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As a Man-Made Famine Looms, Christmas Comes Early to South Sudan

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Posted on Aug 8, 2014

    Refugee family in the Yusuf Bathil camp in Maban County, Upper Nile. Photo by European Commission DG ECHO (CC BY-SA 2.0)

By Nick Turse, TomDispatch

(Page 3)

During her first week at the hospital, nurse Monica Alvarez tells me, Nyajuma didn’t crack a smile.  “But now, voilà,” she says lifting the child, sparking a broad grin that reflects the sea change in her condition.  Nyajuma is enduring the rigors of kala azar and tuberculosis treatments with great aplomb.  “She’s eating well and she’s smiling all the time,” says Alvarez, who’s quick with a smile herself.  But Nyajuma is still in the early stages of treatment.  Once stable, severely malnourished children can be transferred to ambulatory care.  But it takes roughly six weeks for them to make a full recovery and be discharged.  And in today’s South Sudan, they are the lucky ones.

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One-year-old Nyajuma sits on a bed next to her mother at the Médecins Sans Frontières hospital at the U.N. Mission in South Sudan camp in Malakal.

Of those who make it to the hospital in such a condition, 10% don’t survive, Javier Roldan, MSF’s medical team leader, tells me.  “We have people who come in in later stages or have a co-infection because malnutrition has compromised their immune system, which makes treatment much more complicated.”  He talks of the difficulty of losing patients for want of better facilities, more staff, and greater resources.  “The outcome of a baby weighing one and a half kilos [3.3 pounds] in Europe or America would be no problem at all, but here there’s quite a high mortality rate,” says Roldan.  “It’s very frustrating for the medical staff when you have patients die because you don’t have the means to treat them.” 

And Malakal is no anomaly.  At the MSF feeding station in Leer, a town in adjoining Unity State, they’ve treated roughly 1,800 malnourished children since mid-May, compared to 2,300 in all of last year.  North of Leer, in Bentiu, the site of repeated spasms of violence, the situation is especially grim.  “Over five percent of the children are suffering from severe acute malnutrition,” says CARE’s Country Director for South Sudan Aimee Ansari. “On the day I left Bentiu, CARE helped parents transport the bodies of children who had died from malnutrition to a burial site.”  In all, according to the United Nations Children’s Fund (UNICEF) and the U.N. World Food Program (WFP), almost one million South Sudanese children under five years of age will require treatment for acute malnutrition in 2014.  UNICEF projects that 50,000 of them could die.

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The Camps and the Countryside

At the U.N.’s Tongping camp in Juba—where nearly 11,500 of the area’s tens of thousands of internally displaced persons are taking refuge—the food situation is “not very good at all.” So John, a 17-year-old resident, emphatically assures me beneath the relentless midday sun.  “Outside, when I was living at home, we could have fruit or whatever we wanted.”  Here, he eats no fresh food and no vegetables.  Its sorghum and “the yellow food” mixed with sugar, oil, and water.  “This food doesn’t even compare,” he says more than once. 

Still, people here aren’t dying of malnutrition and even those in the ruder, more dismal locales in Bentiu, and Malakal are luckier than most since they have access to aid from NGOs.  At a time when South Sudan needs them most, however, almost eight months of war, insecurity, and attacks on aid workers have severely limited the reach of humanitarian organizations.  Speaking of the entire NGO community, Wendy Taeuber, country director for the International Rescue Committee in South Sudan, says, “The remoteness of rural areas of South Sudan combined with the rainy season means that there are hundreds of thousands of IDPs still in need of additional assistance.”

Sitting in the trailer that serves as his office, I ask Paulin Nkwosseu, the chief field officer for UNICEF in Malakal, about the situation of those in less accessible areas along the Nile River where World Food Program distributions are limited.  “Due to the crisis, people have no income and no food, so they’re surviving on monthly food distributions from WFP,” he tells me.  “But they say that the food distributed by WFP is not sufficient for the whole family.” 

UNICEF works with NGO partners to reach people outside the camps, but it’s a struggle.  Nkwosseu walks over to a large wall map and begins to point out Nile River towns to the north like Wau Shilluk (currently suffering a cholera outbreak), Lul, Kodok, and Melut.  These, he says, are hubs where South Sudanese from rural areas go when faced with hunger. The reason is simple enough: the river is one of the few viable transport options in a country the size of Texas that has almost no paved roads and whose dirt tracks in the rainy season are quickly reduced to impassable mud. 

Even using the Nile is anything but a slam-dunk operation.  Earlier this year, for instance, a convoy of barges transporting food and fuel to Malakal was attacked by armed men.  Even absent the acts of rebels, soldiers, or bandits, food barges are regularly delayed by everything from mechanical issues to drawn out negotiations with local powerbrokers.  Air drops are costly, impractical, and—thanks to a lack of airfield infrastructure—often unfeasible.  Security is minimal and so thousands of tons of food stocks have simply been looted.  Even when road transport is possible, vehicles are attacked and food is stolen by both government and rebel troops, eager to feed themselves.  When food supplies do make it to the river towns, many in need are unlikely to make it in from the water-logged countryside in time.


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