Famine Looms as Cholera Strikes the Children of South Sudan

World Vision UK CEO, Justin Byworth, has just returned from a trip to see the dramatic, life-threatening impact that the conflict in South Sudan is having on more than half of its population. Hunger is rife and famine is looming, but it's the new - and very real - threat of cholera that poses the most immediate danger.

By Justin Byworth, CEO, World Vision UK

The wide open spaces and wind in the hair on the boat to Wau Shilluk felt a relief from the claustrophobic atmosphere of the UN camp we had just left.

A few miles downstream and across the Nile river from Malakal lies the small market town of Wau Shilluk, now overwhelmed by a sprawling camp of nearly 40,000 displaced people, with their tarpaulin roofed shelters far outnumbering the domed thatch of the local tukuls (huts).

It was here today that we glimpsed the next crisis that seems doomed to follow the conflict in this part of South Sudan – famine.   It’s also where we came face to face with the spectre of cholera which is already stealing the lives of children here.

Food shortages

Nyabet and her eight  children have been sheltering here since December.  Without the income she used to get as a cleaner in Malakal’s education department or the support of her husband who’s been missing since the fighting, she’s had to walk miles into the bush to forage for firewood to sell so she can buy food for her family. It’s not enough.

All of them have had to survive on smaller and fewer meals.  The cost of sorghum, the staple cereal here, has doubled since December.  The fish that they used to eat has disappeared from their diet and they can’t afford the few vegetables in the local market. 

World Vision’s food distribution in Wau Shilluk last month was the first they’ve received since the fighting and the month’s ration of sorghum, lentils, oil and salt was a lifeline but will only last a few days more.

The lack of paved roads throughout most of the country means that food cannot be trucked to communities in need. Instead it must be air-lifted which is significantly more costly and less efficient. World Vision along with the World Food Programme is doing everything it can to keep the supply of food flowing. But insecurity and poor infrastructure present very real challenges.

Conflict crisis to food crisis

Any way you look at it, South Sudan’s conflict crisis is turning into a food crisis.

Thousands of displaced farmers weren’t able to plant their crops this year because of the conflict.  For many, their next harvest may be more than a year away, stretching the normal three month hungry season five times over.  With less food in local markets prices are already rising. 

In this vast country with virtually no roads and most transport impossible through the rains, access to food in other parts of the country is only possible with expensive airlifts.  We’re not yet seeing visibly starving children, which would bring world attention to the impending disaster, but in a country where over 40% of children are already chronically malnourished and in a normal year acute malnutrition can impact one in five children, all of this is a recipe for disaster.

In parts of South Sudan food crisis is very likely to tip into famine. 

Another looming threat

While the threat of famine claiming the lives of South Sudan’s children is near, another threat is already killing them right now – cholera.  

As we sat talking with Nyabet she gestured towards a small mound just a few metres away in front of the shelter opposite hers.  The grave of her neighbour’s child dug just five days ago. 

It’s a fate that almost claimed the life of Nyabet’s eight-year-old son Djiima who has just spent a week at the emergency cholera clinic run by Medicins Sans Frontieres in Wau Shilluk.  Djiima sits next to his Mum and tells us, “My stomach was aching and then I started being sick.” 

Nyabet says, “There was so much water – from diarrhoea and vomiting.  I was really scared, I thought he was going to die.”

I saw how frightening cholera can be 25 years ago in Mauritania [West Africa], my first ever field posting with World Vision.  A cholera outbreak there had dead bodies piled up on top of each other in the local hospital and World Vision helped set up a quarantine camp on the edge of town.  One of our staff went home feeling sick one day and was dead the next.  The severe dehydration cholera brings can kill very quickly if not treated rapidly.  

Thank God for Djiima that cholera is treatable and it can be prevented fairly simply.  Nyabet told us that they had stopped drinking water from the river and were now using a well, that they’ve been given a bar of soap to wash their hands before eating and have oral rehydration salts in case of any more diarrhoea or vomiting.

Containing cholera is a battle and in Wau Shilluk alone they had over 100 new cases the day before we were there.  Both there and in the UN Malakal camp handshakes have been replaced with fistpumps and I’ve never washed or sanitised my hands more times than this week.

A clean water supply is vital and in Malakal’s UN camp World Vision has worked with other agencies to provide clean water to its 22,000 displaced residents, with three huge water purification and storage tanks that from which water is pumped to 144 taps throughout the camp.

No child should live in fear

Djiima and his tired little face will be in my prayers tonight. So too will his neighbour’s family and the face I never saw, that of their child buried under that tragically small mound of earth that I found so hard to walk by. 

Whether the violence of war, an epidemic of cholera or the looming threat of famine, the children of South Sudan face more fears in a day here than any of my four children are likely to face in a lifetime. 

No child should have to live in fear. No mother should have to bury their child.  Hope is in short supply in South Sudan, but hope we must. 

Hope, pray, and take actions so that this country’s leaders hear the voice of their children over those of their own foes, fears and grievances and that the people of the world do not forget this young and most fragile of countries.