Sudan in Crisis

Some people and organisations are questioning the severity of the situation in South Sudan. As an organisation working in 7 locations in Bahr-El-Gazal, Médecins Sans Frontières confirms that the population is facing a dire situation. We would like to share with you the following data and thoughts.

Three nutritional and retrospective mortality surveys have been carried out by Epicentre and MSF in 3 different locations of Bahr-El-Gazal: Ajiep, Panthou and Mapel. The methodology included mapping to estimate the size of the population over a radius of 3 - 5 km from the airstrip in each of the locations and then a 2 stage cluster sampling survey. (The Primary results are shown in the table below).

These indicators represent a more serious situation than famines in Somalia (1992) and Korem (Ethiopia) in 1984. They also show big differences between displaced and resident populations. The problem is not restricted to only one or two specific places in Bahr-El-Gazal. Routine mortality surveillance^* has been established in several places and the first figures collected showed a similar mortality rate in Acumcum and Bararud (around 25/10,000/d). Even in Mapel, where the situation appeared to be less critical, the mortality rate is over 15/10,000/d.

In the rural part of three counties of Bahr-El-Gazal (Wau, Gogrial and Aweil east counties), MSF is running supplementary and therapeutic feeding programmes in 7 places (Mapel, Bararud, Acumcum, Ajiep, Panthou, Panliet and Thiekthou). Due to capacity limitations the admission criteria for SFPs have been lowered to cut-offs which are
normally used for admission in Therapeutic feeding centres . Today there are more than 12,000 beneficiaries enrolled in the SFP. The number of weekly admissions to SFP is now increasing, (in Bararud and Acumcum there are 330 and 200 admissions in a week respectively). Many adults and adolescents are admitted to the feeding centres which is a further sign of the seriousness of the situation. In Bararud now, some adults and children are found dead in the morning at the doors of the feeding centres. We are also witnessing this pattern in Ajiep and Panthou.

In the face of this evidence can we still doubt the reality of a famine and its extent?

We are very concerned about the future. Because, even if the harvest starts soon, it will be far from sufficient to cover the needs of this
population. And we fear that this dire situation will last until next year. To date even with many organisations (UN and NGOs) responding to the crisis, it is still not enough to meet needs. We know that war in Sudan has been going on for too long and that its consequences result in a harrowing and hopeless situation for the population. We acknowledge that the only lasting solution will be a political one rather than relief and nutrition related interventions. But this does not mean that we should deny the extent of the problem or accept mortality rates at this level.

Everyone is concerned by the situation but as professional nutritionists, what can we do?

Fabienne Vautier, MSF Belgium.

^*ICRC and MSF Holland confirmed the severity of the situation adding a CMR: 10-15/10,000 per day in Waw and malnutrition rates of 43,4 % Global and 19.7 % severe malnutrition. Once again returnees and displaced suffered higher PEM prevalence than did residents. Of great concern also is the high proportion of unaccompanied minors - 4.1% in the population.