During the 2017 lean season when food availability is at its lowest, generally between April and July, a Standardized Monitoring and Assessment of Relief and Transitions (SMART) survey was conducted in Twic County, Warrap State.1 According to the validated report2 the prevalence of Global Acute Malnutrition (GAM) by weight-for-height z-score (WHZ) was 35.9%3 (with a confidence interval of 31.6%-40.3%), including Severe Acute Malnutrition (SAM) prevalence of 11.6% (with a confidence interval of 8.7%-15.3%) by WHZ.4 This is well above the World Health Organization’s (WHO) thresholds for humanitarian emergency, and significantly higher than the prevalence of GAM by WHZ in Twic County in April 2016, 19.7%. However, drivers of the high malnutrition rates were unclear. REACH deployed to Twic County, between 10 and 20 November, to fill key information gaps related to what could have caused the increased GAM rates, in addition to livelihood strategies used during the lean season in Twic County. In total, 5 Focus Group Discussions (FGDs) with 16 community members and 6 Key Informant (KI) interviews were conducted with nutrition teams from World Vision International and local authorities. This was supplemented with direct observation and informal discussions with community leaders and humanitarian actors. A total of seven locations were assessed, six locations in Twic County including Turalei Payam, Pan Nyok Payam, Akak town, Mayen Abun town, Wunrok Payam, Ajoung town, in addition to Agok in Abyei, a contested territory between Sudan and South Sudan.
• Nearly all KIs from community health centres reported that during the 2017 lean season, an abnormal increase in malaria combined with poor household diets led to a spike in malnutrition.
• Akoc Payam in western Twic County is considered to be one of the worst affected payams in the county, as a result of high food insecurity, relatively poor Water, Sanitation and Hygiene (WASH) conditions, and limited access to humanitarian aid due to flooding.
• Below average rainfall in central and eastern, and localised flooding in western Twic County severely reduced this year’s harvest. KIs reported that food stocks will likely be diminished by January, increasing the length of the lean season and exhausting available resources earlier than normal.
• Due to a lack of available resources and insecurity near traditional dry season grazing areas, cattle migration has been restricted to a limited number of locations which are relatively further away than in previous years, raising concerns about the communities’ ability to utilise cattle trade as a lean season coping strategy and increasing cattle mortality rates.
• Humanitarian actors, particularly health partners, have relatively high access to communities in central Twic County. However, the eastern and western portion of Twic County are inaccessible for months at a time due to flooding and insecurity.