Estimated 7.5 million people in need of humanitarian assistance in South Sudan

Summary of Humanitarian Needs

• TOTAL POPULATION: 11.7M
• PEOPLE IN NEED: 7.5M

Context and impact of the crisis

A year after the signing of the Revitalized Agreement on the Resolution of the Conflict in South Sudan (R-ARCSS), the ceasefire holds in most parts of the country. Armed conflict between State security forces and opposition armed groups has been contained to a small number of areas in the Equatorias where Government forces continue to clash with non-signatories to the agreement. Many areas are seeing intra- and inter-communal violence, enabled by small-arms proliferation and weak rule of law. This is often driven by resource scarcity in areas that have experienced years of severe food insecurity.

Overall progress on the implementation of the R-ARCSS has been modest. The deadline for the parties to the agreement to form a transitional government of national unity has been extended twice, most recently until early 2020, following regional mediation efforts aimed at preventing the country from slipping back into conflict.

Delayed cantonment of former fighters, full integration of forces, decisions concerning the number of states and their boundaries, and unresolved issues between R-ARCSS signatories around security arrangements for the opposition are among the sources of uncertainty concerning the country’s short-term future.

This can affect displaced people’s decisions about returning to their places of origin or habitual residence. Although an estimated 1 million people have returned from displacement inside South Sudan or from countries of asylum since November 2017, nearly 4 million people remain displaced by the humanitarian crisis: 1.5 million internally and more than 2.2 million as refugees. Recent interviews with internally displaced people (IDPs) found that beyond the continued threat of conflict, potential barriers to return included lack of safety, services and livelihood opportunities in areas of return; the destruction or occupation of former homes; and lack of accountability for human rights violations committed during the war, including sexual violence. Intention surveys with refugees found lack of livelihoods; inadequate basic services; lack of political solutions; safety and security; and lack of education opportunities as key reasons for not returning.

Scope of analysis

Since no part of the country has been spared from the humanitarian crisis, the Humanitarian Needs Overview (HNO) analysis covers all 78 counties of South Sudan. All segments of the population apart from the wealthiest quintile in each county were considered to be affected by the crisis. Specifically, the analysis considered the needs of four segments of the population: IDPs, returnees from within South Sudan and from countries of asylum, host community members and people who are otherwise affected but not displaced, and some 300,000 refugees from neighbouring countries in South Sudan.

The severity analysis and calculations of people in need focused on two main humanitarian consequences of the crisis: physical and mental well-being, and living standards. As South Sudan remains in a protection crisis, protection-related needs were prominently integrated within the analysis of these two humanitarian consequences. Resilience and recovery needs were also considered in the analysis.

The severity levels used for the HNO were adjusted to needs that are most related to sustaining and improving physical and mental well-being, and living standards. The thresholds of calculating the people in need are higher than in many other emergencies. This is in a context where the level of development remains compromised and fragile: South Sudan ranked third last out of 189 countries in the 2018 Human Development Index. It is a setting where, two years into the country’s independence, basic services were limited or absent in many areas, even before the conflict broke out in 2013.

Humanitarian consequences

South Sudan and its people continue to reel from the impacts of years of conflict, violence and limited of development investment. Some 7.3 million people are facing problems related to their physical and mental well-being. Almost half of all counties have a convergence of high needs related to food insecurity, protection, and water, sanitation and hygiene (WASH).

Food insecurity is the main driver behind the number of people in need. Nearly 6.4 million people or 54 per cent of the population were acutely food insecure in August 2019, according to the Integrated Food Security Phase Classification (IPC) analysis. The prevalence of global acute malnutrition (GAM) among children increased from 13 per cent in 2018 to 16 per cent in 2019, exceeding the global emergency threshold of 15 per cent. In 2020, more than 1.3 million under-five children are projected to be acutely malnourished. Needs are closely interrelated across sectors. For example, acute malnutrition is attributed to the persistent high food insecurity, poor quality and diversity of food, low water quality as well as high morbidity due to a weak health system.

Forty-four per cent of the population are at risk of communicable and non-communicable diseases. At any one time, every other child is sick with fever or malaria, and every fourth child with diarrhoea. Around 75 per cent of all child deaths in South Sudan are due to preventable diseases, such as diarrhoea, malaria and pneumonia. Applying the latest prevalence estimates of mental disorders in conflict settings to South Sudan, approximately 2.5 million people might have a mental disorder at any point in time. Up to 900,000 children are afflicted with psychological trauma as a result of witnessing violence or experiencing it directly during attacks on schools or similar violent incidents. Vaccination coverage is low, with 43 per cent coverage of one of the most critical vaccinations for children under 1 year, PENTA 3 (diphtheria, pertussis, tetanus, hepatitis B and haemophilus influenza).

An estimated 5.2 million people are facing severe issues with their living conditions. Two thirds of the counties have a convergence of high WASH, protection and education-related needs. Lack of basic services is one of the main drivers of need and one of the main obstacles for people to begin recovering from the years of conflict and violence. More than 40 per cent of the population have no access to primary health care services. An estimated 60 per cent of the total population either rely on unimproved or surface water sources; or have to walk more than 30 minutes to reach the improved water sources or face protection risks even if they could access the improved sources. In some parts of the country, three in four children are out of school. Only 20 per cent of at-risk women and girls have access to services related to gender-based violence (GBV). Only 6.5 per cent of at-risk children—those below the age of 18 years with likelihood that violation of and threats to their rights will manifest and cause harm to them—can access psychosocial support and other child protection services.

Displaced people and spontaneous returnees face specific challenges with their living conditions. This includes IDPs and refugee returnees in IDP-like situations living in overcrowded conditions in camps and spontaneous settlements, without access to safe shelter, and returnees without access to accountable legal remedies related to housing, land and property.

While a marked increase in displaced people deciding to return would be an indication of greater stability and prospects for prosperity and potentially reinforce these in the long term, high volumes of returns could in the short to medium term worsen vulnerable people’s well-being and living conditions, and erode community resilience. This could be due to greater competition over limited food and livelihoods, pressures put on already stretched basic services, or problems related to housing, land and property. The current level of service provision in areas of return is estimated to be unsustainable for higher rates of return.

People in need and severity of needs

In total, nearly 7.5 million people are in need of some type of humanitarian assistance or protection. Of the 78 counties in South Sudan, 45 are in severe need and 33 are in extreme need.

Of these 33 counties, people in 23 of them have faced extreme need for at least two consecutive years. Some 30 per cent of the counties in extreme need are located in Upper Nile, followed by 21 per cent in Jonglei and 15 per cent in Eastern Equatoria. Some 5.2 million of the people in need are host community members or people who are otherwise affected but not displaced, while 1.4 million are IDPs, nearly 600,000 are returnees and about 300,000 are refugees. Within these population groups, some of the vulnerable groups that may have specific needs include children, women at risk, the elderly, people with disabilities, single-headed household members, and the extremely poor.