South Sudan's struggle with Mental Health and Malnutrition

South Sudan's struggle with Mental Health & Malnutrition

Nyayaul Gatkuoth Chol fled the violence in South Sudan, to a refugee camp in Ethiopia. Memories of violence and attacks still haunt her young grandson

By Action Against Hunger

Apr 15 2019

 “We want to go home to South Sudan, but we can’t”

When her 5-year-old grandson wakes in the middle of the night, shaking and screaming from the nightmares that haunt him, Nyayaul Gatkuoth Chol is worried but not surprised. The youngster watched his father and grandfather’s, Chol’s husband and son’s, murder two years ago in neighbouring South Sudan.

Chol, along with tens of thousands of other South Sudanese refugees, fled the violence in Mathiang, a community about 500 kilometres away, to this dusty refugee camp in Ethiopia, where she now lives with four of her grandchildren and an orphan she also looks after.

Mental health issues are common among refugees in the camp, with some here blaming them on evil spirits. But Chol knows the violence her grandson saw back home is responsible for his night terrors. Living in this temporary camp, far from home and without enough to eat, adds to the child’s mental health challenges.

“We want to go home to South Sudan, but we can’t,” Chol says. “Not until the fighting is over.” Despite recent positive political strides, including a peace deal last year aimed at ending the country’s five-year civil war, the world’s youngest state remains perpetually unstable, home to one of the worst humanitarian disasters. The crisis is characterised by gross human rights abuses, according to a recent UN report. “Rapes, gang rapes, sexual mutilation, abductions and sexual slavery, as well as killings, have become commonplace in South Sudan,” noted Yasmin Sooka, the chair of the Commission on Human Rights in South Sudan, which produced the paper. The result is a dispersed population with extensive mental health issues.

1.9 million displaced people

Decades of armed conflict in South Sudan have resulted in high levels of post-traumatic stress disorder, including among those who have fled the country. Out of a population of about 12 million, 1.9 million South Sudanese are currently displaced within the country and more than two million are living in camps like these in neighbouring countries.

Nguenyyiel, the newest and biggest camp in the Gambella region, is home to more than 75,000 South Sudanese refugees. It was opened in 2016 following flare-ups between opposing South Sudanese factions to accommodate a new influx of refugees to this sparsely populated, low-lying and remote corner in southwest Ethiopia. The region currently hosts more than 360,000 refugees from South Sudan.

Nguenyyiel camp, Gambella region, Ethiopia. 

Unlike most refugee camps, Nguenyyiel at first appears calm, clean and orderly. Neat rows of tukuls, the cone-shaped mud huts with thatched roofs common to this region, give the appearance of a genuine local village. But behind this hygienic order is a tenuousness that continues to threaten those living here. Outside the camp, the crisis has destabilised the region, where clashes between different ethnic groups are common. Women, children and youth make up the majority of residents in the camp — 62 per cent are younger than 18 — because many men remain behind in South Sudan to guard homes and farmland. Several women and children who left the safety of Nguenyyiel to collect firewood in the nearby forests have been sexually assaulted and killed.

Inside the camp, the human cost of regional instability is brought into focus when you see the high number of unhealthy children in the clinics set up here to treat malnutrition. Action Against Hunger, runs these health centres, which have recently seen a spike in the number of cases of severe acute malnutrition, also known as wasting. The rise is partially due to a lack of clean water. Local officials and aid organisations installed a water system in 2017, with pipelines to serve Nguenyyiel and other camps in the region — as well as the local population — but a generator recently broke down. This has meant that camp residents only get half a day of water at a time, if they’re lucky.

As one member of our team in Nguenyyiel noted, “If one thing falls apart in the camp, everything falls apart.”

Images: Naomi Garneau for Action Against Hunger.