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South Sudan, 11 April 2018: Introducing agricultural practices in a pastoral community yields rewarding results

An innovative, integrated approach to agricultural production is reducing, as well as preventing, incidents of malnutrition in the Unity State, South Sudan

By Pavithra Rangan

© UNICEF/2018/Rangan

BENTIU/RUBKONA, South Sudan, 11 April 2018 – The destroyed beige walls of the Bentiu civil hospital, ridden with bullet holes, stand as a somber reminder of the deadly fighting that engulfed the town over four years ago, claiming hundreds of innocent lives.

It was during those tumultuous months that Elizabeth Abraham was pregnant with her third and youngest child. While everyone was fleeing the brutal violence, she stayed on in the Saba village, abandoned by her husband, with no money and two children who were barely old enough to walk. Shuddering at every sound of shooting, she said to herself ‘Don’t worry, don’t worry’. And so, her daughter was born in the midst of the conflict in April 2014, a chirpy, bright girl called Nyachudier, meaning ‘Don’t worry’ in the local language.

Today, Elizabeth spends a significant part of her day farming in a plot behind the hospital with nearly 40 other mothers. Each of them is responsible for a small portion of the land. This yield is now helping her save money she would otherwise spend in the market, sustain her three children and, importantly, prevent them from slipping into malnutrition, disease and eventually death.

© UNICEF/2018/Rangan

“I had never sowed a single seed until a few months ago. But, I was told about it, I readily agreed to learn because there was no other way to feed my children. Before the conflict, we had a few cows and goats and my two children grew up with a constant supply of milk,” says Elizabeth. “I lost everything I had during the crisis, and Nyachudier, like the rest of us, had little or nothing to eat on several days. She fell so ill in December that I was terrified I would lose her.” Only a few months ago, Nyachudier was suffering from severe acute malnutrition and was treated at a UNICEF supported nutrition center in the hospital compound. It was during the eight weeks of treatment that Elizabeth was introduced to farming as a means of sustenance.

Traditionally a pastoralist populace, many people in the region lost their livestock during the crisis. This has led to the loss of livelihoods, depletion of assets and an ever-worsening food security situation. In the absence of all forms of humanitarian assistance, 57 per cent of the population (some 6.3 million people) were classified severely food insecure from February to April, 2018. This figure is projected to rise to 7.1 million people between May and July. In particular, the Bentiu Protection of Civilians (PoC) – the biggest settlement of internally displaced in South Sudan – and the towns of Bentiu and Rubkhona, are increasingly under strain due to a continuing influx of people from across the country. At least 2,500 persons are currently moving into the region each month.

UNICEF and partners have, therefore, introduced vegetable cultivation techniques into their programme to tackle malnutrition, not only as a curative practice, but as a means to ensure prevention and relapse. Vegetable production is aimed at supplementing and improving households’ dietary diversity scores and income, particularly during the dry season - an off-farming period in South Sudan. All caregivers of malnourished children enrolled at outpatient therapeutic programmes in the PoC and in Bentiu and Rubkona are given simple lessons on growing a variety of plants – onion, tomato, okhra, eggplant, cabbage, sukumuwaki, spinach, finger millet, water melon, pumpkin and groundnut – in plots close to the treatment Centre.

© UNICEF/2018/Rangan

In 2017, over 1,400 caregivers were trained only in the Rubkona town at the demonstration farm behind the hospital. They are also provided seeds that they can sow in sacks at their homes, in order to make optimal use to of the limited space. “I no longer need to buy any vegetables at the market. I’ve planted eggplant, okhra, onions, tomatoes and pumpkin in my house,” says Elizabeth. “Okhra, for instance, takes only 45 days to mature and one eggplant is big enough to feed the children one whole meal.”

So that caregivers across the community are able to produce their own vegetables, ‘lead mothers’ are selected and trained to train to others on the various aspects of vegetable production including, seed selection, nursery establishment and management, pest control and seed preservation. The aim is to enhance local consumption, while also training caregivers to collectively sell surplus produce at the market. “Last year, at this time, we had nearly 3,000 cases of severe acute malnutrition. This year, we have only about 1,200 cases,” says the nutrition assistant at the Centre in Rubkona. “We have seen a significant decrease in the number of children who relapse into malnutrition after being cured once.”

Besides training caregivers in vegetable production, UNICEF and partners are also conducting kitchen demonstrations at the nutrition centres to show the different ways in which local produce can be cooked and served to ensured a clean, balanced diet for children of different age-groups and for pregnant and lactating women. “These demonstrations are very important because, earlier, we were entirely dependent on cow or goat milk and meat. But we lost all our animals during the conflict and were on the brink of starvation,” says Martha Nyalony, a lead mother trained to undertake kitchen demontrations for caregivers in the PoC. “These lessons then provide healthy eating options by including fruits, vegetables, especially a lot of leafy vegetables, and meat if you can afford it, in the diet. All options are different and viable because you can sow everything you need.”

© UNICEF/2018/Rangan

While focusing on the nutritional requirements of children, the programme also is also ensuring that cognitive abilities of a child are not compromised. “The first 1,000 days after birth are most critical in determining a child’s future. Children affected by severe acute malnourishment are most vulnerable to impeded brain development,” says UNICEFs Nutrition Specialist, Chandrakala Jaiswal. “Our programme, therefore, tries to enable mental stimulation in children through child-friendly outpatient centres, with colourful paintings and other elements to stimulate a child’s visual and mental abilities.” Interestingly, caregivers are also trained in making age appropriate toys (rattles, pull along toys etc) using local material at the centre, as they have little or no means to buy toys in the market.

A wide range of services, including health care and sanitation facilities, birth registration, early childhood development classes among others have also been integrated into the nutrition programme so that all critical needs for a child’s holistic development are met. For instance, all malnourished children at the Centre are compulsorily immunized. “Not even ten per cent of the children at the PoC were vaccinated for life-threatening diseases. We, therefore, ensured that this is linked to the treatment for malnutrition,” says Chandrakala.

Unity state currently has 127 nutrition centres, of which six are in the Bentiu PoC. “We are ensuring that a behaviour change component is engrained in all programmes, so that development and sustainability become a part of the emergency response,” says Mustapha Ben Messaoud, Chief of the UNICEF field office in Bentiu.

(Grants for the integrated effort at combating malnutrition are generously provided by the Government of Italy and the US Fund.)



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