While fighting in South Sudan’s Unity state continues to create ongoing health emergencies, the emergency medical group Doctors Without Borders (known by its French acronym MSF) said it is also responding to a peak in malaria cases in the western part of the country – which has been largely unaffected by the conflict.

In the fighting that broke out in the Unity state capital, Bentiu, late last month, MSF treated 24 people. One nine-year-old boy, who was shot in the chest, died after he arrived at the facility.

Like many aid groups, MSF said it rapidly increased its capacity in the period after fighting broke out in South Sudan nearly a year ago. They are currently running 22 medical and emergency relief programs. But the organization warns that the fighting has only increased the challenges the country faces. Even before conflict broke out, South Sudan had some of the worst health indicators in the world.

That includes the need for ongoing malaria treatment. MSF reports rates of malaria patients have soared in parts of Abyei, Northern Bahr el Ghazal, Unity, Western Equatoria and Warrap states. So far, health workers have treated more than 60,000 patients for the disease this year.

“With the rainy season coming to an end, access by road should improve, but only if the security situation allows, and only if humanitarian aid is able to move freely to the places of greatest need,” MSF warned in a recent release.