace agreement was a census, which got underway last week. It was unclear whether the fighting was related to the count, which is meant to pave the way for national elections next year and a referendum in the south on eventual independence from Sudan.

The civil war, which pitted the Arab-led government in the north against rebels in the mostly animist and Christian south, left 2 million people dead, primarily from famine and disease, and 4 million homeless.

Vanessa van Schoor, Sudan operations manager for Doctors Without Borders, said her organization is struggling to contain outbreaks of meningitis and cholera and to keep food supply-lines open. Donor countries that committed to helping the southern region recover from the war were scaling back on contributions for building schools and medical facilities, she said.

"The return of refugees in the thousands and the existence of thousands of displaced Sudanese are increasing the potential for conflict. There is a gap between emergency needs and development needs, and we are absolutely stretched to the limit," said van Schoor, who was in Washington last week to discuss the challenges her organization is facing.

For example, she said doctors operating basic clinics have been forced to debate their priorities, such as whether to temporarily close the centers so they can carry out measles vaccinations.

"Emergency funding needs to continue, and we are facing the problem that money from a multi-donor trust fund is arriving in Juba but not coming on line," she said, referring to the regional capital. "So many of our development programs are not on the agenda anymore, and we are struggling to bridge this gap."

Outpatient capacity has doubled and vaccination campaigns to prevent meningitis, cholera and other epidemics are necessary, but there is a shortage of experienced staff, van Schoor said. The few skilled south Sudanese are leaving nongovernmental organizations to work with their regional government, she said.

"The food distribution system in south Sudan is also strained due to last year's flooding, and we are starting to see pockets of malnutrition. Food convoys are being stopped," she said, adding that robberies of nongovernmental organization compounds and U.N. agencies were on the rise.

"Two of our vehicles were stolen last week," she said.

Frictions between tribesmen in the Bahr al-Ghazal region and Sudanese defense forces have been aggravated by political splits and approaching political deadlines, and conflicting claims to the oil-rich region of Abyei are a particular source of tension, van Schoor said.

"People are spilling back to the south, while there is nothing for them there, no schools for their children, no electricity," she said. "Yet they have high expectations of the troops coming in."