Racing to save Wilson
Supporting malnourished children in South Sudan
Nurse Betty leaves the busy and dusty streets of Juba behind her and steps through the archway of Al-Sabbah, the only children’s hospital in the city. For the past three decades, Betty has dedicated her life to supporting malnourished children and comforting anxious parents.
In South Sudan, severe food insecurity is at the highest levels ever, surpassing those seen during the years of conflicts which ravaged the country in 2013 and 2016. As the youngest nation on earth enters its 4th year of persistent flooding, climate shocks relentlessly wipe out crops, infrastructure and livelihoods. This year, 1.4 million children with acute malnutrition battle to survive and stay healthy.
Two-year-old Wilson was weak from hunger, severe diarrhea and dehydration.. His weight plunged suddenly from 9.5 kgs to 5.8 kgs, significantly less than the average 12-kilogram weight of a boy the same age. Wilson’s father, Angelo couldn’t afford the cost of medication and by the time Wilson arrived at hospital, he needed emergency care including oxygen.
Angelo, like many workers in the country, had not been paid for most of the year. Determined to make a better life for his young family, he was also studying natural resources and environmental studies, skills in high demand as the country faces extreme weather events and climate induced impacts.
Seasonal and long-term floods have been intensifying since 2018, leading to the worst flooding in decades, submerging entire villages, towns and regions and displaced populations.
South Sudan is responsible for just 0.004% of global carbon emissions but ranks number 7th most affected country on the global UNICEF Children’s Climate Risk Index Report – based on children’s exposure to climate change and environmental shocks.
Angelo is adamant the climate crisis is not the only driver of severe malnutrition amongst children.
“We have natural disasters and manmade disasters. Civilians didn’t expect to face war after gaining freedom in 2011. Our houses were demolished and burned; we had no shelter and we had to move,” says Angelo. “This year, a family of nine lost their lives in flooding, four of them were children under 12 years. As a young country, we are trying our best, but we don’t have enough support.”
Angelo is one of only two fathers in the hospital. Mothers, many of whom are widows or single parents, are traumatized by poverty and violence and sit anxiously next to their children. As more children arrive, Betty looks for the tell-tale signs of malnutrition; if there are signs of weight loss, lethargy, thin or rust-coloured hair. She closely observes their eyes as a malnourished child will likely have difficulties focusing. Some children are swollen from the legs upwards, others have protruding bellies. Other children arrive too late at the hospital, the long journey delayed due to the costs of transport.
Angelo reaches for his phone, determined to show a confronting photo of Wilson 21 days prior with ribs protruding and vacant eyes. The father is still haunted by the near loss of his son and cradles Wilson tightly, watched over closely by nurse Betty.
“Wilson’s weight was going down every day. His skin was wrinkled, and the diarrhea was non-stop. We had almost lost hope, but every doctor was on their legs here,” says Betty, recalling the team’s efforts to work around the clock to save him.
Severely malnourished children die because their digestive systems can no longer absorb nutrients. They are up to 11 times more at risk of dying from disease than well-nourished children, and diarrhoea can quickly become a killer disease.
Unable to process a normal diet right away as their digestive systems are severely compromised and gut bacteria damaged, sachets of RUTF – ready-to-use therapeutic food are given to children like Wilson. The energy and micronutrient dense, paste contains peanuts, sugar, milk powder, oil, vitamins, and minerals. UNICEF procures almost 80 per cent of the world's RUTF supply, and after just three days, Wilson’s weight started to increase.
As another child’s life is saved, countless others hang in the balance. One in six children will face acute malnutrition and the projections for 2023 are troubling humanitarian actors. Two-thirds of the South Sudanese population (7.76 million people) are likely to face acute food insecurity during the April-July 2023 lean season. This includes a projected 2.9 million on the brink of starvation (IPC Phase 4) and another 43,000 who are expected to be living in Catastrophe (IPC Phase 5) acute food insecurity.
Eric Alain Ategbo, Chief of Nutrition for UNICEF South Sudan, says urgent action is needed to prevent rates of malnutrition soaring even further.
“Children are in grave danger. The need for humanitarian programmes is increasing while funding is in decline. To continue saving lives, UNICEF needs to urgently mobilize more resources for procurement, distribution, and treatment of children with severe acute malnutrition.”
Pockets of violence and insecurity continues to prevent children from accessing the services they need and rely on, and the entire county of Panyikang in Upper Nile State, an area with historically high levels of food insecurity, was unable to be surveyed due to insecurity.
Angelo says medical experts like Betty are key to ensuring that children like his son are treated regardless of their cultural or tribal affiliations.
“Betty has treated all the malnourished children here without discrimination. You feel a sense of unity is in this hospital,” says Angelo with admiration.
There’s a long way to go before two-year-old Wilson makes a full recovery, although the early signs are promising. In a country where 1 in 10 children die before their 5th birthday – one of the highest infant mortality rates in the world – more than hope is needed to ensure other children have the same chance to survive.
These life-saving nutrition supplies and support have been made available thanks to the support from the United States Agency for International Development (USAID), UK Aid, Canada, the European Civil Protection and Humanitarian Aid Operations (ECHO), the German corporation through the KFW Bank and the UN Central Emergency Response Fund (CERF). As well as UNICEF National Committees.
In 2021, UNICEF and partners treated more than 240,000 children affected by severe acute malnutrition, of whom more than 95 per cent successfully recovered.