Action Against Hunger is working in South Sudan where half the population faces acute food shortages.

The Human Cost of South Sudan’s Civil War

Four years on from conflict, hope remains …

By Action Against Hunger

Dec 5 2017

People are accustomed to scarcity in South Sudan, a relatively new nation which declared independence in 2011. But this year, the situation is devastating. Food costs have skyrocketed, fighting has uprooted at least 3.9 million people according to the United Nations, and half the population faces acute food shortages.

Despite independence bringing hope for peace in the war-torn country, in December 2013, civil war broke out. Political upheaval and ongoing conflict—combined with widespread insecurity, inflation, food deficits, and an unstable economy—have contributed to a spiralling humanitarian emergency.

In February 2017, famine was officially declared in two counties in Unity State in South Sudan and today, an elevated risk of famine threatens many parts of the country. Six million people are in urgent need of food assistance – the greatest number of people suffering from hunger ever recorded in the nation.

When her first son was born, Agawol lived in Yargot, a village in the north of what is now South Sudan. There, life has always been hard: depending on a small plot of land to grow food, and coping with very little access to clean water, income opportunities, or health care services.

In the historic 2011 referendum, she cast her vote in favour of South Sudan’s independence from the Republic of Sudan.

"I thought that peace would be established and that hunger would be a fading memory,” says Agawol. Her hope was short-lived as the country erupted into civil war two years later.

Fighting made many roads unsafe, interfering with the delivery of food and other essential goods to local markets. Rising food prices have forced families to eat less and less.


Agawol rises at dawn to tend her crops, then goes out to collect firewood. Once she has enough, she ties it up, put it on her head in perfect balance, and walks toward the market. There are no fresh fruits or vegetables. Agawol sets her bundle down, and a woman examines her wood and offers to purchase it. With the money Agawol earns, she buys two sachets: one of milk, another of peanut powder. She smiles. Her family will eat today.

Last year, when Agawol's sixth daughter got sick, she was not surprised. Her sorghum harvest had been ruined and prices were high. She had no choice but to eat boiled leaves as the only food.

"My child cried and cried, but I had nothing else to feed her," says Agawol. When the girl barely had enough strength, she was taken to the health center and Action Against Hunger staff diagnosed her with acute malnutrition. 

"I was told I should feed her a special peanut paste," she explains, referring to a ready-to-use therapeutic food full of protein and micronutrients designed to treat acutely malnourished children and restore them to health. Action Against Hunger admitted Agawol’s daughter into its outpatient program for acutely malnourished children, where caregivers are given weekly supplies of the special therapeutic food, and health workers provide weekly monitoring to track children’s health and nutrition status.

Agawol says: “We went back for a check-up every week, and I saw my child gaining weight until she was discharged one month later."


Dr. David Zakaio used to work in South Sudan’s capital city of Juba. Although the civil conflict and the fighting were happening in places far from where he lived, for Dr. Zakaio, the crisis hit him close to home. He decided to leave his job and the safety of his home and apply his skills as a medical doctor to help people in his country who were suffering.

"I worked as a volunteer for eight months in the areas most affected by the conflict. The situation requires everybody’s help and I contribute with my medical knowledge," Dr. Zakaio said.

He then took a position with Action Against Hunger as a Roving Medical Doctor: "I train health workers at local health centres to identify and treat children with the most serious cases of malnutrition with medical complications," he says.

In his time working with Action Against Hunger, Dr. Zakaio has helped to save the lives of many malnourished children. There have also been many whose lives he could not save. Days of despair and days of hope. Acute malnutrition is a major public health emergency in several parts of South Sudan.  

Dr. Zakaio keeps his hopes for his country high. Helping people is just something that is in him, he says. He believes in change. Ending hunger is possible, he says. “My happy days are when I know I am doing my part.”


Watch the 'Four Years of Conflict: Four Forces for Change' short film about South Sudan here.

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Images: A.Parsons/i-images for Action Against Hunger