Theresa Abuk Dut outside of a new latrine
Please find this update from David Traynor, Concern's Programme Quality Coordinator, below. South Sudan still faces chronically high malnutrition rates due to a conflict the country has faced since 2013. It has disrupted food production, leading to high levels of illness among the population and widespread poor hygiene, health and nutrition practices.
Much of the country remains in what the Famine Early Warning Systems Network classifies as 'Crisis and Emergency' levels of food insecurity. While also contending with the impacts of conflict, South Sudan faces more erratic weather patterns, resulting in prolonged drought periods or late rains disrupting the normal agricultural seasons.
The former Northern Bahr el Ghazal (NBeG) State is no exception. Despite having escaped much of the direct impacts of the conflict, NBeG has faced unacceptably high rates of malnutrition. In 2016, people said that it was “worse than the hunger in 1988” during the civil war with northern Sudan.
Global Acute Malnutrition rates for children under five in the area are as high as 32%, according to the Food Security and Nutrition Monitoring System of the South Sudanese government and various international bodies. A recent survey conducted by Concern found the rates above emergency thresholds of 15% in the two worst affected counties in NBeG.
Children suffer frequently from illnesses such as malaria and diarrhea, which then results in malnutrition and high levels of infection, further compounded by poor hygiene and sanitation practices. Other findings shows that only 30% of households knew the three critical times to wash hands and only 2.5% had a functional handwashing station.
Responding to Malnutrition
Concern first began operations in NBeG in 1998 and has since moved into long-term recovery and resilience building programs. While NBeG remains fragile, it is relatively stable compared to other parts of South Sudan. However, the continuing high levels of malnutrition requires Concern to implement emergency responses to save lives and prevent malnutrition rates from increasing.
Last year, Concern implemented an emergency program with the aim of providing treatment to children under five-years-old and pregnant and lactating women with acute malnutrition. This program also assists in preventing malnutrition through Infant and Young Child Feeding education to caregivers.
In total, 49 health facilities were supported. Children, along with pregnant and lactating women who have Moderate Acute Malnutrition were treated in the Targeted Supplementary Feeding Program. Young children with Severe Acute Malnutrition (SAM) were treated in the Outpatient Treatment Program, while Children with SAM and medical complications were treated as inpatients in Concern Stabilization Centers.
Mary Nyandit and Mol Garang, both volunteers in their communities, understand the importance of getting malnourished children to the health facility for treatment. They were selected by their communities and trained on their roles as community health volunteers.
The training, as they explained, involves knowing how to screen for malnutrition using the Mid Upper Arm Circumference (MUAC) strips and being able to teach mothers the causes of malnutrition. Mary described how the erratic climate and problems with food affect malnutrition and how the chronic food insecurity situation impacts on malnutrition.
“People do not have anything to eat. Some people sleep without eating. I visited homes, and they had no food and they are sick. When I see their gardens, they have food but have problems with insects, because they planted late.”
However, lack of food is not the main reason for malnutrition. Having recently come from a refresher training, Mol says:
“We were trained last week on the symptoms of Severe Acute Malnutrition. We see that there is decreasing malnutrition and fewer children with diarrhea.”
Mary and Mol explain how illness drives malnutrition rates up. As it was dry season, there was less contaminated water around and thus fewer children with diarrhea. With the recent arrival of the rainy season, the numbers of mosquitoes increases and with it the prevalence of malaria and diarrhea due to contaminated water. Increased illness means increased malnutrition. Mary and Mol say that they need to teach mothers to put children under mosquito nets and to connect them to basic hygiene and sanitation services in order to protect children from illness and resulting malnutrition. When treatment is not possible in the communities, the volunteers refer children to health centers.
Thanks in part to your generous contributions, brave volunteers like Mary and Mol are able to target children most in need, preventing malnutrition when possible and treating it when necessary. For this, we deeply thank you.
A young child attending a nutrition checkup