JUBA: At 14 months, Adut Duor should be walking. Instead, his spine juts through his skin and his legs dangle like sticks from his mother’s lap in a South Sudan hospital. At half the size of a healthy baby his age, he is unable to walk.
Adut’s mother, Ayan, couldn’t breastfeed her fifth child, a struggle shared by the 1.1 million pregnant and lactating women who are malnourished in the east African country.
“If I had a blessed life and money to feed him, he would get better,” Ayan said at a state hospital in Bor, 200 kilometers (124 miles) from the capital, Juba.
A recent UN-backed report projects that about 2.3 million children under 5 in South Sudan now require treatment for acute malnutrition, with over 700,000 of those in severe condition. The report attributes the rising numbers to renewed conflict in the northern counties and reduced humanitarian assistance.
Independent since 2011, South Sudan has been crippled by violence and poor governance. United Nations investigators recently accused authorities of looting billions of dollars in public funds, as 9 million of South Sudan’s almost 12 million people rely on humanitarian assistance. Now, funding cuts, renewed violence, climate change and entrenched corruption are converging to deepen the unfolding hunger crisis.
Funding cuts
In the basic ward at the hospital in Bor, dozens of mothers cradle frail children. Malnutrition cases have more than doubled this year, a crisis worsened by recent staff cuts. Funding cuts this spring forced Save the Children to lay off 180 aid staff, including 15 nutrition workers who were withdrawn from Bor in May.
Funding cuts have also hit supplies of ready-to-use therapeutic food, RUTF, the peanut paste that has been a lifeline for millions of children around the world. USAID once covered half global production, but Action Against Hunger’s Country Director Clement Papy Nkubizi warns stocks are now running dangerously low.
“Twenty-two percent of children admitted for malnutrition at Juba’s largest children’s hospital have died of hunger,” Nkubizi said. “Triangulating this to the field… there are many children who are bound to die.”
He explains that families now walk for hours to reach support after the organization closed 28 malnutrition centers. UNICEF says more than 800 (66 percent) of malnutrition sites nationwide report reduced staffing.
Violence hampering aid delivery
Violence in South Sudan’s northern states has compounded the crisis, blocking humanitarian access and driving hundreds of thousands from their farmland.
Although a 2018 peace deal ended the country’s five-year civil war, renewed clashes between the national army and militia groups raise fears of a return to large-scale conflict. In Upper Nile State, where the violence has resurged, malnutrition levels are the highest.
The UN said intensified fighting along the white Nile River meant no supplies reached the area for over a month in May, plunging more than 60,000 already malnourished children into deeper hunger.
In June, the South Sudanese government told The Associated Press it turned to US company Fogbow for airdrops to respond to needs in areas hit by violence. Although the company claims to be a humanitarian force, UN workers question the departure from the established system.
Global humanitarian group Action Against Hunger had to abandon warehouses and operations in Fangak, Jonglei State, after an aerial bombing of a Doctors Without Borders hospital left seven dead in May.
“Our sites in these locations are now also flooded, submerged as we speak,” said Nkubizi.
Around 1.6 million people are at risk of displacement from flooding, as submerged farmland and failed harvests compound hunger in the climate-vulnerable country.
“Malnutrition is not just about food insecurity — cholera outbreaks, malaria and poor sanitation compound the problem,” says Shaun Hughes, the World Food Program’s regional emergency coordinator.
With more than 60 percent of the population defecating in the open, flooding turns contaminated water into a major health threat.
No nutritional support
At Maban County Hospital near the northern border with Sudan, 8-month-old Moussa Adil cries with hunger in his mother’s arms.
Moussa’s nutritionist, Butros Khalil, says there’s no supplementary milk for the frail child that evening. The hospital received its last major consignment in March.
US funding cuts forced international aid groups to reduce support to this hospital. Khalil and dozens of colleagues have not been paid for six months. “Now we are just eating leaves from the bush,” he says, describing how the exorbitant cost of living makes it impossible to feed his 20-person family.
The neighboring war in Sudan has disrupted trade and driven up the cost of basic goods. Combined with soaring inflation, the economic pressure means 92 percent of South Sudanese live below the poverty line — a 12 percent increase from last year, according to the African Development Bank.
“People pull their kids out of school, they sell their cattle just to make ends meet, then they become the hungry people,” says Hughes.
Action Against Hunger says it had to halt school feeding after US funding was withdrawn, raising fears of children slipping from moderate to dangerous hunger levels.
In Maban’s camps near the Sudan border, refugees say WFP cash and dry food handouts no longer cover basic needs. With rations halved and over half the area’s population removed from the eligibility list, many face hunger — some even consider returning to war-torn Sudan.
Critics say years of aid dependence have exposed South Sudan. The government allocates just 1.3 percent of its budget to health — far below the 15 percent target set by the World Health Organization, according to a recent UNICEF report. Meanwhile, 80 percent of the health care system is funded by foreign donors.
Corruption
The UN Commission on Human Rights in South Sudan recently said billions of dollars had been lost to corruption, as public officials diverted revenue. The government called the allegations “absurd.”
Committee member Barney Afako said leaders were “breaching international laws which oblige governments to apply maximum available resources to realize the rights to food, health and education.”
The Commission Chairperson, Yasmin Sooka, said the funds siphoned off by elites could have built schools, staffed hospitals and secured food for the South Sudanese people.
“Corruption is killing South Sudanese. It’s not incidental — it’s the engine of South Sudan’s collapse, hollowing out its economy, gutting institutions, fueling conflict, and condemning its people to hunger and preventable death,” she said.
As the international community warns of a worsening crisis, it has already reached the hospital floors of South Sudan and the frail frames of children like Moussa and Adut.