This article explores the social and political dynamics of health service provision in and around an important garrison town in South Sudan, during the second Sudanese civil war (1983–2005). Drawing on semi-structured interviews, informal conversations and focus group discussions, the author found that opportunity hoarding and exploitation happened frequently. Northern Sudanese and the military were able to obtain care not available to the general population. Soldiers taxed women entering the town to sell produce. Resource shortages shaped efforts by the government to extend its reach outside of the town.