South Sudan Complex Emergency Fact Sheet #12

September 30, 2017

Highlights

• Cholera transmission declines countrywide, persists in Budi and Juba counties.
• WFP reaches 4.5 million people with food assistance to date in 2017.
• Relief actors record 830 humanitarian access incidents from January–September.

Key Developments

On September 21, the U.S. Government (USG) announced more than $283.6 million in additional humanitarian funding for the South Sudan response. During FY 2017, the USG provided nearly $746 million in emergency assistance inside South Sudan, as well as approximately $246 million in life-saving assistance for South Sudanese refugees in neighboring countries.

Despite logistical constraints and insecurity, including attacks against humanitarian staff and assets, relief actors continue to provide food; water, sanitation, and hygiene (WASH); and other emergency assistance to conflict-affected populations in South Sudan.

CURRENT EVENTS

On September 21, USAID Administrator Mark Green announced more than $283.6 million to support emergency relief interventions for conflict-affected and food-insecure populations in South Sudan and South Sudanese refugees in neighboring countries. The new funding included more than $5.1 million from USAID/OFDA, nearly $236 million from USAID/FFP, and approximately $42.5 million from State/PRM.

A high-level delegation, including U.S. Africa Command Deputy Commander for Civil-Military Engagement Ambassador Alexander M. Laskaris and U.S. Mission to the UN in Rome Chargé d’Affaires, a.i., Thomas M. Duffy visited the capital city of Juba on September 21 to discuss the scale and scope of the humanitarian response in South Sudan. The delegation observed how the humanitarian community and the UN Mission in the Republic of South Sudan (UNMISS) are responding to the challenges of managing protection of civilian (PoC) sites for displaced populations, as well as how the UN is collaborating with other relief actors to access remote locations and deliver life-saving assistance. While in Juba, the delegation also met with UN representatives to discuss coordination among UN agencies in response to the Famine—IPC 5—declaration in early 2017.5 In addition, the group visited the UN World Food Program (WFP) commodity warehouse at Juba International Airport to discuss the logistics of food transport by road and air, and observe WFP, a USAID/FFP partner, prepare emergency food assistance for airdrops.

The USG imposed economic and financial sanctions on two senior Government of the Republic of South Sudan (GoRSS) officials and one former GoRSS official on September 6. Among other justifications, the sanctions cite the targeted individuals’ roles in destabilizing peace, security, and stability in South Sudan, such as committing attacks against UNMISS forces, contributing to the continued deterioration of the humanitarian situation, and obstructing the provision of relief assistance to people in need.

INSECURITY, DISPLACEMENT, AND HUMANITARIAN ACCESS

Armed clashes, attacks on humanitarian workers, and other security incidents continue to result in civilian deaths, humanitarian program suspensions, and the relocation of relief workers to areas of relative safety. From January to September, relief actors reported 830 humanitarian access incidents in South Sudan, including more than 100 incidents during September, the UN reports. The recorded incidents in September represent the second-highest monthly total since January 2016, underscoring the dangerous operating environment for humanitarian organizations in South Sudan.

Approximately 65 percent of humanitarian access incidents in September involved violence against humanitarian personnel, assets, or civilian infrastructure, while two incidents resulted in the deaths of humanitarian workers, bringing the total number of aid workers killed in South Sudan to 19 people since January, according to the UN. Additionally, active fighting in September forced nearly 90 relief workers to temporarily relocate from areas of operation in Unity, Upper Nile, and Western Equatoria states, disrupting the delivery of life-saving assistance, according to the UN.

On September 8, a gunman attacked an International Committee of the Red Cross (ICRC) humanitarian convoy traveling in Western Equatoria’s Mundri West County, killing one driver, ICRC reports. The convoy, composed of vehicles clearly marked with the ICRC logo, was returning from delivering assistance to vulnerable populations in Western Equatoria. The incident prompted ICRC, a State/PRM partner, to temporarily suspend activities in the area, local media report. ICRC also issued a statement condemning the attack and calling on all parties to the conflict to ensure the humanitarian access required to provide life-saving assistance to populations in need.

In mid-September, renewed clashes between GoRSS and opposition forces in Upper Nile’s Fashoda County prompted more than 10,000 people to flee Upper Nile’s Aburoc town for areas of relative safety, international media report. Additionally, the UN evacuated nearly 30 staff members from Aburoc to Upper Nile’s Malakal town as a precaution in response to the fighting. As of late September, security conditions had improved slightly and relief actors resumed emergency food, health, protection, and WASH activities.

Fighting across South Sudan continues to prompt populations to flee their homes, including to neighboring countries. In August, the number of South Sudanese refugees in neighboring countries reached 2 million people, of whom more than 1 million people were sheltering in Uganda, according to the UN. Despite flooding and worsening road conditions during August, nearly 12,000 people fled to Uganda due to widespread insecurity and fighting in South Sudan’s Greater Equatoria region, comprising Central Equatoria, Eastern Equatoria, and Western Equatoria states. Additionally, nearly 6,000 South Sudanese refugees arrived in Sudan in August, while an estimated 25,000 people from Upper Nile fled to Ethiopia from August 16–31 due to escalating conflict and insecurity, the UN reports.

FOOD SECURITY AND NUTRITION

The recent USAID/FFP contribution to WFP, announced by Administrator Green on September 21, includes 48,410 metric tons (MT) of U.S.-grown, in-kind food assistance and approximately 53,000 MT of regionally procured food commodities for distribution to conflict-affected populations in South Sudan, as well as support for South Sudanese refugees in neighboring Uganda. In total, USAID/FFP provided approximately $526.6 million in humanitarian assistance inside South Sudan during FY 2017.

In August, USAID/FFP partner WFP distributed 27,100 MT of emergency food assistance to 2.9 million people across South Sudan, including more than 380,000 people reached through integrated rapid response mechanism (IRRM) missions and 349,000 people reached with cash-based transfers for food. Since January, WFP and implementing partners have provided emergency food assistance to 4.5 million unique beneficiaries across the country.

As of July 2017, the price of food—particularly bread, cereals, and other staple food items—and non-alcoholic beverages in South Sudan had increased by 124 percent compared to the previous year, according to the GoRSS National Bureau of Statistics. Staple food prices will likely remain above-average over the coming months, adversely affecting household purchasing power and the food security situation for market-dependent households, WFP reports.

Early September market assessments conducted by WFP indicated that staple foods were available in Northern Bahr el Ghazal State’s Aweil town due to ongoing cross-border trade with Sudan. However, road inaccessibility due to heavy rains and related increases in transportation costs contributed to an increase in staple food prices in the area, constraining access to food for households with limited purchasing power, according to the assessments.

The nutrition situation in South Sudan remains critical, despite the conclusion of the May-to-August lean season, the UN Children’s Fund (UNICEF) reports. Nutrition surveys conducted in July, the peak of the lean season, found that global acute malnutrition (GAM) levels exceeded the UN World Health Organization (WHO) emergency threshold of 15 percent in eight of nine assessed states. GAM levels were approximately 23 percent in Unity—the highest of the assessed states. From July to August, UNICEF and implementing partners screened more than 270,000 children younger than five years of age across South Sudan for acute malnutrition, identifying approximately 28,200 facing moderate acute malnutrition and 8,900 children experiencing severe acute malnutrition (SAM). As of August 31, nearly 119,000 children in South Sudan had received treatment for acute malnutrition through outpatient therapeutic programs and at stabilization centers, the UN agency reports.

In recent weeks, USAID/OFDA partner the UN Food and Agriculture Organization (FAO) held seed fairs in Central Equatoria and Western Equatoria, reaching a total of 16,300 households with assistance. In addition, FAO distributed emergency livelihood kits to more than 32,000 households in the two states, increasing the total number of households reached with FAO livelihood kits since January to at least 714,000 households. Ongoing insecurity, including an uptick in fighting in Mundri East and Mundri West counties, has negatively impacted seed and tool distribution activities, FAO reports. In addition, adverse weather and flooding continues to impact roads and disrupt transport networks, hindering the movement of commodities to some parts of Western Equatoria.

HEALTH AND WASH

Cholera transmission continues to decline countrywide, according to the GoRSS Ministry of Health and WHO. Despite the reduced caseload, cholera transmission remained active in Central Equatoria’s Juba County and Eastern Equatoria’s Budi County as of late September, according to health actors. Humanitarian organizations are working in conjunction with local health authorities in Budi and Juba to reduce cholera transmission by providing case management support at cholera treatment units and oral rehydration points and conducting oral cholera vaccination (OCV) campaigns. As of late September, health actors had recorded nearly 20,700 suspected cholera cases, including 378 deaths, since the outbreak began in June 2016, the GoRSS and WHO report.

Health actors reported nearly 1.6 million malaria cases in South Sudan between January and early September, representing a more than 30 percent increase compared to 1.2 million cases recorded during the same period in 2016, the UN reports. Malaria, which accounts for an estimated 65 percent of all illnesses reported in health facilities across the country, is endemic to South Sudan, and cases typically increase during the May-to-September rainy season. In Northern Bahr el Ghazal’s Aweil County, UNICEF and other health organizations evaluated nearly 10,800 women and children for malaria, of whom more than 9,300 tested positive and received treatment during the same period. In addition, UNICEF supported distribution of more than 43,800 mosquito nets to mitigate the spread of malaria in affected areas.

In September, UNICEF and implementing partners also reached nearly 260,800 people, including approximately 140,600 children younger than five years of age, with primary health care consultations and more than 8,500 women with reproductive health care services, including 1,300 deliveries. During the same period, UNICEF also supported health care staff to immunize 7,400 children between the ages of six months and 15 years against measles and conducted follow-up vaccinations for more than 5,500 children in and around the UNMISS PoC site in Upper Nile’s Malakal town.

Heavy rains and resultant flooding in late August and early September left populations in some areas of Jonglei and Northern Bahr el Ghazal in need of health and WASH assistance, the UN reports. From September 1–30, UNICEF and implementing partners reached more than 20,000 flood-affected households—approximately 120,000 people—in Northern Bahr el Ghazal with WASH assistance, including water purification tablets and water containers. Additionally, WHO and other health actors are scaling up activities—including dispatching medical teams and delivering life-saving medical supplies—to respond to emergent health needs in flood-affected areas, the UN reports.

In FY 2017, USAID/OFDA provided approximately $26.2 million to support emergency WASH programs across South Sudan. USAID/OFDA partners are addressing humanitarian WASH needs by increasing access to safe drinking water and sanitation facilities, conducting hygiene promotion campaigns, and assisting with solid waste removal, among other WASH interventions. USAID/OFDA also contributed an estimated $18 million in FY 2017 funding to support emergency health care services for vulnerable populations in South Sudan.

PROTECTION

UNICEF continues to respond to acute child protection needs due to ongoing conflict in South Sudan. From mid-July to late August, UNICEF and implementing partners provided more than 350 unaccompanied and separated children with emergency assistance, including family tracing services, which resulted in the reunification of 34 children with their families. In addition, the UN agency distributed child protection awareness messaging to approximately 10,000 people and provided psychosocial support services to 13,600 conflict-affected children in child-friendly spaces and schools, as well as through rapid response interventions. During the same period, UNICEF and partners also conducted gender-based violence prevention and response activities—including case management, psychosocial support, and referrals—for 8,000 people in Central Equatoria, Jonglei, Upper Nile, Western Bahr el Ghazal, and Western Equatoria states.

With USAID/OFDA funding, the International Organization for Migration (IOM) is supporting the integration of mental health and psychosocial support activities in multi-sector humanitarian interventions. Since January, IOM has led a national-level mental health and psychosocial support coordination group, a forum for relevant stakeholders in South Sudan to collaborate on aligning response activities with the needs of conflict-affected individuals. Through the group, IOM has initiated meetings with the Health, Food Security and Livelihoods, Nutrition, and Protection clusters—the coordinating bodies for humanitarian health, food security and livelihoods, nutrition, and protection activities, respectively, comprising UN agencies, non-governmental organizations, and other stakeholders—to provide guidance on the integration of mental health and psychosocial support activities across humanitarian sectors.

In FY 2017, USAID/OFDA contributed more than $10 million to support implementing partners conducting humanitarian protection interventions—including family reunification services, case management and referrals, and support for survivors of gender-based violence—in South Sudan.

OTHER HUMANITARIAN ASSISTANCE

On September 12, the World Bank contributed $50 million to FAO, UNICEF, and WFP to address food insecurity and acute malnutrition in South Sudan. The contribution—through the GoRSS Ministry of Agriculture—will enable FAO to support the recovery of crop, livestock, and fisheries production; support UNICEF to treat children experiencing SAM; and assist WFP to provide emergency food and nutrition assistance to approximately 100,000 people.