UNICEF and partners provided primary health care consultations to 1,051,918 people, including 576,057 women and 404,760 children under 5, through health facilities, IRRM missions, Integrated Community Case Management of Common Childhood Illnesses and outreach activities.
On 26 March, a joint UNICEF/WFP Education in Emergency programme. funded by the EU, was launched in Northern Bahr el Ghazal constituting the largest education collaboration between these two agencies in South Sudan, aiming to reach 75,000 children in 150 schools in four states.
During the first half of the year, 246 children (80 girls, 166 boys) were formally released from armed forces and armed Groups - 227 children (76 girls; 151 boy) in Eastern Equatoria and 19 (4 girls and 15 boys) in Central Equatoria.
Situation Overview and Humanitarian Needs
Restrictions on humanitarian access have changed considerably in the first six months of 2019. By January 2019, following the signing of the Revitalized Agreement on the Resolution of the Conflict in South Sudan (R-ARCSS) in September 2018, there was a significant reduction of armed hostilities in most of the country, including Greater Upper Nile, Western Bahr el Ghazal and Western Equatoria. At the same time, a series of peacebuilding meetings between government and opposition officials took place at the state level, leading to local agreement to facilitate the movement of both the civilian population and humanitarian actors. As a result, there have been far fewer access restrictions due to insecurity and active denials of access by parties to conflict compared to the previous six months. A number of key roads and water passages in Greater Upper Nile are now accessible and there has been a noticeable reduction of checkpoints and demands for ‘fees’ along main supply routes.
UNICEF and its partners have taken advantage of this situation to improve access and expand their programme delivery for vulnerable women and children in previously hard to reach areas. For example, UNICEF and WFP opened the road between Wau and Yambio without the need for force protection and conducted the first humanitarian assessment in northern Yambio county since 2015. UNICEF and partners have also expanded their static and outreach programmes for the people of Greater Baggari, many of whom remain displaced following intense fighting in September through November 2018. A noticeable exception to this trend was in southern Central Equatoria, where fighting between the South Sudan People’s Defense Force’s (SSPDF) and the National Salvation Front (NAS – an armed group that did not sign the R-ARCSS) between January and March greatly limited access outside of Yei town. However, by April, hostilities subsided in the area and UNICEF has been gradually expanding its regular programme activities and EVD preparedness efforts in key border areas with the DRC and Uganda.
However, while security-related access restrictions have reduced, UNICEF and humanitarian partners continued to face challenges to consistent and principled access due to an increase in bureaucratic impediments by national and local authorities, and violence and intimidation of humanitarian actors and assets by civilian and criminal elements. In areas such as Upper Nile, Jonglei and Western and Central Equatoria, local government authorities have increasingly been seeking to influence humanitarian action by seeking to influence hiring and contracting of staff and partners, increasing airport usage fees and changing customs and tax exemption processes to bring humanitarian goods into the country. Similarly, following the adaption of a new harmonized incentive scale for health workers in May, as many as 75 health facilities were temporarily closed as health workers went on a temporary strike over the reduction in their incentives. Road side attacks by criminal elements also continue to impede access, with a number of UNICEF partners having been highjacked and robbed of their belongings on key routes throughout the country. UNICEF, together with key partners such as OCHA and the NGO Forum, are engaging with local authorities and stakeholders to address these ongoing constraints to principled humanitarian access.
With Ebola cases having been registered only 70 km from the DRC/South Sudan border, the risk to South Sudan remains very high (WHO). Likely transmission routes include from Ituri in DRC to Yei in South Sudan, but also through Uganda. Any outbreak in West Nile in Uganda will increase the risk of transmission. Preparedness is continuing to scale up, around a national response plan, with inter-agency mobilization. There have been over 66 alerts in the country, but all have been negative to EVD. There is significant donor engagement in coordination mechanisms but limited financial support has been made available. South Sudan will require more financial support than other countries, because most recurrent expenditure will be carried by humanitarian actors, rather than government. The community awareness of EVD is also low, and the it will be important to take up the lessons from DRC, including the need to address other community needs beyond Ebola. UNICEF continues to co-lead WASH IPC and Risk Communication, Social Mobilization and Community Engagement (RCSMCE) working groups, whilst participating in a Strategic Advisory Group (SAG), National Task Force (NTF), UN Ebola committee meetings and supporting state level in coordination.
The latest IPC assessment indicates that an estimated 6.96 million people (61 per cent of the population) are likely to face Crisis (IPC Phase 3) acute food insecurity or worse, out of which an estimated 1.82 million people will face Emergency (IPC Phase 4) acute food insecurity and 21,000 will likely be in Catastrophe (IPC phase 5) and at risk of famine. In 2019, approximately 860,000 children under five are estimated to be acutely malnourished including 259,000 severe acute malnutrition (SAM), out of which 220,700 (85 per cent) are targeted for treatment. The Global Acute Malnutrition prevalence stands at 11.6 per cent and stunting at 17.9 per cent. To reach 2019 targets and be ready to respond for first semester 2020, UNICEF requires US$ 40 million between September and December 2019 for procurement of Ready-To-Use Therapeutic food (RUTF) and frontline cost of the programme. There is risk for RUTF pipeline break during the last quarter of 2019 or early 2020 if UNICEF fails to mobilize adequate resources before September 2019.
Perpetration of gender-based violence (GBV) with impunity continues in most parts of South Sudan and the weak legal system in the country does not promote accountability for perpetrators and further compromises the trust in the system. The dual legal system in the country further reinforces the weak legal system in addressing rights of women and girls. For instance, a case of early marriage where perpetrators were convicted was annulled by the court following an agreement for the relatives of the girl to commit and sign that they will not force the girl into marriage. Limited funds had immense effects on overall Child Protection and GBV in Emergencies programming including suspension or ending of partnerships with key child protection and GBV partners. This has drastically compromised UNICEF’s ability to respond to children and women affected by the conflict. The overall number of children and women reached during the first half of year has drastically reduced due to funding limitations.