South Sudan

South Sudan: Our days are long but the needs are great

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My name is Lily Rose and I’m an intern with CARE South Sudan’s nutrition programme in Pariang, Unity state. I’m from Magwi County in Eastern Equatoria, in the country’s south.

When the opportunity came to work with CARE, I didn’t hesitate. This is a long way from my comfort zone, but it is a great opportunity for me to help my own people, and to learn skills that will help me grow professionally.

CARE’s Nutrition Centre is in the grounds of the Pariang Primary Health Care Centre so it’s a busy place. Nutrition is important here; the people in the community are pastoralists who don’t practice agriculture but depend mostly on milk and a daily meal of flour and sour milk, but that’s not enough for their nutrition needs.

More importantly, the crisis that began here in South Sudan in December 2013 has displaced hundreds of thousands of people, and disrupted people’s livelihoods.

"Markets have been destroyed, and people aren’t growing enough food. This has had a major impact on peoples’ nutrition needs."

My first task when I came to the centre was to screen children and pregnant and lactating mothers in order to identify anyone in need of nutrition supplements. During my first week, I screened 193 children, both boys and girls, for their nutrition status. To do this we apply a MUAC test. MUAC stands for Mid Upper Arm Circumference, meaning we measure the circumference of the patient’s upper arm to find out if their malnutrition status is Stable (Green), Moderate (Yellow) or Severe (Red).

Children are given Plumpynut and Plumpysup. Plumpynut is a therapeutic food given to children with severe acute malnutrition (red in the MUAC test), and Plumpysup is a supplementary food for children with moderate malnutrition (yellow in the MUAC test). Mothers receive oil, corn, and a soya blend flour for making porridge, which is an important boost for their diet.

We monitor them every two weeks to check their progress, and discharge them once they have fully recovered.

Two patients stand out in my memory of that first week. The first was Mary, a 17-year-old girl who had never been to school. She was part way through her first pregnancy, yet she did not know it until she was told by the doctors at the health facility.

Another was Nyankir, a mother of three, who arrived very tired after walking four hours from her home to seek nutrition services. Nyankir was also pregnant, something she learned that day from the doctors at the clinic.

Identifying people’s needs

In addition to my nutrition work, I also help out in health education, creating awareness on how to improve hygiene in the community and preparing food in a clean environment.

One of the most exciting things I’ve done since I got to Pariang was participate in a food security assessment. The survey ran for four days, and involved trekking for hours and talking to people in their villages. Ours is a big country with a sparse population and although the survey was ‘door to door’, the distances were so great we could only cover five families per day.

The reception we received from the people in the communities we visited made every moment worthwhile. Nobody wanted to be left out, and some of the families complained if we didn’t visit them.

"More than 4.6 million of my fellow countrymen are believed to be in need of assistance from organisations like CARE, and I worry there are not enough resources to help them."

The needs were the same in just about every community we visited. People are suffering and in need of our support. They lack basic needs like food and water, so they drink dirty water from the ponds and depend solely on milk for their food. The few who can afford to buy food have to walk the whole day to get to the market and back to their homes. Even with all the cattle in these pastoralist communities, there are still some people who don’t have cows and have to depend on their neighbours for milk to survive.

There are still many sick children coming through our doors. Take Samuel (not his real name), for example. He’s just a tiny baby, only 11 months old. When he came to us, his fever was so high I sent him straight to the doctor. It turns out Samuel had malaria so our medical team gave him medication. He recovered from his illness but he remained in our nutrition programme for three months. It was a good day when Samuel finally left the programme. He’s still tiny but looking so much better than when I first met him.

We’ve opened a Stabilisation Centre here, which sounds grand but it’s actually a small room with four beds. Here we treat children who are severely malnourished and who may also have medical complications. We give them both medicine and nutrition supplements. Most of the children stay with us here for a few days before they are OK to go home to their families.

We spend a lot of time treating and preventing malnutrition in children. Our days are long but the needs are great, and it’s been that way for all my time here. Put simply, there just isn’t enough food and many, many children – too many of them – are now hungry.

"I pray that in 2016, we South Sudanese find true peace. Without it, the people of Pariang will struggle and children like Samuel will not have enough food to eat."

Lily Rose Oddo is a nutrition intern working with CARE in Pariang county, Unity state.