The survival of more than 7 million people, 60% of the population, depends on international humanitarian aid.
JUBA — In a large room with green walls serving as common room, mothers wait in silence at the bedsides of their children for the doctor's morning visit. Cecilia arrived a few days ago with her son, who is 28 months old and weighs barely more than 10 kilogram — the average weight of a healthy one year old. His body is swollen.
Peace does not fill bellies. Beneath an apparent return to normalcy, malnutrition has gripped Juba, the capital of South Sudan. At the heart of the city, the Al-Sabah Children's Hospital is the only establishment in the country with a department dedicated to the fight against severe acute malnutrition.
"I don't know what's happening," says Cecilia, recognizing that the only food she can offer her two children is a porridge of cassava. The young woman, originally from the north of the country, lost her husband at the start of the war.
Peace hasn't changed anything.
Next to her sits Julia, who walked all the way from the Kenyan border — over 15 hours away. "They didn't have anything for my baby there," she says. The majority of children in the Al-Sabah Hospital suffer from diseases such as malaria or measles, in addition to nutritional deficiencies.
"The situation is getting worse," says Betty Ocheng, the nutritionist in the department, where staff are available 24 hours a day. "Women can't do it. They're often widows and have lost everything in the war. We treat their children but then we see them come back. Once, twice, three times … They haven't got any land, any work, and food prices have gone up. So far, peace hasn't changed anything."
The hospital, which receives the support of UNICEF, treated 927 children in 2018. Figures on the walls of the staff meeting room show that admissions go up in the period just before the harvest, when the stock from the previous year is almost finished. Figures also show the dreadful mortality rate, which is as high as 20% during some months. UNICEF says that about 1 million children are malnourished countrywide.
Six months after the signing of the peace agreement between President Salva Kiir and the main rebel groups, the number of people suffering from hunger continues to increase in South Sudan.
Photo: South Sudanese citizens in Khartoum celebrate the signing of the final deal on power-sharing
In a joint statement in February, UNICEF, the Food and Agriculture Organization of the United Nations (FAO) and the World Food Program (WFP) estimated that over 7 million people could find themselves in "acute food insecurity" from now on until July. A situation which requires the urgent delivery of aid, according to UN classification. The survival of over 60% of the South Sudanese population will depend on humanitarian assistance — 10% more than the same period last year.
Between 50,000 and 260,000 people, depending on the aid which may arrive, remain at risk of famine. in February 2017, the young country, which was born only six years ago after breaking free from Khartoum, declared famine in its northern state of Unity, which at the time was the epicenter of the fighting and was completely cut off from international aid. The worst was eventually avoided.
Hotbeds of tension remain.
Children are the first victims of the civil war, which, since 2013, has cost the lives of nearly 400,000 people and displaced some 4.5 million, from an estimated population of 13 million. More than half of the displaced have fled towards neighboring countries: Ethiopia, Kenya, Uganda, Sudan, or the Democratic Republic of the Congo.
The war destroyed the agriculture. Farmers abandoned their fields to escape the fighting and the looting. Production collapsed, even in the more fertile southern regions, those of the "green belt", initially isolated from the clashes between the Dinka (President Salva Kiir's tribe) and the Nuer (that of his principal opponent, Riek Machar).
The 2018 peace agreement lowered the level of violence across the country and improved access to zones that had been previously isolated. But hotbeds of tension remain, such as Yei state, where government troops are still fighting the National Front of Salvation, led by Gen. Thomas Cirillo, who has not signed the peace agreement.
"Yei produces 20% of the country's grain," says Pierre Vauthier, FAO's South Sudan representative. He adds that farmers are still reluctant to return home, even in regions that are expected to be calm: "Fighters have not been demobilized, they are there and often left to themselves."
According to FAO, grain production — principally of sorghum and maize — will cover only half of the food requirements this year. "South Sudan should be a country exporting agricultural commodities. It has all the assets. Instead, we had to distribute nearly 5,000 tons of seeds to farmers in 2018 to save part of the harvest. A world record," says Vauthier.
The UN humanitarian response in 2019 is estimated to cost $1.5 billion, half of which is to be dedicated to fighting hunger and malnutrition. By the end of February, less than 2% of the necessary funds had been collected.