This evaluation of MSF OCP concerns the review of MSF-OCP's emergency intervention for South-Sudanese refugees in Ethiopia, early 2014 (part of an intentional global review of MSF response to crises with major population Displacement - decision IB/5 DG, 2014). Here in Gambella, the response to well-known 11 priorities/refugee needs is checked out systematically - while the initial reactivity is fair, there are some limitations concerning know how in key operational domains (cf details in report). Adapting MSF resources (stretched) in the difficult local context is definitely complex; this hampered efficiency (such as for meeting operational obj. in time/vital needs/standards) or efficacy (such as mortality control, 1st months). Certain innovative strategies have encountered a certain success (vaccination, although it came late). – International community responsibility is also questioned (respect of basic humanitarian principles, refugee assistance and protection, INGOs late).