A hunger emergency is looming on the border between South Sudan and Sudan as families fleeing fighting in Sudan continue to cross the border every day, the United Nations World Food Programme (WFP) warned on Tuesday. New data shows that among the nearly 300,000 people who have arrived in South Sudan in the last five months, one in five children are malnourished and 90 percent of families say they are going multiple days without eating.
Almost all of those who have crossed the border since fighting broke out in Sudan in mid-April are South Sudanese, and they are returning to a country already facing unprecedented humanitarian needs. In addition to South Sudanese returnees, there are also some 30,000 Sudanese refugees and asylum-seekers arriving who have fled the war in Sudan. One out of four of all the people who have fled Sudan are being hosted now in South Sudan.
Most of the people fleeing the conflict in Sudan are entering South Sudan through Renk, a town located in the northernmost state of Upper Nile. Since the fighting erupted in the neighboring country, 80 percent of them arrived through the Joda/Renk border.
A new food security assessment completed by the UN agency shows that 90 percent of returnee families are experiencing moderate or severe food insecurity. Screening data from the border crossing found that almost 20 percent of children under five and more than a quarter of pregnant and breastfeeding women are malnourished.
"We are seeing families leave one disaster for another as they flee danger in Sudan only to find despair in South Sudan," says Mary-Ellen McGroarty, WFP's Country Director in South Sudan.
"The humanitarian situation for returnees is unacceptable, and WFP is struggling to meet the mounting humanitarian needs at the border. We simply do not have the resources to provide life-saving assistance to those who need it most."
According to the UN food agency, the rainy season has made conditions at crowded transit centers and border crossings even more difficult, with flooding worsening food insecurity and contributing to the spread of disease.
Currently, there are around 12,000 people in transit centers waiting to be transferred, McGraoarty said.
Many families report being robbed and experiencing violence as they escaped the war in Sudan and are crossing the border to South Sudan with nothing but the clothes on their backs. Those arriving recently are in an even more vulnerable condition than families that fled in the early weeks of the conflict.
WFP is providing food assistance to meet the immediate needs of the families at the border, delivering hot meals, high-energy biscuits, dry rations, and cash-based transfers, as well as providing specialized nutrition support for children and mothers.
But the UN agency says it urgently requires more than US$120 million to increase support for people fleeing Sudan's war into South Sudan over the next few months. Significant resources are also needed to help people move onwards from the crowded border area and to support them as they rebuild their lives in South Sudan, a country many of the returnees have never actually lived in.
McGraoarty said many of the returnees had been living in the urban areas of Sudan for years and were now returning to mostly rural areas and did not have the necessary skills. Those people needed longer-term support to rebuild their livelihoods.
The international non-governmental organization Médecins Sans Frontières (MSF, Doctors without Borders) is also urgently calling for an improved medical and humanitarian response for people fleeing the conflict in Sudan and entering South Sudan through the town of Renk.
“Aid is woefully inadequate in Renk compared to the needs, which are growing every day,” said Jocelyn Yapi, MSF head of mission in South Sudan, in a statement Tuesday.
“We are calling on humanitarian and medical groups to do more by strengthening activities at the entry point and at transit centers. Basic healthcare services should be made available at all times on the border for those coming with medical conditions,” she said.
Although the formal and informal transit centers in Renk are ideally a temporary stopover for people to move further into the country, returnees can spend weeks or even months there. This stay is often exhausting and painful, as people have limited access to food, shelter, water, sanitation and healthcare.
MSF teams are supporting Renk civil hospital in the measles isolation ward, as well as the inpatient therapeutic feeding center and a pediatric ward. Since July, the NGO’s teams have admitted 232 patients for malnutrition and treated 282 cases of measles requiring hospital care.
“A systematic vaccination catch-up should also be available 24/7 on the border, given the current low vaccination coverage in Sudan and ongoing outbreak of measles in both countries,” Yapi said.
Many people, especially children, are arriving to the border in alarming health conditions, suffering from deadly diseases like measles or malnutrition, and require immediate medical care. Amidst the rainy season, medical facilities in the area are recording a 70 percent positivity rate of malaria, a disease that already kills more people than any other in South Sudan.
“Malnourished children, in particular, must be given urgent nutritional support at the border and be transferred to medical facilities at once,” Yapi said.
“Relief items such as mosquito nets, plastic sheets and other essential items should also be provided at the border so nobody who is in need is missed out,” she added
“The community of returnees don’t have sufficient food or drinking water, and they don’t even have shelters – they use pieces of cloth to protect themselves from the sun and rain,” said Abraham Anhieny, an MSF medical doctor in Renk.
“As we treat malnourished children in the hospital, we see that many mothers are also malnourished,” he said.
Years of conflict have already caused one of the world’s largest humanitarian crises in South Sudan.
On Friday, the World Health Organization (WHO) warned that soaring rates of severe malnutrition, acute hunger, and deteriorating health conditions are threatening the lives and well-being of millions of people in South Sudan with the situation set to worsen as the climate crisis kicks in.
“South Sudan is a country where you see the overlap and compounding impact of conflict, climate crisis, hunger crisis, and disease outbreaks that have been going on for several years,” said Liesbeth Aelbrecht, WHO incident manager for the Horn of Africa.
“Three in four South Sudanese need humanitarian assistance this year; two in three are facing crisis levels of hunger,” she said. “And these numbers are only getting worse.”
South Sudan already suffers from insecurity, displacement, disease outbreaks, flooding, and high rates of malnutrition. Conflict, climate change, and soaring costs in South Sudan are causing some of the highest levels of hunger in the world. An estimated 7.8 million people – 68 percent of the country’s population - are experiencing high levels of acute food insecurity in the country.
More than 1.4 million children under five are estimated acutely malnourished, including some 346,000 children under five years that are severely acute malnourished and in need of urgent medical care.
“The numbers of children with severe malnutrition needing medical intervention have been higher this year than at any point in the last four years,” Aelbrecht said, adding that almost 150,000 children had been treated for severe acute malnutrition so far this year.
She warned the humanitarian crisis facing South Sudan will worsen with the onset of El Niño, a climate phenomenon that can cause temperatures to rise and excess rains.
“Flooding and hunger and drought will increase hunger even further. But it is also very likely to increase the risk of mosquito-borne diseases, especially malaria and dengue and water-borne diseases,” she said, adding that malaria is one of the five main causes of death in South Sudan.
Before the conflict erupted in Sudan, at least 9.4 million people in South Sudan needed humanitarian assistance. Among those in need are 5 million children. These numbers are likely to rise with the returnees from Sudan.
With 4.6 million people forcibly displaced, South Sudan has the highest proportion - 40 percent - of its population displaced of any country in Africa. While 2.3 million people are internally displaced, more than 2.3 million people have fled to neighboring countries. Most of them are now in Uganda, which hosts 1 million South Sudanese refugees.
Humanitarian operations in South Sudan are severely underfunded. The 2023 Humanitarian Response Plan for South Sudan, which requires $1.7 billion to support 6.8 million people, is only 53 percent funded.
Across South Sudan, the World Food Programme has a funding gap of US$536 million over the next six months and is only able to reach 40 percent of food insecure people with food assistance in 2023. Those who are receiving assistance only receive half rations due to funding shortfalls, which is further entrenching food insecurity.
The UN Office for the Coordination of Humanitarian Affairs (OCHA) says lack of security in South Sudan and Sudan is also a huge hindrance to the delivery of aid to the millions in need.
“South Sudan and Sudan are the world’s most dangerous countries for aid workers,” said Jens Laerke, OCHA spokesman, on Friday. Of 71 aid worker deaths recorded so far this year, he said, 22 were in South Sudan and 19 in Sudan. “The victims are overwhelming local humanitarians working on the front lines of the response,” he said.
Further information
Full text: 'Fleeing danger, finding despair': hunger emergency looms for South Sudanese fleeing conflict in Sudan, warns WFP, WFP press release, published October 3, 2023
https://www.wfp.org/news/fleeing-danger-finding-despair-hunger-emergency-looms-south-sudanese-fleeing-conflict-sudan
Full text: Aid woefully inadequate for returnees stuck in deplorable conditions in Renk, MSF press release, published October 3, 2023
https://www.msf.org/south-sudan-aid-woefully-inadequate-returnees-deplorable-conditions
Full text: Press Briefing by the United Nations Information Service (UNIS) in Geneva, September 29, 2023
https://www.ungeneva.org/en/news-media/bi-weekly-briefing/2023/09/press-briefing-united-nations-information-service-7