Hunger and disease wreak havoc in war-devastated South Sudan

Government soldiers in South Sudan. File photo.
Image by: CHARLES LOMODONG / AFP

A long queue forms every morning in front of a clinic in Tomping refugee camp of South Sudanese capital Juba, where thousands have sought shelter for fear of being killed for their ethnicity.

Mothers bring children wrapped in blankets whom nurses place on scales to weigh for malnutrition. But one afternoon, the small bundle in the arms of one mother was silent and no longer moved.

"It's a shame," said Matthieu Ebel, coordinator of the clinic run by the aid organization Medecins Sans Frontieres (MSF), after he arranged for the tiny body to be collected for burial.

"People think of the fighting. But these are the consequences, too." Disease and hunger are taking a toll across South Sudan, four months into the conflict between President Salva Kiir and his former deputy Riek Machar.

Thousands of people have been killed and more than 900,000 displaced in the power struggle.

An unknown number of civilians have perished from disease and malnutrition as armed groups have ransacked medical facilities and displaced people have missed the planting season.

Diseases spread fast in Tomping camp, which houses more than 10,000 refugees - 13 times as many as the International Organization for Migration has set as a standard for a camp of its size.

 In February, measles swept through the camp, killing 30 children until a vaccination campaign brought the disease partially under control. Eighteen-month-old Nyakuma Buth survived the measles outbreak, but now battles malnutrition.

 "In the village, she would not have got measles," said her father Simon Buth as he spooned porridge into Nyakuma's mouth. "When we were at home, I gave my children meat and all kinds of fruit and vegetables."

 The Buths, like others in the camp, refuse to return home out of fear of being attacked for being Nuer, the same ethnic group as Machar. In other parts of the country, it is the Dinka, the group of Kiir, who are afraid to return. Camp administrators are worried about the April rainy season.

That could be "catastrophic" for the camp, Ebel said. "If you have stagnant water, you will have more mosquitoes and malaria. Water will spread from the latrines and cause more diarrhea."

Early storms flooded Tomping last week. "Even with a few days of heavy rain ... it is a huge health problem," said Jose Barahona, South Sudan country director for the aid agency Oxfam. The United Nations is preparing a new site on higher ground to move the more than 30,000 refugees sheltering in Juba.

But for some, it is too late. "My uncle died because of the condition of the camp," a man named James said in Tomping. "When someone is killed (in fighting), at least you know whom to blame."

Outside the capital, conditions are even worse. Many areas remain inaccessible to humanitarian aid because of ongoing fighting despite a ceasefire signed in January. Aid deliveries are also hampered by the ethnic dimension of the conflict, because aid agencies cannot deploy South Sudanese staff to certain areas for fear they could be targeted because of their ethnicity.

Agok Makueni fled to the forest with her two children, when rebels and government troops fought in Bor. They hid during the day and walked at night. She only returned after the government captured the town from the rebels. The riverside town is now little more than burned huts and charred metal. "We feared wild animals," Makueni said of the weeks spent in the bush. "It was cold.

We had no blanket. We ate from the trees, fruit and even the leaves. At night we sneaked to the Nile to fetch water.

My children became sick with diarrhea and malaria." Ayool G Ayool, the only doctor in Bor hospital, receives dozens of patients as people trickle back from the bush. "Everything was looted" by armed groups, he said, showing empty cabinets in the hospital. "If a woman comes in with labour complications, I don't know what we'll do."

Aid groups are also worried about famine in South Sudan - a country that even before the conflict had problems with food security - because people will miss the planting season.

"This is the planting season, from now up to June," Barahona said. "Every week that we miss, thousands of people . are not planting and continuing their normal life." Barahona said pre-positioning of medical equipment and food aid in remote areas before the rainy season has not been possible because of the fighting. The UN is now taking expensive emergency measures of conducting air drops of food.