According to the DEC’s Response Review, the situation in South Sudan was already “very grim” due to conflict, poverty and hunger when Covid-19 arrived in the country. Since then, flooding has displaced 800,000 people who are now living in crowded conditions, creating conditions for the virus to spread quickly. Crops have been washed away, causing further food insecurity, and six counties are already on the brink of famine with hunger growing across the country.
Covid-19 is one more health risk to be added to a list which includes waterborne diseases, contagious outbreaks such as smallpox, kala-azar infection, Ebola and Marburg viruses, as well as malaria and typhoid. Along with conflict and violence, Covid-19 is one more thing that is killing the people of South Sudan, says Annette Hearns, Deputy Head of UN OCHA in South Sudan.
Deaths from the virus may have been lower than feared but it is likely that transmission has been widespread. Vulnerable populations in South Sudan include people with HIV/AIDS and/or TB and older people in a society where 57 is the average life expectancy.
Confirmed cases have started to rise again after a recent decline, leading to fears of a second wave. The official figures show that 87 people have died and 6,931 people had tested positive by late February 2021. But, with minimal testing, it is hard to get a clear picture of the epidemic in South Sudan.
At the outset of the pandemic there was no dedicated laboratory capacity, so the WHO and UN member states were key to supporting the Ministry of Health to get one established. At the end of 2020, a private laboratory was established for those who need tests to travel, testing capacity remains challenged when serving a population of 12 million.
Many people are fearful of going to hospitals due to conflict while others consider it ‘just a flu’ and so they stay at home and treat the symptoms with herbal remedies. Only if they get very sick will they then try to go to hospital.
In some quarters there is community denial of the existence of Covid-19, with belief that it doesn't exist or doesn't affect African people severely.
When the coronavirus pandemic was declared, specific measures could be rolled out, leveraging some of the Ebola preparedness work already in place.
The UN’s Annette Hearns says, however, that Covid-19 mitigation measures, while vital for protection, have complicated the already grave situation: “Humanitarian needs are high, and the Covid pandemic has increased the cost of care and slowed the time it takes to provide aid by the right kind of expert professionals.” For example, a distribution of household items that would previously have taken a day might now take a week and the cost has increased due to social distancing and use of PPE.
Constraints on the movement of people and goods have affected both the formal and informal economic sectors at all levels. Markets remain open but are much less active. Farming, livestock-raising and fishing activities in remote rural areas appear to have been less affected, but trade of agricultural products has been affected by the global economic downturn.
The South Sudan pound has devalued significantly, with high prices, hyper-inflation and unpredictability in the markets. The cost of a food basket in Juba increased by 42% between August to September 2020, says Sulaiman Ken Sesay, Action Against Hunger’s acting country director.34
Aid workers say the greatest issue across the country is food security. Hunger and malnutrition are major concerns, which they believe will exacerbate the transmission of the virus and the spread of other infectious diseases due to reduced immunity.
IPC figures indicate that six counties in South Sudan are on the brink of famine, showing they were reaching Phase 5, the worst classification possible, with ‘famine likely’ or ‘catastrophe’ conditions.35
Closures of schools due to lockdowns, which previously provided children with at least one meal a day, have made matters worse. Mesfin Loha, World Vision’s country director in South Sudan, says: “I spoke to Akech, a mother of seven children, in one of the villages. She told me how important school meals were for her family, as this was the only proper meal her children got in a day. Akech was desperate for the schools to reopen and said it wouldn’t matter if her children didn’t learn anything as long as they could have this free school meal.”
Conflict is commonplace in South Sudan with tribal, ethnic and historical components contributing to the violence. Conflict has led to high levels of displacement internally, with displaced people largely dependent on aid, including food distribution.
But violence affects the safe delivery of this aid to affected communities, with nine aid workers killed in 2020.
Displaced people are also likely to do informal work that they secure day to day; this type of insecure work is particularly vulnerable to the economic impact of the pandemic, such as job losses and increased prices.
South Sudan does not have sufficient donor funds to address its challenges. In 2020 its Humanitarian Response Plan was 56% funded compared with 67% for the previous year.36
If the country receives the same amount of funding in 2021, the ability to reach the same number of people in the same way to the same standard would be less because aid delivery costs more with necessary Covid-prevention measures. Annette Hearns confirms that Covid-19 is therefore complicating people’s access to vital services such as healthcare and education, and, because of the duty of care to aid workers, it’s more expensive to provide humanitarian assistance.
Mesfin Loha from World Vision says: “As we speak, South Sudan has 7.5 million people who rely on food assistance to survive, 800,000 people affected by flooding and about half of them are displaced, making them vulnerable to the transmission of coronavirus. We’d like to continue to focus on our lifesaving interventions, but at the same time we recognise the duty of care we have to our staff and the people we serve.
“My biggest worry for the next few months is therefore how we can continue with our relief and humanitarian work within the Covid framework and how that requires some additional resources.”
This is a view shared by other aid workers. Action Against Hunger’s Sulaiman Ken Sesay explains: “If we don’t have more funding at least to provide basic food to keep infected people at home, they will have to go out to get more food and they will spread the disease.
“Moreover, the flooding will displace more people and an outbreak in such environments where people are living so close together will be catastrophic.”
South Sudan was allocated 15% of the funds available for the first phase of the DEC’s coronavirus response. In the first three months of the response (up to the end of October 2020), seven DEC charities – Action Against Hunger, Age International, CAFOD, Christian Aid, Oxfam, Plan International and Tearfund – used most of the funds spent to date on livelihoods and multipurpose cash assistance (47%), and 13% on water, sanitation and hygiene projects, such as water points and handwashing stations.
DEC members provided support across South Sudan from Central and Eastern Equatoria in the south to Jonglei in the north. PPE and training were provided for frontline and community health workers, and faith and community leaders were given training in Covid-19 prevention in several locations.
Water supplies were provided to around 4,000 people and more than 10,000 hygiene kits containing soap, jerry cans and cloths were distributed in Juba, including to many displaced people. More than 23,000 individuals were reached with hygiene promotion messaging.
Hundreds of households were given food parcels including oil, sorghum, maize and beans or vouchers for food and hundreds more were supported to boost their livelihoods through the provision of seeds and fishing gear and training. More than 1,000 households benefited from cash assistance to buy food and other essential household items.
Covid-19 has exacerbated stress levels in the country and more than 1,000 people received mental health and psycho-social support.
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