Bentiu, South Sudan - The onset of the rainy season has further exacerbated the ongoing humanitarian crisis in South Sudan. The UN warns that up to four million people are at risk of food insecurity, with young children facing the highest risk of malnutrition.
One-year-old Chieng has been battling for his life for weeks. His father Peter sits by his side, fending off the relentless assault of flies. Chieng suffers from acute diarrhoea, suspected TB and is fighting respiratory failure. His ribs protrude visibly through his thin skin as his chest rapidly pumps air into his tiny body.
Chieng is one of 58 children admitted to Doctors without Borders (MSF) intensive therapeutic feeding centre in Bentiu's UN Protection of Civilians (POC) site. Peter expresses hope that Chieng is getting better and says this clinic is his only chance for survival. As he speaks, a thunderstorm erupts, putting an end to a week-long dry spell unusual for this time of the year. Within minutes, the camp gets submerged in mud and water.
Some of the medical staff fear that the latest downpour will bring a new wave of admissions - and deaths. "The children are already malnourished and have very little fat to keep them warm. When it rains, they easily develop a cough or catch pneumonia, which makes their condition very serious," Helmi Emmen, a paediatric nurse at the MSF clinic, told Al Jazeera. The next morning she tells Al Jazeera that Chieng was one of three children who passed away overnight.
Child mortality in Bentiu's POC site has reached alarming levels, with approximately four children below the age of five dying per day. Aid workers fight an uphill battle against the deplorable water and sanitation conditions in the camp, which provide fertile ground for diseases.
"Repeating cycles of infections accompanied by a drop in appetite often result in children eventually developing malnutrition. They never quite get better before the next infection comes along," Vanessa Cramond, MSF's health adviser, explains.
Crowded conditions and nowhere else to go
Approximately 45,000 internally displaced persons (IDPs) have sought refuge at the POC site near Bentiu. They constitute the largest share of over 100,000 people currently living in UN bases as a result of South Sudan's most recent violent conflict . An additional million are displaced around the country, and unlikely to return home anytime soon given the lack of respect for the ceasefire by government and opposition forces.
With the increasing likelihood of a protracted humanitarian crisis, the UN and NGOs are trying to cope with the overcrowded conditions in Bentiu camp. "We are trying our best to catch up with the needs but it ' s very difficult with the rainy season plus the insecurity outside," says Nora Echaibi, medical team leader at MSF Bentiu.
We only eat once per day.
As of mid-June, only four litres of clean water were supplied per day compared to the minimum international standard of 15 litres, forcing many people to draw water from contaminated water sources. Only one pit latrine is available per 241 people, resulting in substantial open defecation around the camp. Heavy rains and muddy soil pose additional logistical challenges for water and sanitation teams trying to expand and maintain critical infrastructure.
With ongoing insecurity and fighting outside the UN base, the population has been largely reliant on food aid. The WFP conducts biweekly food distributions, yet ensuring families get the right amount of nutritional intake has proven difficult given high fluctuations in population levels as well as frequent sharing with families within, as well as outside the camp.
"We only eat once per day," Mary Nyajak, a mother of 10 told Al Jazeera. Four of her children stay with her inside the camp, while six others hide in the bush attending to the family's cattle. "Sometimes family members come here and we give them food which they take back," Nyajak says. Sharing food with extended families often means that children, the weakest members of the family, fall short of their requirements.
Severe food insecurity risk
Aid agencies warn that the rainy season further compounds the humanitarian crisis which already affects almost a third of South Sudan's population of 11.3 million. According to UN estimates, 3.5 million people suffer from food insecurity, a number expected to increase to 4 million by August. Although famine has not yet been declared and most people fall into categories three (acute food insecurity) and four (humanitarian emergency) on the UN's five scale integrated food security phase classification, the situation could quickly deteriorate.
We give the assistance to the right people, but ensuring they hang on to it is difficult.
"We are very worried about this population of 3.5 million, particularly those in phase four, because additional shocks, such as the lack of access to humanitarian assistance or continued inability for traders to come in with commercial goods, means that the population is extremely vulnerable to further decline," Sue Lautze, deputy humanitarian coordinator and head of FAO in South Sudan told Al Jazeera.
Diversions of aid from intended beneficiaries to other parts of the population, including armed groups, risk further diluting of relief efforts. Only a few kilometres away from the Bentiu POC site, USAID grains openly get sold in the Rubkona market. Many of the customers here are SPLA soldiers from Rubkona's fourth division.
Sue Lautze says aid diversions are difficult to trace. "We give the assistance to the right people, but ensuring they hang on to it is difficult. But we are currently investigating allegations of food diversion."
The past six months of conflict further exacerbates the effects on long-term food security. Massive displacements and ongoing fighting have prevented farmers from tending to their fields. Development programmes aimed at increasing farming productivity and livestock health have come to a grinding halt, thus laying the foundations for long-term dependency on humanitarian aid.
Funding and access constraints
Despite the growing needs, international donor support has fallen short of the requirements thus far. Only $756m have been received towards the $1.8bn consolidated humanitarian appeal to cover the ongoing emergency in 2014.
A lack of funding has been further compounded by a 30 percent drop in oil production as a result of the conflict, prompting the government to cut much needed development funds in favour of other spending areas. "We are producing 175,000 barrels [of oil] per day, which is sufficient to pay for the salaries of those who work for the government, but in the area of development, the impact has been very bad," Ateny Wek Ateny, the spokesperson of the Office of the President, told Al Jazeera.
Gaining access to vulnerable populations has been a challenge amid ongoing fighting. Some areas are off limits to aid agencies, while the situation along the front-lines complicates liaison with the relevant authorities to ensure smooth passage of aid. The proliferation of armaments within the population along with a rising number of often autonomous checkpoints implies that orders from the top do not always get respected on the ground.
WFP has recently confirmed instances of looting which tend to occur especially when areas change hands between the government and rebels. “More recently 4,600 metric tonnes were looted, which is enough to feed a population of 275,000 people per month,” Joyce Luma, WFP’s country director in South Sudan told Al Jazeera.
With the indefinite adjournment of peace talks, and the lack of a mechanism to enforce the ceasefire, hostilities as well as the humanitarian crisis are unlikely to subside. " The main problem is that they are fighting. The lack of respect for the cessation of hostilities agreements is the number one access constraint, " Lautze told Al Jazeera.