By Ilya Gridneff
Juba, South Sudan 19 May 2017 – After more than three years of war there is a growing food crisis in a region of South Sudan once famous for its farms, agriculture and abundance of food. But this tragic irony, and the complexities of how to respond, is a similar story spreading across the war-torn nation.
South Sudan’s breadbasket, or fruit basket, that was Eqatoria state is no more. Residents of the town of Yei, in south west South Sudan in the Equatoria region, can longer tend to their crops and have been surviving on mangoes that are found in abundance along most of the main roads and rural areas.
South Sudan, the world’s newest nation, descended into civil war in December 2013. Despite numerous peace efforts, the fighting has continued for nearly four years.
The United Nations estimate that close to 1.9 million people have fled the country to escape various waves of violence. In July 2016 fighting reignited in the capital and areas like the Equatorias region – that had managed to be free of fighting – become caught up in the spiral of violence that had by now splintered into numerous militias, rebel groups and forces pursuing various agendas.
In April and May it is a common sight to see men using long extended broom stick-like poles to reach the tops of huge mango trees and shake the sweet fruit down. Young kids on their way to school wrestle and collect ripe mangoes that have fallen to the ground. Women sell small piles of them on the once-bustling main road.
The food shortages are evident at one of the two remaining primary health care units (PHCU) on the outskirts of Yei. In one of the dark rooms, mother Jane Jama sit quietly with her one-year-old twins. It is immediately noticeable that one is considerably healthier, and larger, than the other.
“Both my babies had fever. I brought them here as one was not eating,” said Jane. The PHCU, hosted in a disused house in Lomoku part of Yei town, diagnosed Victoria, one of the twins, as being moderately malnourished while the other, Bismark, was diagnosed as severely malnourished.
“The father is dead. He was shot by soldiers in December when making charcoal in the bush. I cannot go out to look for food. I used to cultivate with my husband but it is difficult now. Anything we do is very little,” she said.
Jama is one of about 40 people who every day visit the PHCU. This centre has become increasingly important for Yei residents as insecurity in the region has forced the closure of numerous other similar facilities.
Evans Wyani, a facilitating officer at the PHCU, who works for Action Africa Health the UNICEF partner, points to an empty wheel barrow out the front of the house turned clinic.
“A pregnant woman was brought in that when she was in labour last week,” he said. “She could not walk and was brought in from hiding in the bush. We are the only facility for the region as insecurity has closed down the other clinics.”
In Yei, insecurity, and a mass exodus of people to neighbouring Uganda, has prevented planting or harvesting in once fertile lands that provided food for the region and capital Juba. It is a common story across South Sudan, as displacement forces millions from their homes and makes them reliant on aid agencies who are over stretched.
Jesper Jensen, an emergency specialist for UNICEF, heading the Yei field office said there will be a deepening of the crisis as maize crops in Equatoria, that usually are harvested after mango season, were not planted earlier this year.
“A serious food crisis is developing,” he said. “People were without food in the beginning of 2017 and there may be no food until the end of the year.”
Even areas not affected by fighting are now experiencing serious food shortages.
In Aweil, in northern South Sudan, economic collapse has forced many people to leave their farms to seek work rather than plant crops. Acute malnutrition rates in Aweil were the highest in the country last year. Now, as other parts of South Sudan recover from famine, they remain at emergency levels.
In Aweil town, an outpatient therapeutic programme run by a UNICEF’s partner, Action Against Hunger is now always oversubscribed. Augustine Akuien, a community nutrition worker, who runs the supplementary feeding program every Monday and Tuesday, sees long lines of mothers with their babies.
“It is clearly getting worse, we are seeing more people compared to previous months, it is because of hunger, there is not enough food,” he said.
A bumpy two-hour drive north towards the Sudan border shows the situation much more clearly. In what feels like the middle of nowhere another small primary health care centre in Aweil North has become a vital lifeline.
A hundred or so women, dressed in colourful flowing dresses, sit with their children and new born babies. Some have walked days through the burning heat to get to the only health clinic in the area. Inside mothers cradle malnourished children, some skeletally thin. Others are on the road to recovery.
Aweil, and more broadly Northern Bar el Ghazal state, is not directly affected by South Sudan’s fighting. But the war’s indirect causes- like skyrocketing food prices, inflation above 600 percent, a depreciating currency and a reduction in food imports – mean most staples are too expensive for most.
David Mutethia, from Première Urgence Internationale, a French NGO supported by UNICEF, that runs the primary health care centre in Aweil North, said the situation was dire. They are already stretched managing 400 patients a day, four times the capacity of a normal centre.
People in Aweil are so desperate now that during planting or cultivation periods they seek manual labour jobs to find money to buy food but this means they don’t plant and have nothing later during the harvest period.
“It is a vicious cycle,” Mr Mutethia said. “This is not sustainable and longer term food security interventions are needed urgently,” he said.
Almost 5 million people in need of urgent assistance in South Sudan. In February 2017 famine was declared in Leer and Mayendit counties of Unity State. But the situation remains perilous across country. While some improvements have been seen in Unity State, severe food insecurity remains in many other parts of the country.
In Bentiu’s protection of civilians site in Unity State, more than 120,000 people are seeking shelter. It has become South Sudan’s second biggest population after the capital Juba. Close to 60 per cent of the population is under 18 years old.
Much needed food comes from the UN’s World Food Programme. The overcrowded PoC does not offer any space to cultivate land or build oneself back up after losing everything. For children the PoC site provides access to education unavailable elsewhere as fighting makes going to school too dangerous in some parts of South Sudan.
Jane Walea Opoka, a reproductive health officer in an International Rescue Committee run health clinic in Bentiu PoC, said in just one sector of the POC they make 1600 consultations per week.
“It always changes but we see on average 28-35 births every week,” she said. “People already don’t have enough to eat and as more face tough times it is only going to get tougher for everyone.”
In a newly established stabilization centre in Bentiu hospital, Jacob Gatdet, a clinical officer goes through the ward and assures mothers that their children are improving. All of the children were recently admitted to the hospital and are suffering from severe acute malnutrition with medical complications.
“I was here in Bentiu since 2011 well before the first fighting broke out in 2013. Because of the war many people have lost their property and now rely on food aid rations, and the treatments that we provide here in the hospital” he said.
Gatdet echoed other health professionals at the hospital that they are seeing more patients.
“It’s due to food insecurity. We provide antibiotics, or milk formula but we have very basic conditions and limited supplies, the fighting has to stop,” he said.
Working with partners, UNICEF is treating severely malnourished children across South Sudan with therapeutic food – a peanut paste specially formulated with the micronutrients children need to survive and grow. In 2017 UNICEF has already provided treatment to over 46,000 children across the country who were admitted in either one of 700 outpatient therapeutic programme and inpatient therapeutic sites across the country.