“Will we be able to care for the growing number of children in need?”

In Pibor, the floods and intercommunal violence have led to an explosion of malnutrition in children

Yves Willemot
01 June 2021
A malnourished child is seated on her mother's lap in a hospital bed
Joice (17 Months) and her mother Sunday Nyabok at Pibor Stabilization centre.

Pibor, South Sudan – Nursers are hasting along the beds to examine the newly arrived children at Pibor stabilization centre. This is where the weakest and sickest children suffering from severe malnutrition come. A nurse is administrating the treatment through a nose tube making the nutritious milk go directly into the stomach. The most fragile children are too weak to swallow themselves. Over the past weeks, a growing number of severely malnourished children with complications have been admitted to the center.

I am very concerned about the increasing number of children arriving every day. They suffer from severe acute malnutrition but also have diarrhoea, vomiting, fever and malaria. I don't know if we will be able to take care of all these children,” nurse Simon Uwer Araclumo sighs.

Many families had to flee their villages due to the floods a few months ago. The floodwater swallowed their houses. The rich patches of land that used to carry okra and tomatoes were also submerged by the dirty water who would then find its way into the wells, making anyone who would dare take a sip of it sick. The floods led to a spike in cases of diarrhoea and malaria and triggered an increase in acute malnutrition in children. UNICEF estimates that the 2020 floods affected more than 1 million people and displaced at least half of them.

The walls of the health center in Pibor bear the marks of the floods that put the entire town of Pibor under water. Dirty brown horizontal stripes showing how high the water reached. Some places, the water levels rose by three meters and submerged entire neighbourhoods. The water has now receded, but people fear of what is to come when the rainy season sets in again and the river overflows yet another time.


A nurse is taking a child's temperature using a thermo gun
Nurse Simon Uwer Araclumo is taking Thilalo's temperature at Pibor the stabilization centre.

The critical humanitarian situation in the region is further exacerbated by recurring intercommunal conflicts, including cattle raiding which comes with extreme violence. Villages are burned to the ground, wells destroyed or damaged, humanitarian supplies are looted, and women and children are abducted.

Joice is 17 months old and should be running around with her peers by now, but her body is tiny, and she needs to be supported to sit up for longer periods. Sunday Nyabok, Joice’s mother, fled Gumuruk a village 100 km southwest of Pibor because of violence. She walked for two days to get here.

“Our homes were burned down. There was no food or water left in Gumuruk. Joice was losing a lot of weight. She was suffering from diarrhoea and had a cough. She had no appetite, and I could not breastfeed her.”

Simon remembers what a bad state Joice was in when she arrived in Pibor.

“She was barely 4.7 kilos when she was admitted, half of what a child her age should weigh. She is still very weak, even though she has gained some weight. But she will recover if no further complications occur.”


A mother with her malnourished child on her lap in a hospital bed
Seven-month-old Acheren and his mother Thuwen Aieyi at Pibor Stabilization Centre.

A few beds down I find Thuwen Aieyi, she has also a strenuous journey behind her. She fled from Kongor west of Pibor when fighting erupted. It took her three days by foot through the thick and thorny bush with her two children before she reached Pibor.

“Acheren, my seven-month-old boy, got sick during the long walk. He was suffering from diarrhoea and fever. And he was vomiting. When we finally arrived at Pibor the third day I rushed to health center for treatment.”

Floods and intercommunal violence have contributed to a peak in acute malnutrition in children throughout South Sudan. UNICEF estimates that 1.4 million children will be affected in 2021. Some 300,000 will be suffering from the worst forms of malnutrition, which is life-threatening.

Pibor is one of the areas hit the hardest with the number of cases doubling the first quarter compared to last year. 1/5 of all children under five years of age is suffering from acute malnutrition, which is well above the emergency threshold of 15 per cent.

I am very concerned about the increasing number of children arriving every day.  I don't know if we will be able to take care of all these children.

Nurse Simon Uwer Araclumo

In response to the growing needs, UNICEF and partners have doubled the number of outpatient therapeutic treatment centers in the Pibor area from 16 to 29. This allows for early screening and initiation of treatment, while also increasing the total capacity.

Most of the children suffering from severe acute malnutrition with complications do not survive without proper medical treatment. Luckily, for those that reach the stabilization center in Pibor, the recovery rate is high. More than 95% of children survive. But many children do not make it to the stabilization center and die in their community or while on the run.

  Acheren got timely help and was diagnosed with severe acute malnutrition and admitted to the stabilization center in Pibor. Thanks to the therapeutic treatment he has gained weight and his overall condition has improved a lot. It is amazing to see how quickly children bounce back once they get the right treatment. If the positive development continues, he can be discharged soon. By then, Thiwen Aieyi hopes she will be able to return to her village.

“If the violence has ended…”, Thiwen Aieyi says.


UNICEF’s nutrition programmes are generously supported by the EU and ECHO, the German Nat.Com, the People’s republic of China, UK Aid, USAID. UNICEF is grateful for the many governments who continue to support emergency response by funding part of our Humanitarian Action for Children appeal, including Belgium, Canada, Germany, Norway and Sweden.