Right now, the land around Mankien in Mayom county, Unity state is green and lush – the telltale sign that rain has fallen. But all is not as it seems. This year’s rains have been few, compounding the county’s already fragile food situation. There are no crops to be seen and Mankien’s market, in the centre of town, is deceptive. It’s bustling with stalls selling soap, plastic shoes and football shirts. There is little food for sale, mainly small bags of sugar and salt. One of the few sacks of sorghum on display sells for as much as USD60, a fortune in this part of South Sudan.
Earlier this year, Global Acute Malnutrition (GAM) rates of 30 percent were recorded in Mayom county, double the maximum acceptable standard of 15 percent. One out of every three children was found to be acutely malnourished, with a high prevalence of stunting in children under the age of two. “When I started work in February this year many people were in need of nutrition services,” says Peter Marum, a Community Nutrition Worker at CARE’s Nutrition Centre in Mankien. “Due to the crisis, people were not cultivating. It was the least of their priorities - they had to look out for their safety first.”
Midwife Agnes Kaka treats a pregnant woman in a CARE-supported hospital in Pariang, South Sudan. Photo: Josh Estey/CARE.
Although Mayom county is more peaceful than it was in 2014, the effects of the fighting that tore through this part of South Sudan remain. And in addition to the local population, Mayom county is currently home to around 30,000 IDPs (Internally Displaced People), mainly women, children and the elderly fleeing ongoing violence in southern Unity state. More than two million people have been forced to flee their homes since fighting broke out in South Sudan in December 2013. While many have sought refuge in Protection of Civilian sites at UN bases, nine out of 10 IDPs are sheltering in towns and villages such as Mankien. These communities, many of them cut off by distance, poor infrastructure, seasonal rains or conflict, remain chronically underserved.
CARE’s nutrition centre in Mankien is housed in the Primary Health Care Centre in the middle of town. The line of patients waiting for screening on the verandah outside is long. Many travel from as far as ten kilometers away, usually by foot, to use its services. Patients are screened for malnutrition, those showing signs are given nutrition supplements and monitored for progress.
Patients wait for a nutrition screening at the Mankien Primary Health Care Centre in Unity State. Photo: Robinah Baseka/CARE.
“We’re screening both children and adults here,” says Peter Marum. “We see many lactating mothers with malnutrition, meaning they simply do not have enough breast milk to feed their babies.”
CARE is the only organization delivering nutrition services in this part of South Sudan, operating centres in Abiemnom, Rubkona and Pariang counties, as well as eight locations in Mayom. Operations in Guit county have been suspended because of ongoing insecurity. But resources are stretched, and the needs are great. “The role of agencies like CARE is more critical now than ever before,” said Joel Makii, Nutrition Advisor with CARE. “We’ve done everything we can to increase our nutrition programs in Unity state but without more resources and without access to those populations that need it the most, many more South Sudanese will suffer.”