Children face illness and death in S. Sudan’s refugee camps

Children playing in Bentiu camp. Photo: UNMISS.

Six months after the eruption of an ethnic conflict, South Sudan faces a chaotic humanitarian crisis in which children are the first casualties. The United Nations estimated on Tuesday that 50,000 children are at risk of dying of starvation or hunger by the end of the year. We spoke with two humanitarian aid workers on the ground.

“Since many communities can no longer farm or raise livestock, the risk of famine is high. In certain particularly remote regions of the country, there are already people dying of hunger,” Toby Lanzer, the head of UN humanitarian operations in South Sudan, has warned. He indicated that the United Nations would launch a relief operation to provide emergency aid to 3.8 million people “affected by hunger, violence, and illness”.

According to Abdinasir Aboubakar, a doctor in charge of procuring supplies for the UN mission in South Sudan (UNMISS), mortality rates might be very high in the refugee camps. “In Bentiu camp, there are about three deaths per day out of a population of 10,000 people. The situation would be considered normal only if there were one or fewer.”

Over a million people were forced to flee their homes to escape the violence that started in December 2013. Of these, 94,000 are now in refugee camps, notably those of the capital, Juba, a camp close to Tomping, and the camps of Malakal, Bor, and Bentiu. In the latter two camps, which are the newest, the situation is particularly alarming.

Displaced people collecting water at Bentiu camp. Photo: @Kent Page

Children in the muddy Bor camp. Photo: UNMISS.

Displaced people setting up shelter in a Juba camp. Photo: UNMISS.

“Children are the most vulnerable”

Sergio di Dato is the Doctors Without Borders coordinator for the Tomping refugee camp near Juba.

Children are the most vulnerable within the population of internally displaced people: their immune systems are weaker than those of adults, so they are at greater risk of falling ill.

 

The rainy season only heightens this permanent risk. Water in the camp becomes stagnant or creates mud that children touch while they’re playing, after which they do not wash their hands. So they end up catching bacteria that cause diarrhoea and cholera. We emphatically tell people to immediately come see us as soon as a child or adult has diarrhoea because, at the very beginning, cholera is fairly easy to treat. This is essential: cholera provokes a loss of fluids, which leads to dehydration, which causes constriction of veins, which in turn makes shots difficult, especially so for children’s veins.

 

Respiratory infections are also frequent, and there, too, the risks increase with the rainy season. We are dealing with cases of pneumonia that could be deadly.

 

A little girl holds her cholera immunisation certificate in Bentiu. Photo: UNICEF.

 

“They don’t get enough protein and their nutrition is not sufficiently varied”

 

There are also malnutrition problems: the primary foodstuffs distributed in the camps are rice, beans, oil, and salt. So they are lacking in protein. We give them calorific puddings to eat in order to try to contain the risk of malnutrition.

Finally, many of those who fled the fighting are suffering from post-traumatic stress disorder after witnessing atrocities, murders, and rape. Sometimes you can tell just by looking at a patient’s face. We have a psychiatrist in the camp who, with translation help from other residents, tries to treat these problems. It affects both adults and children, who we try to calm down by making them play games. But this type of problem cannot be resolved in a day or two of treatment; it’s a long process and a massive challenge for us.

 

Children in the Juba camp. Photo: UNMISS.

“The Bentiu camp is one of the worst I’ve ever seen in my life”

Jehanne Henry is an officer for Human Rights Watch in east Africa. She has just returned from a visit to camps in South Sudan, namely those of Juba, Bor, Makalal, and Bentiu.

Around Juba, the camps are better organised because they have been around for a long time. But Bentiu, for instance, is a complete disaster: there are about 40,000 residents, people are constantly coming and going, and the total population of the camp keeps increasing. There is a severe shortage of water, which threatens the health of everyone in the camp, and children suffer most from this.

 

Aside from the sanitary problems, there are also security problems. The camp residents go outside the camp to search for water. Since they are primarily ethnic Nuers, they are at risk of being shot by the government forces, which are controlled by the Dinka ethnicity. Recently, a man was gunned down as he was standing at the entrance of the camp.

 

These people have seen ghastly things, lived through extremely violent combat, and have survived months of living in the bush, scraping by on meagre fruits and vegetables. And in the camp, too, they also live in terrible conditions, especially with the arrival of the rainy season: I’ve seen mattresses set down in muddy puddles, children running barefoot in the mud, latrines that have collapsed due to the slippery soil… It’s worse than what I saw in Darfur. It’s one of the worst refugee camps I’ve ever seen in my life.

 

A tent flooded with water and mud in Bentiu. Photo: @MSF_Sweden

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According to the United Nations, total humanitarian aid in South Sudan has reached USD 740 million (547 million euros). Covering the most basic needs of the displaced people would require a billion dollars (739 million euros) more.

South Sudan obtained its independence from Sudan in 2011 after years of conflict. But on December 15, 2013, the young country’s fragile ethnic and political situation shattered: fighting broke out in Juba between supporters of president Salva Kiir, a Dinka, and vice-president Riek Machar, a Nuer. On June 12, Kiir and Machar committed to creating a national unity government in the next two months. However, many have doubts, as two cease-fires negotiated in 2014 were broken within hours. The conflict is said to have killed at least 10,000 people, although there are no reliable estimates.