NAIROBI (Thomson Reuters Foundation) – The number of centres in South Sudan offering inpatient treatment for children suffering from severe malnutrition has almost halved since 2013 due to conflict, the United Nations children’s fund (Unicef) said amid warnings of famine.
Fighting between government forces and rebels, which began in December, has triggered a hunger crisis in South Sudan, while also making it harder for malnourished people to receive help. Many health centres have been destroyed and people have fled into the bush, beyond the reach of aid workers.
The number of stabilisation centres, which treat severely malnourished children with medical complications, has dropped from 51 in 2013 to 27 in late May, Priscilla Bayo Nicholas, a nutrition specialist with Unicef in South Sudan, told Thomson Reuters Foundation.
The number of outpatient therapeutic programmes (OTP), where children are monitored and provided with nutritious ready-to-use foods to take home, is down by 25 percent to 268 over the same period, she said.
"We expect the nutrition situation to worsen," Bayo Nicholas said. "In Malakal hospital, there was a stabilisation centre there but the hospital was completely looted and destroyed. Even Unity Hospital, the same thing, and Bor… Most areas are cut off."
Some 223,000 children will suffer from severe acute malnutrition (SAM), which leads to death without therapeutic feeding, in South Sudan this year, Unicef said. It estimates up to 50,000 of these children will die unless humanitarian access improves.
Hostilities have continued in violation of ceasefire agreements on May 9 and January 23. On Tuesday, regional leaders threatened to impose sanctions if the warring parties did not stop fighting, which has internally displaced over one million people.
Malnutrition was a problem in South Sudan before the conflict and those who were receiving treatment, which takes an average of 60 days, can no longer access nutritional supplies.
"It’s extremely difficult to reach them. There are still ongoing pockets of fighting," Doune Porter, Unicef’s spokeswoman in South Sudan, told Thomson Reuters Foundation by phone.
Almost four million people – more than a third of the population – are facing acute food insecurity and require $1.8 billion in assistance, the U.N. said.
The seasonal rains, which last until September, have cut off road access to two-thirds of the country.
The World Food Programme (WFP) is using airlifts and airdrops – where food is dropped out of the back of the aircraft in areas where conflict or rains make landing impossible – to reach people in remote areas of Jonglei, Unity and Upper Nile states. These are the oil-producing regions that have been most fiercely fought over by the government and rebels and have the worst levels of displacement and hunger.
"We have launched a special operation requiring almost $17 million to provide aircraft needed for food deliveries," said Amanda Lawrence-Brown, WFP’s Nairobi spokeswoman.
It has hired four aircraft and two helicopters, which can deliver a month’s rations for around 14,000 people between them in a day. An additional three aircraft and two helicopters will be added to the fleet soon, she said.
Helicopters are ferrying joint rapid response teams from Unicef, WFP and the Food and Agriculture Organization to remote areas to register people for food rations, screen children under five for malnutrition and vaccinate and deworm them.
At a recent screening in Akobo, near the Ethiopian border, 35 percent of children were found to be malnourished, Unicef’s Porter said.
Since January, more than 475,000 children under five have been screened for malnutrition with more than 29,000 found to have SAM, the U.N. said. Almost 2,000 were admitted with complications, such as pneumonia, diarrhoea or anaemia.