South Sudan: Floods, disease and death in Bentiu

29 August, 2014
August 2014, Bentiu, South Sudan: Two young children wade through water at the UN base in Bentiu in the north of South Sudan. Aid groups warn that worsening sanitary conditions and poor access to clean water are contributing to severe malnutrition rates. Credit: OCHA/Ann Weru
August 2014, Bentiu, South Sudan: Two young children wade through water at the UN base in Bentiu in the north of South Sudan. Aid groups warn that worsening sanitary conditions and poor access to clean water are contributing to severe malnutrition rates. Credit: OCHA/Ann Weru

The sight of people wading in knee-deep water between dilapidated and flooded shelters in the UN base in Bentiu has become increasingly common as the rainy season peaks.

With the flooding, already squalid living conditions for the over 46,000 people seeking shelter at the UN base in Bentiu in South Sudan’s northern Unity State have worsened. Latrines have collapsed contaminating ground water; debris has clogged drainage channels.

A cycle of disease and death

The risk of infectious waterborne diseases is increasing, especially for children under age 5.

Ivan Gayton, Emergency Coordinator for the medical NGO Médecins Sans Frontières (MSF) in Bentiu explains:

“What’s happening here is that a child drinks dirty water or they don’t have a latrine,” he says. “So they get faeces on their hands and it gets into their mouth and they get a little infection.

“And then they have some diarrhoea and vomiting so they lose a little weight. And when they lose weight, the immune system starts to be depressed.”

A weakened immune system predisposes a child to further infections which almost inevitably leads to malnutrition. There is food available in the Bentiu base, says MSF’s Gayton, but children are still dying from malnutrition. “It’s absolutely unnecessary, it’s preventable. The issue here is the water and sanitation. It urgently needs to be improved.”

Water, sanitation and hygiene directly linked to malnutrition

According to the World Health Organization, water supply, sanitation and hygiene, given their direct impact on infectious disease, especially diarrhoea, are critical for preventing malnutrition.

In June, MSF reported that as many as four children under five were dying each day at the Bentiu site, mainly as a result of acute diarrhoea and pneumonia. While mortality rates have improved in recent weeks, MSF still reports that at least one child is dying every day in Bentiu.

“Overall the health situation of the population in the [Bentiu] site is deteriorating. The arrival of heavy rains has made the provision of medical care and water and sanitation services even more difficult and a lot more needs to be done and fast,” says MSF’s Gayton.

Need for an integrated approach

While aid groups are improving access to water and sanitation, needs are overwhelming.

“A lack of space in some of the displacement sites, which are congested and characterized by haphazard settlements, makes improving access to water and sanitation difficult,” said Subodh Vijapure, Concern Worldwide’s (https://www.concern.net/) emergency Water, Sanitation and Hygiene Programme Manager. “Garbage is another issue with dumping in existing drainage systems a problem.”

Dozens of latrines need to be constructed to meet the recommended minimum humanitarian standard of one latrine for every 50 people.

Growing needs

While the situation there is dire, the Bentiu site continues to draw in people seeking safety and food even as others leave due to deteriorating conditions.

“We have come here because there is no food. Before we decided to come here, we were feeding on wild grass and water lilies,” said Angelina Nyagai, who had just arrived at the UN base in Bentiu with her four children from the village of Barmalual in Rubkona County, Unity State.

To address growing needs, aid groups are providing health screening services at the entrance of the Bentiu displacement site. This allows them to identify and promptly refer for treatment those who are sick. An additional outpatient therapeutic programme site has been set up for the malnourished.

In 2014, health and nutrition partners in South Sudan are aiming to provide treatment and support to 176,000 children aged six months to five years who are suffering from severe acute malnutrition. So far, some 42,000 children have been reached. More funding is needed to boost the nutrition and water and sanitation response.