South Sudan

Situation Report

Highlights

  • Measles outbreak confirmed in Ikotos County, Eastern Equatoria
  • South Sudan: Three humanitarian workers killed
  • Amid rising concerns about mental health, increased suicide cases in Malakal Protection of Civilians site
  • South Sudan Humanitarian Fund allocates US$36 million to respond to life-saving needs
  • New research finds 1.5 million internally displaced persons in South Sudan
In Akobo, a mother feeds her child nutritious supplementary food. More than 6.35 million people were severely food insecure in August. Credit: Medair
In Akobo, a mother feeds her child nutritious supplementary food. More than 6.35 million people were severely food insecure in August. Credit: Medair

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South Sudan

Situation Report

Key Figures

7.2M
People in need
5.7M
People targeted
1.47M
Internally displaced people
4.54M
Acutely food insecure (Sept-Dec)

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South Sudan

Situation Report

Funding

$1.5B
Required
$1B
Received
68%
Progress
FTS

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Contacts

Stephen O'Malley

Head of Office

Emmi Antinoja

Head of Communications and Information Management

South Sudan

Situation Report
Feature
Map of counties affected by measles in 2019
Map of counties affected by measles in 2019

Measles outbreak confirmed in Ikotos County, Eastern Equatoria

A measles outbreak has been confirmed in Ikotos County, Eastern Equatoria after four samples from suspect cases tested positive. At least 28 suspect cases, including eight related deaths, have been reported in Kidepo valley, Ikotos County between 12 and 20 November 2019. The most affected age group are children under five years of age; cases were also mainly reported among refugee returnees from Uganda.

According to the authorities, the number of cases are increasing daily, and some residents have resorted to using local medicines. Local authorities have urged humanitarian organizations to coordinate efforts to help address the outbreak, noting that the state urgently needs vaccines and supplies. An emergency health team has been dispatched to Kidepo valley in Ikotos County, to respond to escalating cases of measles.

These outbreak come in addition to already reported outbreaks in 19 counties including Budi and Torit counties in Eastern Equatoria, Juba county and Juba PoC site in Central Equatoria, Pibor county in Jonglei, Aweil East, Aweil South and Aweil West counties in Northern Bahr el Ghazal, Gogrial East, Gogrial West, Tonj North and Tonj South counties in Warrap, Wau and Jur River counties, and Wau PoC site in Western Bahr el Ghazal, Mayom county and Bentiu PoC site in Unity, Malakal, Melut and Renk counties in Upper Nile and Yambio county in­ Western Equatoria since the begining of 2019.

Overall, a total of 3,875 suspected cases, including 23 related deaths, have been reported in the country between January and 10 November 2019, according to World Health Organization data. Pibor county, an area, worst affected by the floods recorded the highest number of cases with a total of 2,056, including nine deaths. Of those, about 71 per cent of the cases are children under 5 years of age, and 32 per cent of the cases reported are not vaccinated against measles.

Since the outbreak was declared in January 2019, humanitarian organizations have conducted vaccination campaigns and reached more than 689,900 children aged six months to 15 years in the counties of Pibor, Abyei, Gogrial West, Aweil South, Melut, Gogrial East, Juba, Tonj North, Tonj South, Aweil West, Aweil East, Renk, Wau, Tonj North, Jur River, Yambio and Budi as well as Bentiu, Juba, Malakal and Wau Protection of Civilians sites.

Humanitarians have reported that the major factors for a measles outbreak in South Sudan are low vaccination coverage, malnutrition, population movements, and overcrowded internally displaced camps. The low coverage which was about 59 per cent, well below the desired thresholds of 90 to 95 per cent, was in turn, attributed to low access to basic healthcare, estimated at 44 per cent, and insecurity affecting health facilities.

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South Sudan

Situation Report
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South Sudan: Three humanitarian workers killed

On 27 October, three International Organization for Migration (IOM) volunteers, one female and two males, were killed in a crossfire during clashes that broke out between armed groups in South Sudan. Two other volunteers were wounded during the incident and one volunteer is currently missing.

The Humanitarian Coordinator in South Sudan, Alain Noudéhou, strongly condemned the killings and called for the safety and security of humanitarian workers at all times. He also demanded that those responsible for the acts be brought to justice.

“Humanitarian workers risk their lives every day to provide life-saving assistance to people in need in South Sudan. Their safety and security must be assured at all times,” he said.

IOM has suspended Ebola virus disease screening at five sites along the border with the neighbouring Democratic Republic of the Congo and put on hold its support to health facilities in the area.

This is the first killing of aid workers reported in South Sudan since 2018.

At least 115 aid workers have been killed since the start of the conflict in December 2013. Most have been South Sudanese nationals.

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South Sudan

Situation Report
Feature
Number of suicide cases reportedat Malakal Protection of Civilians site by gender between January and July 2019.
Number of suicide cases reported at Malakal Protection of Civilians site by gender between January and July 2019.

Amid rising concerns about mental health, increased suicide cases in Malakal Protection of Civilians site

The legacy of conflict, displacement and lack of mental health services in South Sudan have led to a reported increase in the number of people dealing with mental health conditions across the country. In Upper Nile, a rise of suicides and suicide attempts has been recorded especially among young adults in Malakal Protection of Civilians site and Malakal town.

Ninety-five suicide cases were reported in the protected site between January and July 2019. Of those, 94 per cent were attempted suicide. Some 55 per cent involved women. Two thirds were people between the age of 19 and 35.

No systematic research has been done yet, but according to focus group discussions done in the site,  the high number of suicide cases was attributed to the effects of the years of conflict, violence, depression, poor health, loneliness, caused by isolation from family and friends, with some displaced people often finding themselves hundreds of miles from their homes and support networks, socio-economic hardship, lack of opportunities for youth and therefore inability to start one’s own family, increased level of drug abuse or of locally brewed alcohol.

Despite the high psychosocial stress, the mental health care system in the country is still weak. South Sudan has only three psychiatrists serving the entire population, and only one psychiatric inpatient facility in Juba. The situation is even worse in the most conflict-affected parts of the country, including Upper Nile.

Yet, suicide is preventable and prevention is one of the most effective ways to reduce the burden. The earlier signs of distress are identified and addressed, the better. Knowing the risk factors and recognizing the warning signs for suicide can help prevent suicide.

Humanitarian organizations have established a mental health medical facility at the site to tackle mental health issues. A mental health and psychosocial support mobile response team has scaled up suicide prevention messages. Key messages are being passed at the water points and through plays in the site. Aid agencies are conducting referral to existing services, conducting dialogue sessions with vulnerable groups, fighting the stigma and taboo around suicide, and working with other humanitarian organizations to improve access to socio-economic opportunities for the site’s young population. In addition, community leaders in the site have been trained as mental health first aiders and are disseminating key messages on suicide prevention to communities.

In 2013, conflict forced most of the population in Malakal town and surrounding areas to flee their homes, with some seeking shelter in the UNMISS protected site in Malakal. The site population peaked at just under 48,000 individuals in August 2015 and has since reduced to some 30,000 people, per the population head count conducted by humanitarians at the end of September 2019. Nearly 52 per cent of the people currently sheltering in the site are women who face risks of violence daily. Women and girls who must leave the camp in search of firewood are particularly at risk.

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South Sudan

Situation Report
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Estimated beneficiaries by age and sex
Estimated beneficiaries by age and sex

South Sudan Humanitarian Fund allocates US$36 million to respond to life-saving needs

The South Sudan Humanitarian Fund (SSHF) has allocated US$36 million under the second standard allocation of the year, targeting an estimated 1.3 million people. Fifty-six per cent of the beneficiaries are women and girls.

The funds will allow about 212,000 vulnerable South Sudanese to access mobile health services and some 130,000 individuals to access safe water. Nearly 160,000 children will be vaccinated against measles to stem the spread of the disease; some 145,000 infants and young children will access feeding counselling; and nearly 33,000 children will receive meals at school. Some 576,000 individuals will receive vegetable kits consisting of seeds and tools, improving families’ self-sufficiency and access to food. Some 103,000 people will receive essential household items, and nearly 103,000 internally displaced persons will benefit from site management activities in Protection of Civilians sites and collective centers.;

This is the first time that an integrated multi-sector approach to the humanitarian response was introduced during the allocation process since the pooled fund was established, with $16.5 million allocated for 31 projects implemented by more than one humanitarian cluster. Activities undertaken by humanitarian organizations working across sectors include mitigating underlying causes of high mortality, like severe malnutrition in children under 5 years of age, and targeting schools with WASH activities and hygiene campaigns.

Some $15 million representing 42 per cent of the total allocation were channeled to local NGOs, in line with the Grand Bargain localization agenda, which emphasizes the promotion of principled humanitarian action that is “as local as possible and as international as necessary”. Another 45 per cent was allocated to international NGOs and 13 per cent to United Nations agencies.

The 26 counties targeted by the SSHF funding are Morobo, Kajo-Keji and Yei in Central Equatoria; Akobo, Bor South, Canal/Pigi, Duk, Pibor and Twic East in Jonglei; Cueibet, Rumbek Centre, Rumbek East, Yirol East and Yirol West in Lakes; Aweil East and Aweil South in Northern Bahr el Ghazal; Koch, Luakpiny/Nasir, Panyijiar, Pariang and Rubkona in Unity; Tonj North and Twic in Warrap; and Jur River, Raga and Wau in Western Bahr el Ghazal.

The second standard allocation brings the total funding allocated by the pooled fund in 2019 to $70.5 million. The funds are used to implement 167 projects to support response to unmet humanitarian needs and implementation of priority sectoral activities outlined in the 2019 Humanitarian Response Plan. The SSHF enables targeting of funds to the most critical needs, and improves efficiency and timely response to emergencies in the country.

The SSHF is a multi-donor pooled fund that supports the allocation and disbursement of donor resources to meet the most critical needs in harmonized ways to create greater overall impact. New contributions are urgently needed to continue addressing the most critical needs of the vulnerable people.

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South Sudan

Situation Report
Analysis
Some of the internally displaced persons who fled their homes in villages outside Yei town at the peak of the conflict in 2017. Credit: UNHCR
Some of the internally displaced persons who fled their homes in villages outside Yei town at the peak of the conflict in 2017. Credit: UNHCR

New research finds 1.5 million internally displaced persons in South Sudan

South Sudan’s baseline on internally displaced persons (IDPs) has been reset from 1,829,223 individuals to 1,465,542 due to the culmination of an 18-month-long review and rationalization exercise between IDP datasets maintained by the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) and the International Organization for Migration’s Displacement Tracking Matrix (IOM DTM).

“For the past 18 months, OCHA has been working closely with IOM DTM to thoroughly update South Sudan’s baseline data on IDPs,” said Steve O’Malley, Head of the South Sudan Office for OCHA. “Now a new baseline has been set, and OCHA and IOM DTM will maintain a unified IDP baseline for South Sudan, which will be regularly updated.”

“The IOM DTM Mobility Tracking exercise published its first round of data in March 2018, at the time covering 230 locations across 23 counties”, says Jean-Philippe Chauzy, the IOM Chief of Mission. “Coverage has steadily expanded and the latest exercise, DTM Round 6, covers 2,312 locations across all 78 counties of South Sudan. The findings are due to be published in September 2019.”

The large-scale reduction of more than 360,000 individuals is caused by updating and verifying displacement data through revisiting locations and obtaining new population estimates, and reviewing all data for potential duplications.

The new baseline does not reflect the actual change in IDP numbers between July and August, but rather the cumulative effect of the data review. Considering all decreases and increases of IDPs throughout the country, there has been an overall net decrease of 26,302 individuals from July to August 2019.

“I am very pleased that we have been able to update the IDP data. The ability to understand the context and measure displacement is crucial to serving people who are impacted by the crisis,” said Alain Noudéhou, the Humanitarian Coordinator in South Sudan.

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South Sudan

Situation Report
Analysis
IPC acute food insecurity for August 2019. Source: IPC
IPC acute food insecurity for August 2019. Source: IPC

More than 6.35 million people severely food insecure in August despite large scale humanitarian assistance

More than 6.35 million people – 54 per cent of the South Sudanese population – were severely food insecure in August, despite large scale humanitarian assistance, according to the Integrated Food Security Phase Classification (IPC) analysis released jointly by three United Nations agencies and the Government on 11 September.

Among these people, an estimated 1.7 million people faced Emergency (IPC Phase 4) acute food insecurity and 10,000 people faced catastrophic conditions (IPC Phase 5). The analysis showed a 5 per cent reduction in the proportion of severely food insecure people compared to the same period last year.  

Decreased armed conflict and people’s improved access to livelihoods and markets are some of the reasons why the food security situation improved, said the Food and Agriculture Organization of the United Nations (FAO), the United Nations Children’s Fund (UNICEF) and the World Food Programme (WFP). The availability of seasonal harvests from September in most parts of the country, which have been relatively secure, was also a factor. Between September and December 2019, 4.54 million people – 39 per cent of the population – are projected to be severely food insecure.

With improved security, some internally displaced persons and refugee returnees have returned to their homes to cultivate their land and increase their own food production. According to FAO, South Sudan’s cereal production has increased by 150,000 metric tons in the last year, attributed to the improved security in most parts of the country. A more stable political environment has also allowed for improved delivery of humanitarian assistance to previously hard to reach areas.

However, in the post-harvest period of January to April 2020, the food security situation will deteriorate again as households begin depleting their supply of food as they enter the lean season, when there is not enough food for them to eat. Some 5.50 million people – 47 per cent of the population – are projected to be severely food insecure in the January to April 2020 projection period.

Despite slight improvements in food security, the number of acutely malnourished children was estimated to reach 1.3 million. This is the highest number recorded since independence.

Jointly releasing the nutrition analysis, UNICEF called for a shift from treatment of malnutrition to prevention, including not only food assistance, promotion of breastfeeding and nutrition counselling, but also access to clean water, proper hygiene and health care. Humanitarians have also called for a speedy implementation of the revitalized peace agreement to facilitate people’s access to livelihoods, markets and humanitarian assistance.

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Media

Watch Joyce Asha Francis, an OCHA National Field Officer in Malakal, talk about being a woman humanitarian and the challenge that it brings.

Forty-six year old Joyce Asha Francis is an OCHA National Field Officer in Malakal, South Sudan’s Upper Nile Region. She was born in Uganda and lives in Kenya, but her roots are in South Sudan. She has been a humanitarian for practically all of her working life. She is a mother of five children.

OCHA asked her about what being a woman humanitarian meant to her, the good parts and the challenges. She answered:

“Being a humanitarian to me means love, compassion, kindness, generosity, being cooperative, patient, caring, helpful, humble and being culturally sensitive, in order to save lives, relieve suffering and maintain the human dignity of the affected people. Without the above listed qualities, one can hardly endure to be a humanitarian worker.

“The most favourite part of my work is around general coordination and providing leadership to ensure that basic services reach the people in need. It is fulfilling to see us humanitarian workers running around to get work done and the people talk of how the services that are there now have changed their lives.

“The most challenging parts of my work are resource mobilization and access. In an event that resources are limited and are not able to reach the affected people, I feel terrible because a life could be lost due to the inability to provide basic services, or the inability to reach people due to poor communication networks or human-imposed barricades. This hurts a lot.”

Watch this video to learn more about Joyce’s experiences coordinating humanitarian action in one of the most challenging places in the world.

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