Juba, 04 December 2017—Six million people in South Sudan—well beyond the half of the population (56%)— were estimated to be severely food insecure in September 2017, out of which 40 000 in humanitarian catastrophe. The current harvest season, between October to December 2017 is expected to reduce the number of people experiencing food insecurity to 4.8 million. However, the situation could worsen next year exposing multiple locations across the country to high risk of famine due to poor harvest. In 2018, 1.1 million children under five are expected to be malnourished.  

According to the September 2017 Integrated Food Security Phase Classification (IPC) analysis, humanitarian catastrophe is expected to persist in 2018 with pockets of population affected in the former Wester Bahr el Ghazal state. Currently 25 000 people in Jonglei and Western Bahr el Ghazal are estimated to be in humanitarian catastrophe. When there is severe lack of food, people are forced to adopt to extremely poor diets, and as a result suffering from starvation, which weakens their immune system. The body becomes more susceptible to diseases that can be fatal if left untreated.

“This food crisis and the impact it is having on people’s health is not going away,” says Mr Evans Liyosi, WHO Representative a.i. for South Sudan. “2018 could be even worse. We are working to prepare more now so that South Sudan does not fall further into an abyss beyond hopes of recovery.”

Ongoing conflict, economic instability and access constraints for humanitarian agencies have further deteriorated South Sudan’s weak health system. Most families have no access to basic health care, including routine immunization, which puts them at greater risks of dying and suffering from diseases when they are already malnourished.
 

Malnutrition on the rise

Rates of Global Acute Malnutrition (GAM), a measure used to gauge the severity of malnutrition in a population, have far surpassed extreme levels in most locations assessed across South Sudan.

Children suffering from severe acute malnutrition (SAM) with medical complications are ten times more at risk of dying than those without. Such children require immediate treatment to stabilize the condition and save their life. Children who have medical problems and do not have an appetite need inpatient care in a clinic or hospital. They need specially-formulated milks and medical treatment to manage infections and other complications. Without this level of care, they will likely to die.

Since famine was declared in February 2017, over 2 500 severely malnourished children with medical complications have received treatment with support from WHO through static and mobile health teams supporting nutritional Inpatient Therapeutic Programs.

“In a humanitarian crisis, children are the most vulnerable and exposed to elevated risk of acute malnutrition. When malnutrition is associated with medical complications, children’s survival is critically compromised unless diagnosed and managed on time and promptly at the health facility level,” says Ms Marina Adrianopoli, Technical Officer for Nutrition at the WHO South Sudan. “Providing appropriate treatment is vital to save lives and restore health and nutrition status of children.”
 

WHO support to manage complicated severe acute malnutrition (SAM)

Despite the fragile security situation and challenging conditions to deliver health and nutrition services, WHO and partners continue to work at improving access to severe acute malnutrition treatment services. Recent efforts included provision of essential medicines to stabilization centers, developing national guidelines, conducting capacity building programs, and performing ongoing disease surveillance and monitoring.

WHO trained 18 health professionals on the management of SAM with medical complications in November2017. The training rolled out the new national package and guidelines on inpatient management of severe acute malnutrition.

In the second half of 2017, WHO donated over 50 severe acute malnutrition (SAM) kits to counties with high rates of Global Acute malnutrition (GAM) in the Greater Equatoria Regions, Northern Bahr el Ghazal, Western Bahr el Ghazal, Unity, Upper Nile and Jonglei regions to support treatment of 2 500 children at high risk of dying.

The WHO's SAM kit is designed to provide medical treatment for children under the age of five years suffering from severe malnutrition with medical complications. One kit can treat and save the lives of 50 malnourished patients. The kit includes antibiotics, antifungal, de-worming, antimalarial and anti-scabies medicines, medical equipment and a rehydration mix specific to treat cases of SAM.

“Preventing children from dying needlessly is WHO’s top priority in South Sudan,” says Mr Liyosi. “WHO is taking every opportunity to ensure that children suffering from severe acute malnutrition (SAM) with medical complications are reached on time with lifesaving health care services. This includes provision of medical supplies, drugs and training programs on inpatient care.”

In preparation for the anticipated nutrition crisis in 2018, WHO started supporting the MOH and partners in the distribution of SAM kits prioritizing areas that are likely to be affected by critical emergency and humanitarian catastrophe.