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Silent Killers: Neglected Tropical Diseases in South Sudan

Neglected Tropical Diseases south sudanSouth Sudan has suffered nearly a decade of conflict and is one of the countries most heavily affected by neglected tropical diseases in the world. The conflict caused almost irreparable damage to the nation’s social support structures that have only in recent years been improving with the help of external humanitarian organizations. Continent-wide diseases such as HIV/AIDS, malaria and pneumonia place a heavy burden on South Sudan. However, many neglected tropical diseases are also rife within the nation, acting as silent killers that hugely contribute to the country’s mortality rate yet garner far less attention and aid than is needed to combat the outbreaks.

Civil War and the Health Care System

The South-Sudanese Civil War occurred from 2013 to 2020 due to President Salva Kiir’s accusation towards Riek Machar, former deputy, and 10 others of attempting to start a coup d’etat. Conflict broke out between the Sudan People’s Liberation Movement (SPLM) and the Sudan People’s Liberation Movement-in-Opposition (SPLM-IO), devastating the country’s social structures, such as the democratic institutions, the weak economy and the fragile healthcare system. South Sudan currently ranks third in the world on the Fragile States Index.

The war catalyzed a vast humanitarian crisis that shook the very core of the nation, destabilizing the basic structures and needs for the population to survive. The inflation rate soared, reaching a peak of 835%, which made commodity prices exponentially rise and plummeted the value of the Sudanese Pound. Millions fled their homes during the conflict, leaving them displaced in a famine and relying on an already-overwhelmed health care system.

In 2020, essential health care coverage stood at 44% and critical care services such as child health care were at risk due to shrinking national fiscal space. Additionally, at the height of the COVID-19 pandemic in 2021, more than 8 million people out of the total 13 million population needed humanitarian aid.

Neglected Tropical Disease Outbreak

The World Health Organization (WHO) recognizes 20 neglected tropical diseases, 19 of which affect South Sudan. While South Sudan has been formulating plans and programs to combat neglected tropical diseases for decades, progress is slow and has only in recent years bolstered more support.

In 2008, the Ministry of Health identified the top neglected tropical diseases that affected South Sudan: visceral leishmaniasis (VL), human African trypanosomiasis (HAT), onchocerciasis, dracunculiasis (Guinea worm), lymphatic filariasis (LF), schistosomiasis, trachoma and soil transmitted helminths (STH).

The ministry recommended the use of integrated mass drug administration (MDA), however, it feared that “the existing financial resources and global political commitment are not sufficient to reach the goals of elimination or control by 2020 at the latest.”

Indeed, in the 2016-2020 South Sudan National Master Plan, it outlined that “the allocation of funds to states and countries through inadequate, lacks guidance on allocation of funds to specific programs areas such as NTD control.” In 2008, the Ministry of Health estimated that around 3.9 million people were at risk of trachoma in surveyed areas, and in 2024, South Sudan remained with the highest prevalence of active trachoma anywhere in the world, with up to 80% of children under 9 suffering from the condition.

The Good News

The story is not all bleak, however, as the continued efforts have been gradually paying off. The 2023-2027 South Sudan NTDs Master Plan details that increased attention has allowed for “significant strides globally in the control, eradication and elimination of NTDs.” These positive steps include 70-80% member states previously NTD-endemic in 2020 now declaring the elimination of at least one disease, 44 member states certified free of guinea-worm disease compared with 2020, and 44 states fully mapped for PCT-NTDs (preventative chemotherapy NTDs) compared with 2020.

With support from the WHO, since 2021, the country has managed to treat almost 17 million people for river blindness, elephantiasis, bilharzia, trachoma and soil-transmitted worms. Additionally, a treatment drive in 2023 traveled house-to-house, performing MDA against bilharzia. Increased awareness and education efforts are allowing isolated villages to receive more accessible treatment diseases; Dr Aja Kuol, the president of South Sudan’s Ophthalmologic Association and first South Sudanese female ophthalmologist has been travelling across the country with her team to perform sight-restoring operations to those suffering from sight-related diseases, reaching almost 4,700 people in 2023, The Telegraph reports.

Lastly, the Centers for Disease Control and Prevention (CDC) introduced Project ECHO, which aims to reduce clinical variations and improve the quality of care for patients. As of 2024, the project conducted nearly 200 sessions and 3,500 health care workers across the nation have received the training.

Closing Remarks

The civil war in South Sudan caused not only physical mass destruction and damage but also took a huge mental toll on the population. The efforts to combat neglected tropical diseases across the country have been slow and demoralizing at times, however, the effort has paid off. Now that the society is breaking initial barriers such as poor awareness and education, the country can expect improvement, with the most recent master plan facilitating “multi-sectoral collaboration” that can achieve the nation’s vision of a neglected tropical disease-free country.

– Helena Pryce

Helena is based in Nottingham, UK and focuses on Global Health and Politics for The Borgen Project.

Photo: Flickr

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Malnutrition in South Sudan

Malnutrition in South SudanSouth Sudan is believed to have one of the highest malnutrition rates among children, with an unsettling rate of 1.4 million. This problem extends to adults, as shown by the estimation that 7.8 million adults face food insecurity at some level. What makes the situation in South Sudan unique is that these are the highest levels of malnutrition in its history, making the nation a top priority for global aid agencies in the past years.

About Malnutrition

Malnutrition is a serious issue directly correlated to extreme poverty, making access to basic necessities like food essential when supporting developing nations. Tremendous steps have been taken in the global fight against malnutrition, largely driven by foreign aid. Foreign aid enables developing countries to invest in sustainable agriculture, ensuring food security until they can establish self-sustaining systems.

Efforts to combat malnutrition often start with direct food assistance, followed by investments in sustainable agriculture. While this approach is generally effective, some countries face external challenges that hinder progress, such as natural disasters and conflicts, which disrupt food production and distribution.

What Makes South Sudan’s Situation Different

South Sudan faces external challenges that complicate the fight against malnutrition, with one of the primary issues being widespread flooding. The region has endured severe flooding for several years, resulting in extensive damage. Areas affected by these floods often experience high levels of malnutrition.

The flooding hampers foreign aid efforts by preventing resources from reaching certain areas. For malnutrition, the issue lies in the inability of crops to produce sufficient yields. The combination of these problems makes the whole situation much harder to control. Another thing making things harder for South Sudan is the recent war. War has displaced millions of people in South Sudan, making the problem harder to track and keep control over.

Organizations Helping

The combined efforts of major organizations such as the World Food Programme (WFP) and the United Nations Children’s Fund (UNICEF) have helped with damage control. WFP has supported more than 600,000 people in South Sudan with fortified biscuits, cash transfers and nutrition support for children and mothers.

Similarly, UNICEF has responded to the needs of people affected and displaced by floods by providing them with basic supplies, such as soap, drugs and education materials. The organization has also strengthened local communities’ flood resilience and preparedness efforts, “including pre-positioning supplies during the dry season when roads are still accessible.”

Conclusion

Addressing malnutrition in South Sudan requires sustained international support and innovative solutions to overcome the country’s unique challenges. While foreign aid and humanitarian organizations have played a crucial role in providing immediate relief, long-term strategies such as improving flood resilience, strengthening food security and restoring stability remain essential. As South Sudan continues to face the highest malnutrition rates in its history, ongoing global efforts will be vital in ensuring that vulnerable populations receive the necessary resources to survive and build a more sustainable future.

– Kaleb Monteith

Kaleb is based in Greeley, CO, USA and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr

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A Bright Future for Renewable Energy in South Sudan

Renewable Energy in South Sudan
South Sudan faces significant poverty-related challenges, with more than 82% of the population living in multidimensional poverty. This includes limited access to basic services, such as clean water, health care, education and adequate nutrition. It is also, however, the least electrified. This situation has been exacerbated by ongoing conflicts, economic instability and recurrent climate-related crises such as floods and droughts, which disrupt agriculture and worsen food security. Most of the country’s current energy production comes from generators that burn imported diesel, a costly method both economically and environmentally. According to the World Bank, only 8.4% of the population had reliable access to power and electricity in 2022, leaving the door wide open to produce much-needed renewable energy in South Sudan.

Renewable Energy in South Sudan

Currently, most of the country’s energy production takes place in the capital city of Juba, with very little power infrastructure outside of this hub. Because South Sudan is still in the beginning stages of their infrastructural development, there is a rare opportunity to move forward and address the issue of energy poverty by building sustainable models of electrification, like solar power, without having to dismantle an already existing energy foundation.

Renewable energy can also help build peace in the country. According to UC Berkeley’s Renewable & Appropriate Energy Laboratory, reducing dependency on fossil fuels by increasing access to renewables could lower costs, improve public health and foster socio-economic stability in this conflict-affected country.

Solar Energy and Refrigeration

Solar-powered refrigeration represents a significant advancement in maintaining a consistent and energy-efficient cold chain for vaccines in remote regions. By reducing the need for costly and unreliable fuel-based generators, these solar refrigerators ensure that essential vaccines are safely stored for extended periods. This technology supports better health care access, allowing clinics to keep vaccines on hand and readily available, thus reducing the need for patients to travel frequently and ensuring consistent immunization coverage across rural areas.

CDC Africa began working with South Sudan in Akobo in 2018, installing 90 solar-powered refrigeration units that allow vaccine storage for up to seven days longer than if they arrived straight off of shipment, ensuring vaccine access for thousands more individuals across the country, particularly in rural areas. These refrigerators hold vaccines at near-freezing temperatures throughout their travel. This reduces a significant obstacle to receiving care for preventable diseases in a country where, on average, one out of 17 children die before their first birthday.

Addressing Hunger With Renewable Energy

Almost half of South Sudan’s population is currently facing “crisis-level” hunger, about 6.3 million people. Many households rely on subsistence farming, lacking any means of food storage, leaving them vulnerable to natural disasters. These solar pumps harness the sun to power sensor-driven drip irrigation throughout villages in South Sudan, fostering a sustainable means of agricultural production while fighting increasingly common effects of climate change such as unpredictable floods and droughts, according to the Rainmaker Enterprise.

Solar-powered Water Pumps

Another way forward is the construction of solar-powered water pumps to disperse water to crops all over the country, increasing yields and providing food sources for populations already struggling with hunger and malnutrition.

Since 2020, Rainmaker Enterprise has made serious strides toward expanding locally-driven, solar-powered water security, increasing environmental resilience and decreasing reliance on expensive, polluting fuels. In 2020, Rainmaker finished installing their first solar-powered irrigation system in Thiet, South Sudan, serving more than 3,000 people. Their holistic approach broadened regenerative agriculture over a 12-acre plot, co-designing projects with communities, installing solar-powered drip irrigation pumps, training and employing farmers and supporting distribution.

Off-Grid Expansion and ApTech Africa

Off-grid expansion could be a major step towards increasing access to and awareness of renewable energy in South Sudan. Distributed renewable energy, or decentralized energy access, brings power directly to rural and underserved communities without relying on a centralized grid. This approach not only accelerates electrification but also empowers local communities by providing them with a sustainable and resilient energy source tailored to their specific needs. Additionally, off-grid systems—such as solar home kits and mini-grids—reduce dependency on costly and polluting fuels, creating a pathway for long-term economic growth and environmental benefits.

ApTech Africa, established in South Sudan in 2011, specializes in delivering off-grid solar solutions and home energy systems tailored to meet the needs of underserved communities. By installing reliable and sustainable solar-powered systems, ApTech Africa empowers households with clean energy, improving access to electricity, enhancing quality of life and supporting long-term environmental and economic sustainability. Furthermore, in 2016, ApTech Africa marked a significant milestone in increasing renewable energy in South Sudan by commissioning photovoltaic (PV) systems for teaching institutions, pioneering the use of lithium-ion battery technology in the region. These systems enabled schools to operate seamlessly without dependence on unreliable grid connections or expensive diesel generators. This project was among the first of its kind in South Sudan, showcasing an innovative approach to providing reliable, off-grid energy solutions. 

Looking Ahead

South Sudan is at a crossroads in terms of its ability to electrify the nation. Looking forward, the path toward clean, renewable energy is both cost-effective and environmentally conscious, resulting in increased energy security, sustainability and community resilience. As renewable projects like UNMISS’s solar farm in Juba illustrate, investing in solar and other renewable infrastructure can significantly improve access to electricity for both urban and rural populations, stimulating economic growth and enhancing quality of life across the nation.

– Katherine Ager

Katherine is based in Bulubandi, Iganga, Uganda and focuses on Global Health and Politics for The Borgen Project.

Photo: Flickr

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Addressing Health Initiatives With Oxfam in South Sudan

Addressing Health Initiatives With Oxfam in South SudanSouth Sudan is a country facing significant challenges due to ongoing conflict and instability. To address this, Oxfam is supporting health and nutrition initiatives that significantly benefit communities in South Sudan. This organization has been active in Sudan for more than 30 years and is helping families rebuild their lives. After becoming an independent state just over a decade ago, South Sudan became caught in conflict when war arose in Juba in 2013, becoming one of the many new hosts of 2.5 million refugees living in poverty.

Taking Action

Oxfam’s health interventions include installing wells remote water and sanitation stations, increasing food security and protecting land rights and natural resources, particularly for farmers. Oxfam has provided aid by distributing food to more than 415,000 individuals and helping more than 140,000 people reach clean water and sanitation stations throughout their time in the country. 

It is increasing access to these resources by prioritizing the islands closest to Nyal, where a majority of families are coming from. To support the influx of people coming in, Oxfam provides emergency services to communities by increasing gardens, water storage points, bathing facilities and providing cooking and farming supplies. This empowers communities to rebuild their livelihoods to support their families long-term. The number of refugees seeking aid in the country has increased 10 times since gaining independence, reaching about 107,000 people in 2012.

Hunger

In addition to an increase in refugees, more than half of the population of South Sudan already lives in extreme hunger. The state relies heavily on imported foods and with the impact of border conflicts making imports less accessible, inflation is at a high. Increasing food prices make it more difficult for people to feed their families, increasing widespread famine and malnutrition. Not only does Oxfam provide families with the tools necessary to restabilize, but it also teaches them efficient farming and planting techniques. These processes could improve their crop yield and soil fertility, ensuring successful food production for future generations. 

Impact of Flooding in South Sudan

The country has faced severe floods for consecutive years since 2018, now leaving approximately 70% of the country covered in water. This destroys homes, farmland, schools and health centers and washes away roads, making transportation and importation incredibly difficult. Due to heavy periods of rainfall, flooding disperses and does not permeate the already saturated soil, making large portions of land inaccessible. This increases displacement as communities lose their homes, farmland and livestock. In turn, this increases the number of individuals requiring food, shelter, clean water and medical aid, increasing Oxfam initiatives throughout the entire country. 

Canoe Vouchers

A town in South Sudan that has been especially welcoming to refugees, Nyal, has become home to many individuals searching for food and shelter. Through support from Oxfam and Irish Aid, the community offers canoe transportation to and from Nyal based on a free voucher system to help displaced individuals access food and medical care. Traveling by foot is considered unsafe for women, making canoe transportation the more efficient and protected route, taking about three days to cross the swamps. This program also provides jobs for community members, allowing both men and women to establish a stable income to support their families for the first time since 2013. 

Supporting Women

Oxfam is specifically addressing issues of under-reported instances of sexual violence against women in South Sudan. In heightened periods of conflict, sexual exploitation is used as a war tool and is often overlooked regarding the outcomes of war. Oxfam is creating safe spaces to offer medical aid and educate women about their rights. Women are encouraged to find a sense of community among each other and to feel empowered to ensure their rights are not violated. 

At the Jamam camp located in the Upper Nile region, Oxfam conducted research to ensure safe and clean access to water collection points and lavatory facilities. A survey revealed that more than 10% of women felt there was not enough privacy in public restrooms, Oxfam increased separation and staffing, prioritizing the safety and wellbeing of these women. Prioritizing privacy as well as sanitation also helps prevent the spread of diseases. Staff is constantly reviewing feedback and comments from community members on how these resources can be improved. 

Overall Impact in South Sudan

These ongoing efforts increase community resilience, improve health and reduce poverty. Oxfam is critical in on-ground relief for refugees and struggling communities in Sudan and regions across southern Africa. Oxfam supports more than 500,000 individuals in these areas with long-term and emergency care. It is actively working to provide access to clean water and sanitation for 90,000 people in South Sudan and is working to reach a goal of $7 million to expand its reach to aid 400,000 people. The organization has been incredibly successful in addressing health concerns and rising poverty levels through life-saving initiatives with Oxfam in South Sudan. These major efforts providing health aid to those displaced have been incredibly beneficial to families looking to reestablish their communities and stability in uncertain times.

– Lauren Sellman

Lauren is based in Rochester Hills, MI, USA and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr

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Child Marriage: An Obstacle to Education for Girls in South Sudan

Education for Girls in South SudanIn South Sudan, about three-fourths of girls don’t attend primary school. As the world’s newest country, South Sudan has struggled with economic and political downfalls, resulting in war, violence and the destruction of schools. Alongside high child marriage and teen pregnancy in South Sudan, it’s difficult for girls to attend school or even to have the option of an education at all.

Economic, social and political changes have to be made to provide a better education for girls in South Sudan. From state-issued fundraising to environmental amendments, more girls will be able to attend school. With more girls in school, cases such as child marriages will begin to decrease, resulting in a brighter future for girls nationwide.

Social Issues

One of the many social, controversial issues plaguing South Sudan is the high rate of child marriages. Approximately 52% of South Sudanese girls are married before age 18. According to Girls not Brides, “Child marriage is driven by gender inequality and the belief that girls are somehow inferior to boys.” Additionally, “Increased school dropout rates push young girls toward marriage and early pregnancies.” Without key motivating factors to keep girls in school, many choose to drop out or not attend at all.

Economic Issues

In 2023, the United Nations Children’s Fund (UNICEF) reported that 70% of the South Sudanese population lives in poverty. According to Girls not Brides, “Child marriage is used as a coping mechanism in response to economic and food insecurity. Families from the poorest households in South Sudan marry off daughters in order to receive dowry.” This is a common practice in South Sudan and raises little to no concerns among citizens.

A 16-year-old South Sudanese girl by the name of Atong was forced to marry a 50-year-old man in July 2011. A 16-year-old South Sudanese girl by the name of Atong was forced to marry a 50-year-old man in July 2011. “I did not know him before. I did not love him,” she said. “I told my family, ‘I don’t want this man.’ My people said, ‘This old man can feed us, you will marry him.”

Political Issues

According to Human Rights Watch (HRW) on child marriage, “There are also gaps in the Transitional Constitution, Penal Code and Child Act related to this harmful practice—including no minimum age of marriage —and no systematic or comprehensive programs to address the root causes of child marriage at the community level.” The Transitional Constitution, for example, “…does not set a minimum age of marriage. Instead, it states that every person had the right to marry a person of the opposite sex and that no marriage shall be entered into without free and full consent.”

This makes it nearly impossible for girls to attend school due to their responsibilities as a wife. According to Broken Chalk, “Shockingly, a girl in South Sudan is more likely to die in childbirth than to complete primary education.” South Sudan lacks a legal framework surrounding many things, including educational requirements. Therefore, the rules and laws are fuzzy and underdeveloped. Additionally, “A lack of quality teaching staff and inadequate school buildings are challenges that add to extreme poverty, as families desperately work for the next meal.”

Solutions

While South Sudan is far from exemplary in educating girls and young women, there are possible steps that could be taken to move toward improvements. Child marriage hinders a girl from receiving an education,and to combat this, organizations like the African Union and UNICEF have been collaborating with the government and other partners to raise awareness about the dangers. They are advocating for laws to protect young girls and working to change cultural and social norms that negatively impact them.

For example, UNICEF’s flagship Communities Care Program, designed to “promote gender-equitable and positive social transformation norms,” established 29 community discussion groups and engaged more than 800,000 people in awareness-raising activities. In 2020, the program expanded to tackle sexual violence, teenage pregnancies and child marriage in South Sudan, with 74% of participants reporting positive changes in their beliefs and attitudes.

Although child marriage is still prevalent in South Sudan, with continued efforts from the government and nonprofit organizations like UNICEF, the nation is making great strides toward reducing the incidence and improving the well-being and rights of its young girls.

– London Collins Puc

London is based in West Palm Beach, FL, USA and focuses on Global Health, Politics for The Borgen Project.

Photo: Flickr

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Addressing Sanitation in Overcrowded South Sudan Transit Centers

Addressing Sanitation in Overcrowded South Sudan Transit Centers On 29 February 2024, Oxfam warned of the increasing threat of outbreaks of diseases due to overcrowded South Sudan transit centers. Amid Sudan’s conflict fallout, Renk transit centers in South Sudan are bursting at the seams, accommodating more than half a million displaced individuals, three times its capacity. With more than 300 people sharing one water tap, Oxfam raises the alarm over heightened cholera risk due to inadequate sanitation.

Escalation of the Humanitarian Crisis in South Sudan

Since its civil war, South Sudan has been an epicenter of humanitarian crises. Extreme violence and food insecurity have left an estimated number of 9.4 million civilians in desperate need of humanitarian assistance. Last year’s conflict in Sudan, which emerged in April, exacerbated existing problems, also encumbering overcrowded South Sudan transit centers. The United Nations Mission in South Sudan (UNMISS) reported 920 violent incidents in three months in 2023, resulting in 405 deaths and more than 600 injuries and abductions. More than 300,000 refugees fled to South Sudan, encountering severe conditions in transit centers.

Overcrowded South Sudan Transit Centers

This crisis worsens the existing cholera challenges in overcrowded transit centers in South Sudan, with 1027 prior cases, prompting urgent calls for intervention to avert disease outbreaks. Currently, Renk’s transit centers, designed to accommodate 4,750 people, now house 15,000, with many more living in open areas without access to water or hygiene facilities. An Integrated Food Security Phase Classification report reveals that 46% of South Sudan’s population faces high levels of acute food insecurity, underscoring the critical need for increased international humanitarian funding.

In addition, Oxfam and its partners have successfully delivered clean water and adequate sanitation to more than 70,000 individuals within overcrowded South Sudan transit centers. However, 7 million dollars is needed to expand humanitarian operations, aiming to provide life-saving food, clean water and sanitation facilities to 400,000 people.

Declining International Funding and Its Impact

International efforts have introduced sanctions against South Sudan by the EU and the United Nations Security Council to address ongoing conflicts. Despite these measures, financial contributions to humanitarian aid have seen a significant decline since 2014. In 2024, funding for South Sudan’s Humanitarian Needs and Response Plan drastically fell to only 3.6% from 51% in 2023, with the EU being the largest donor, contributing 49.5 million Euros.

These funding cuts threaten the execution of critical humanitarian operations within the country. Moreover, Germany leads as the primary donor for South Sudan, contributing 26.2% of the total humanitarian funding reported. In contrast, the United States (U.S.) and Canada are among the lowest contributors, with the U.S. providing only $3,826,798.

Future Prospects for South Sudan Transit Centers

The critical situation in South Sudan’s transit centers underscores a growing need for international solidarity and increased humanitarian aid. Oxfam’s efforts, alongside those of its partners, are pivotal in mitigating the immediate threats of disease and providing necessary resources to those displaced by conflict.

Despite funding challenges, the global community’s commitment to supporting South Sudan can catalyze meaningful change and offer a lifeline to millions in need. The road to recovery is steep, but with sustained support and strategic interventions, there’s hope for a healthier, more secure future for South Sudan. Every contribution, big or small, plays an essential role in building resilience against the cascading effects of humanitarian crises, marking a path toward stability and well-being in the region.

– Naomi Ronner
Photo: Flickr

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3 Nonprofits Providing Relief to South Sudanese Refugees

3 Nonprofits Providing Relief to South Sudanese RefugeesIn the aftermath of Sudan’s brutal civil war of 1983-2005, which tallied approximately 2 million deaths, two separate states emerged in 2011. The southern territory became the Republic of South Sudan, primarily home to Christian and indigenous animist religious groups. However, violence persisted as unresolved conflicts between Sudan and South Sudan, including border disputes and religious differences. Consequently, brutality against South Sudanese refugees, including degrees of sexual violence, is labeled appalling by the United States (U.S.) Department of State.

Seeking a life free from brutality, more than 4 million people, 65% of whom are children, have fled the country as refugees. The United Nations High Commissioner for Refugees (UNHCR) recognizes Ethiopia, Kenya and Uganda as the primary host countries for South Sudanese refugees. The rest of this article will examine the nonprofits operating in these countries to deliver aid.

South Sudanese Refugees and Amnesty International

Amnesty International tackled the refugee crisis by documenting hardships and urging the global community to honor its financial pledges. In 2017, it emphasized Uganda’s crucial role in hosting 1 million South Sudanese refugees, underscoring the urgent need for improved support and resources.

In addition, the organization actively engaged in the refugee crisis by dispatching researchers to assess the situation in four refugee camps, highlighting the severe funding shortfall’s impact on necessities like food, water and shelter. It found a desperate demand for food, water and shelter. By May 2017, Amnesty International observed that 82% of the pledged funds to the UNHCR remained unmet, exacerbating the food scarcity and worsening living conditions in the camps.

However, the organization, with the UNHCR, the World Food Program and 57 other aid agencies, pushed for substantial improvements in funding increases. Consequently, UNHCR’s funding receipt improved to 46% by 2023, compared to the previous 18%.

The Bill and Melinda Gates Foundation

Since 2006, the Bill and Melinda Gates Foundation has been active in refugee aid, focusing on emergency response and programs addressing global displacement. It emphasizes support for African refugee camps, partnering with UNHCR to launch the Saving Newborn Lives in Refugee Settings project in countries including South Sudan, Kenya and Ethiopia, benefiting South Sudanese refugees.

In addition, the project emphasizes family planning and newborn health, equipping health facilities with essential equipment, supplies and oversight, along with offering training and mentoring. These efforts significantly enhance the capacity of health workers at refugee sites to deliver neonatal care services.

The program has been designed to provide knowledge in infant resuscitation and how to prevent post-partum hemorrhage. Knowledge of newborn care essential to its survival has also been disseminated, to decrease infant mortality rates in the two years after birth.

Furthermore, the Gates Foundation collaborates on initiatives to enhance sanitation at refugee camps. Its Waste-to-Value projects introduce advanced technologies, including container-based toilets that convert waste to energy. The UNHCR highlights these efforts as crucial for improving sanitation at refugee sites.

The International Rescue Committee (IRC)

Since 1989, the IRC has been a major aid provider in southern Sudan, focusing on health care improvement, including training health workers and enhancing nutrition and sanitation services. It has put South Sudan on crisis watch, dedicating efforts to strengthen health care infrastructure and support services.

Moreover, the program’s training encompasses collaboration with health workers on essential and reproductive care, enhancing community leaders and urging government officials to support survivors of sexual violence.

The IRC provided aid to 1.1 million South Sudanese refugees in 2019 through its nutrition services and well restoration, combating disease spread. The IRC’s comprehensive training programs aim to rebuild displaced lives and foster peace. Highlighting the importance of donations, the IRC underscores that continuous financial support is crucial for refugee families to survive, recover and rebuild.

– Kayleigh O’Brien
Photo: Unsplash

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The Lost Boys: Rebuilding Literacy in South Sudan

The Lost Boys: Rebuilding Literacy in South SudanLiteracy in South Sudan is a significant challenge, with many women, girls and children queueing daily at wells to fetch water for their families. The program, Literacy at the Well, transforms their waiting time, often exceeding an hour, into a learning opportunity. This innovative initiative offers reading and writing lessons, effectively utilizing the time spent at communal water sources for educational purposes.

Literacy at the Well is an unconventional literacy program. It has been recognized by the United States Library of Congress as a best practice program in the area of Gender Equity and Maternal Literacy. The Literacy at the Well program, launched by the nonprofit organization Lost Boys Rebuilding Southern Sudan (LBRSS), aims to teach South Sudanese women to read and write. Founded in 2005 by South Sudanese refugees, known as the Lost Boys, LBRSS targets the critical literacy challenge in South Sudan.

The Lost Boys

In the 1980s, civil war in Sudan displaced or orphaned 26,000 children, ages 5 to 15, from the Nuer and Dinka ethnic groups. Of those who fled Sudan, only 13,000 reached the Kakuma Refugee Camp in Kenya a year and some 1,000 miles later. They became known as the Lost Boys of Sudan because they arrived at the camp without their parents and separated from their families. These boys spent most of their childhood in refugee camps before resettling in the United States (U.S.).

In 2001, nearly 4,000 of these boys found refuge in the U.S., with many settling in Chicago. The International Rescue Committee assisted hundreds of them in starting new lives in cities across the country. The film “The Good Lie,” released in October 2014, highlights the physical, emotional and educational journey of the Lost Boys.

Literacy Rate in South Sudan

As of 2021, South Sudan holds the lowest adult literacy rate for individuals aged 15 and older, with more than 70% of its population under 30 years and half unable to read or write. The country also has approximately 2.8 million children out of school, representing the highest global proportion of out-of-school children. Moreover, a lack of education could keep South Sudan from developing, realizing its citizens’ full potential and breaking its dependency on external support.

The Vision Becomes a Reality

LBRSS raised funds to build schools and provide education in South Sudan. Yet, upon the completion of the first school, no girls attended. Recognizing that girls play a crucial role in spreading education within their families and communities, Ms. Wendi Dwyer, LBRSS’s executive director, joined the effort after meeting Arkangelo, a Lost Boy and founding member of LBRSS, who sought her assistance.

As LBRSS prepared to open a primary school, it found the building filled with women and girls seeking shelter from the sun while waiting to fill their water jugs. Upon being asked if the girls wished to learn to read and write, nearly all responded affirmatively. Thus, Literacy at the Well came into existence.

The Cost Explained

Providing a community with a teacher costs $4,000. Every dollar supports teacher training, salaries and supplies. South Sudan communities contribute by recruiting, training and hiring residents as teachers. Furthermore, these educators rely on students to extend their instruction by sharing lessons with neighbors, children, sisters and husbands.

Currently, LBRSS has 6 sites in 6 communities. Each site serves more than 200 women and girls. In addition, it has built the Malualkon Community Learning Center where more than 400 students attend classes each day.

Looking Ahead

The Literacy at the Well program in South Sudan is pioneering a transformative approach to education, turning everyday chores into opportunities for learning and empowerment. By tapping into the communal spirit at water wells, this initiative is not just teaching women and girls to read and write but is also fostering a culture of education that resonates throughout communities. Above all, the promise of literacy beckons a future where knowledge flows as freely as the water, enriching lives and nurturing the seeds of development and equality.

– Pamela Fenton
Photo: Unsplash

The 5 Deadliest Diseases in South Sudan

Deadliest Diseases in South SudanSouth Sudan is a country in North Africa, bordering the Central African Republic, Sudan, Ethiopia, Kenya, Uganda and the Democratic Republic of the Congo. According to the World Bank, the world’s youngest country is experiencing a humanitarian crisis and two-thirds of the 11.4 million population is in need of humanitarian assistance. Of note, the World Health Organization states the average life expectancy is only 57 years of age. The rate of maternal deaths is 789 per 100,000 live births, 37.9 for neonatal deaths and 90.7 per 1,000 live births for children under 5. Communicable diseases are the leading cause of death, with malaria, diarrhea and pneumonia being the biggest killers of children under 5. Below are the deadliest diseases in South Sudan.

The 5 Deadliest Diseases Impacting South Sudan

  1. Pneumonia. In 2019, UNICEF reported that one child dies every hour from pneumonia, leading to 7,640 deaths of children under 5. In 2018, 20% of deaths among children under 5 were caused by pneumonia. The disease causes suffocation by the lungs filling with fluids, and is caused by infection from bacteria, viruses or fungi. In places with malnutrition, inequality, high levels of air pollution and unsafe water, pneumonia is likely to be found. It can be avoided by vaccines, having safe water to drink, handwashing and treatment of antibiotics.
  2. Malaria. According to Malaria Consortium South Sudan, “approximately 95% of South Sudan is endemic of malaria, with high transmission in the country throughout the year.” This translates to 2.3 million people who are at risk of malaria nationwide. Of note, 50 to 70% of all health facility visits and hospital admissions are caused by malaria. Its symptoms appear up to two weeks later, which include having a fever, headache and chills before progressing. The disease is caused by parasites and mosquitoes through bites but can be treated and prevented by vaccines, chemotherapy and vector control.
  3. HIV/AIDS. UNAIDS states that 2.5% of 15 to 49-year-olds have HIV in South Sudan as of 2020. One in four people is knowledgeable about their HIV status, whereas only 18% of people are being treated. UNAIDS has a 90-90-90 target of supporting people with HIV, and over five years has trained 69 peer educators and navigators, given out over six million male and female condoms, and over 500,000 water-based lubricants, and has diagnosed and treated 1,271 HIV cases after thousands of gender-based screenings as of 2021. HIV could lead to AIDS if left untreated, and is transmitted by bodily fluids, childbirth and using unsafe or shared needles. There’s currently no cure, but it can be treated by antiretroviral drugs and therapy.
  4. Cholera. In 2014, South Sudan’s capital city of Juba had an outbreak of cholera that hit multiple counties. There were 586 confirmed cases with 22 total deaths. The Ministry of Health created the Cholera Response Task Force to “strengthen the coordination of the outbreak response and support the emergency response task forces in all 10 States.” Cholera is caused by unclean water in unsafe sanitation areas where bacteria cause acute watery diarrhea. It can be treated by oral rehydration solution and prevented by oral cholera vaccines. Without treatment, cholera can lead to death within hours.
  5. Hepatitis E. This disease impacting South Sudan has been on the rise since 2014, with cases increasing from 564 in 2020 to 1,143 in 2021 with five deaths. Males aged 15 to 44 years had the most cases, then male children ages one through four, and lastly, females aged 15 to 44 were also reported to have the greatest number of cases. Hepatitis E is spread through fecal-oral contact that progresses into liver disease. Internally displaced-people camps and pregnant women are most at risk in South Sudan.

Looking Ahead

To combat the deadliest diseases in South Sudan, the Ministry of Health created a five-tier plan called the “National Health Policy,” running from 2016 to 2026. The first tier reduces maternal and child death rates by introducing more technical equipment and professional staff members. The second tier is to prevent all communicable, non-communicable and tropical diseases. The third tier improves emergency management, surveillance and recovery. The fourth tier supports specific-health needs. Finally, the fifth tier reduces environmental factors and promotes awareness of social health factors.

– Deanna Barratt
Photo: Flickr

Healthnet TPO: Improving Mental Health in South Sudan

Mental Health in South SudanDecades of war have had a notable impact on mental health in South Sudan. Few resources are available to help those suffering from trauma and stigma deters people from seeking mental health assistance. Despite how dire the situation is, organizations are stepping up to improve mental health within the young nation.

A History of War

Beginning in 1955, South Sudan has fought three civil wars. The first lasted from 1955 to 1972, the second from 1983 to 2005, and the third, starting after the nation’s independence in 2011, lasted from 2013 until 2018 when warring parties agreed to peace deals. The third civil war alone led to about 400,000 deaths and 4 million displacements.

Even after the agreement, violence remains common. Communities continue to fight “over land, cattle and grazing” and the fact that “political and military leaders” provide locals with weapons further exacerbates the violence. The violence between South Sudanese communities has led to “hundreds of thousands” of deaths and displacements across the country, adding to the nation’s collective trauma.

Mental Health in South Sudan

Information on mental health in South Sudan is limited, but South Sudan Health Cluster estimates indicate that about 5.1 million of the nation’s 11 million people are affected by the war. Specifically, 204,000 suffered severe mental health conditions and 1,020,000 experienced “mild to moderate mental health conditions.” These conditions include post-traumatic stress disorder (PTSD), anxiety and depression.

In 2015, the South Sudan Law Society and the United Nations Development Programme conducted a study that found that out of a group of 1,525 individuals across six states, about 41% met the criteria for PTSD. Despite how widespread mental illness is in the country, less than 1% of people are receiving the necessary treatment, according to the World Health Organization in 2017.

The Complex Mental Health Situation

There are only three practicing psychiatrists and 29 practicing psychologists in the entire country, all of whom are positioned in the capital city of Juba.

Furthermore, stigmas and taboos stand as barriers to addressing mental health in South Sudan. Many believe mental illness “runs in the family,” so if one member is diagnosed, then the rest become social outcasts. In fact, “Most communities believe in supernatural possession or punishment by higher powers, as opposed to accepting a mental illness diagnosis,” South Sudanese psychiatrist Dr. Atong Ayuel tells Al Jazeera. A possession is preferable to mental illness, so people seek assistance from religious institutions instead of mental health care practitioners.

Some believe faith is the cause of their recovery rather than treatment. Paradise Akaag Henry, a schizophrenic patient under Dr. Atong’s care tells Al Jazeera the reasons for her recovery. “First of all Jesus, and then Dr. Atong.”

Mental Health and Poverty

Mental illness and poverty are linked in several ways. Those living without treatment may not function well in their community and receive “limited employment opportunities,” pushing them further into poverty. Adolescent pregnancy and domestic violence rates tend to increase in circumstances of poverty.

In Glasgow, Scotland, a study found that 7.3% of 4-year-olds born into poverty showed “abnormal social, behavioral and emotional difficulties” compared to 4.1% for those not born into poverty. This prevalence increased by age 7 to 14.7% for impoverished children and 3.6% for wealthier children.

Also, the stresses from poverty, like long work hours, can affect cognitive function, which can lead to poor decision-making and increased susceptibility to mental illness.

A 2013 research study published in the journal Science found that the psychological burden created by poverty is the equivalent of “losing 13 IQ points.”

Action to Improve Mental Health in South Sudan

To fight mental illness in South Sudan, Médecins Sans Frontières (MSF), a nonprofit organization started in 1971 by medical professionals, “launched an emergency intervention in Tambura County in December 2021″ after large-scale violence plagued the area.

MSF Mental Health Activity Manager Ariadna Alexandra Pérez Gudiño and a group of four counselors from Tambura set up “community-based mental health services” across displacement camps. These services included “one-to-one counseling sessions, referral pathways for those in need of further treatment or medication and group psychosocial health sessions.”

Psychosocial group sessions included creative activities such as dancing, singing, creating jewelry and drawing. The psychosocial activities are particularly helpful as the sessions give residents an opportunity to process their trauma together. Between January and July 2022, MSF held “more than 11,500 individual and group” sessions across seven projects taking place throughout South Sudan. In June 2022, with the situation improving, MSF handed over its mental health programs to local health care workers.

Healthnet TPO

Healthnet TPO, established in 1992 by MSF, aims to “bridge the gap” between emergency aid and “long-term structural development.”

Its program, called Leaders of Peace, works to provide psychosocial and self-care services for women subjected to gender-based violence, alter society’s attitude toward women to improve gender equality and increase women’s participation in “leadership, decision-making and peacebuilding processes.”

The specifics include establishing community-based mental health programs across 50 communities in five South Sudanese states and placing 50 trained individuals in 50 women groups to manage gender-based violence cases, community engagement, mobilization, mental health advocacy and more. These individuals will also “strengthen different community groups” and advocate for mental health services and the passage of gender-based violence laws. The program will last from 2021 to 2025.

Through continued mental health efforts, the conflict-affected nation of South Sudan can move past its collective trauma and look to a brighter future.

– James Harrington
Photo: Wikimedia