The central reception area of the Imvepi refugee settlement, in northern Uganda, is packed to the brim. Thousands of people are crammed into a patch of land meant to hold just a fraction of the current load. They’ve been waiting for days, stuck in an administrative backlog the government of Uganda attributes to lack of funding and an unceasing stream of people from South Sudan.

Famine, economic collapse and years of fighting have forced people out of South Sudan faster than from any other nation on the planet. The stream of arrivals, who averaged 2,800 each day in March, has begun to take a toll on the country’s southern neighbour Uganda, host to roughly half of the 1.6 million people forced to flee their homes.

Uganda is feeling the neglect. The country has one of the world’s most compassionate refugee policies, which grants migrants land to build a home and enjoy rights to travel and work that are practically unheard of elsewhere.

But without relief in sight, the cracks are beginning to show. A single settlement, called Bidi Bidi, hosts at least 270,000 refugees – more than any other place in the world. It was closed to new arrivals in December to prevent overcrowding. Since then, new settlements have opened roughly every two months.

Initially, the UN expected roughly 300,000 South Sudanese refugees to come to Uganda in 2017. Just three months into the year, the estimate has risen to 400,000.

Filippo Grandi, the UN’s high commissioner for refugees, said Uganda was now “at breaking point”.

“Uganda has continued to maintain open borders,” said Ruhakana Rugunda, Uganda’s prime minister. “But this unprecedented mass influx is placing enormous strain on our public services and local infrastructure.”

At the border, where refugees wait for days to make their way through the system, the untenability is growing increasingly evident.

“The pace at which people are coming is faster than the rate at which we are registering, so there’s a backlog of unregistered persons,” said Solomon Osakan, an official with the Ugandan government. “Unfortunately, funding has also not been going at the pace at which refugees are arriving.”

The Bidi Bidi refugee camp in Uganda is home to about 274,000 people, making it the largest camp in the world. Photograph: Dan Kitwood/Getty Images

Jacqueline Girre, 26, waits at the congested Kuluba refugee registration centre, just minutes inside the border. She’s been there for two days, after walking past the body of her dead stepfather on her way out of her home town of Yei, 100km away.

“They have slaughtered him,” she says, accusing men aligned with the president of slicing her stepfather’s throat. “These are the Dinka groups.”

Thousands more refugees are packed into the main reception area of the Imvepi settlement, crowding into the small slivers of shade provided by UN tents and a few scattered trees. Perimeter fences are covered with drying laundry and the air smells of smoke from burning rubbish and cooking fires.

Crowds gather around every tent, as migrants wait for registration, a meal and medical care. Family members look for information about their loved ones who have fled separately and haven’t been seen in months. Some children have begun ignoring the latrines and are relieving themselves in public.

“We are now suffering because of food,” says James Luonga, 42, who developed a hernia over the days he walked from his home in the South Sudanese town of Kajo Keji before arriving at Imvepi seven days ago. Nearby, a long queue has formed at a food distribution tent as people wait to receive a hot bowl of porridge. “The people are very many,” says Luonga.

Imvepi has previously hosted Sudanese refugees during years of civil war preceding South Sudan’s independence in 2011. It closed several years ago but reopened in February, in response to the new crisis.

Roughly 3.5 million South Sudanese people – at least one-quarter of the entire country’s population – have had to leave their homes since war broke out in December 2013, pitting backers of president Salva Kiir, an ethnic Dinka, against those of former vice-president Riek Machar, a Nuer. Some have stayed inside the country, moving from place to place as the conflict or famine catches up with them. Tens of thousands have been killed, and the UN has warned the conflict could spiral into genocide. In February, it declared a famine in parts of the country, affecting 100,000 people and threatening 1 million more.

South Sudanese refugees arrive at the settlement in Imvepi, Uganda. Photograph: Jerome Delay/AP

Yet even as the humanitarian crisis grows, the international response remains meagre. The UN has requested $781m (£625m) to care for the 1.6 million people coming out of South Sudan. So far, it has received just 8%.

Rose Mary, a 40-year-old from Yei who left after her neighbours were locked in their home and burned alive, has been given a small plot of land, but she says it is too far away from a water tank.

She is also worried that she might not receive the HIV drugs she needs from one of the handful of cramped clinics at the settlement, which treat mostly respiratory diseases and malaria. Mary was diagnosed HIV-positive five years ago. “If there are no drugs now, it will be hard,” she says.

Aid groups have created offices to support those with HIV and Aids, and say that it is relatively rare for medicines to be out of stock. Still, the chaos of the settlement has led to confusion and anxiety.

The US’s consideration of dramatic cuts to UN funding is adding another layer of concern. Last year, Washington provided more than $86m in humanitarian assistance to Uganda, including an emergency $40m to the World Food Programme in December for refugees in northern Uganda.

“That money is the one that is keeping refugees having food now,” said the Ugandan government’s Osakan. “If Donald Trump decided that this money should not come to Africa to help, then you certainly have a problem.”

Rains are due in the coming weeks, which will invariably lead to an increase in malaria cases.

“When rain’s pouring, we are going to have a lot of breeding places for mosquitoes and then some time after that we are going to have an outbreak of malaria,” said Charles Lajuu, programme manager with Medical Teams International.

Last year, with a much smaller refugee population, the number of new malaria cases in one block of settlements nearly quadrupled between March and May.

“Given the severity of the humanitarian crisis, many refugees arrive into Uganda and other countries in desperate need of assistance. And these crises always impact the most on highly vulnerable members of the population,” said Feargal O’Connell, the regional director of the aid group Concern.



“What’s needed is a durable peace so all refugees feel comfortable enough to return home. What’s needed, though, in the short term is funding.”