Severe Acute Malnutrition Skyrocketing In Save The Children Clinics As Sudan Now In Worst Phase Of Food Insecurity

The number of children in Sudan seeking treatment for severe acute malnutrition (SAM) has surged to unprecedented levels with clinics overwhelmed and global experts on food security warning that parts of the country are in the worst possible phase of hunger, Save the Children said.

A health and nutrition manager for Save the Children in the central southern state of South Kordofan said the number of under-fives admitted with SAM in June alone was 99% of the programme’s expected case load for the year [1].

In one clinic cases of SAM - the most extreme form of malnutrition - increased nearly fourfold between June 2023 and June this year, new data shows [2]. SAM shuts down children’s immune systems and makes otherwise non-life-threatening conditions like diarrhea potentially lethal.

The aid group’s findings come as the latest report from the Famine Review Committee of the Integrated Food Security Phase Classification (IPC) - the leading international authority on the severity of hunger crises - flagged the increasing severity of the food crisis in the country [3].

More than 15 months of conflict have killed and injured thousands of children, forced many into child labour, destroyed healthcare and education, upended food systems, and created the world’s worst child displacement crisis with 6.7 million children now forced from their homes [4].

Displaced people are now overwhelming health facilities, turning up starving, sick and exhausted, according to Save the Children staff. They are seeing an increase in conditions such as acute respiratory infections (ARI), which can be caused and exacerbated by malnutrition [5].

Munir-, health and nutrition manager for Save the Children in South Kordofan, said: " IDPs (internally displaced people) have lost all basic needs due to conflict, they can only eat inadequate food, and most children show signs of exhaustion, fatigue, severe wasting and illness. Most ARI cases are linked with poor diet and malnutrition.

Describing the conditions in Kordofan, Munir- said: " I saw schools, mosques, public institutions, villages, and some roads in cities full of displaced people sleeping in plastic sheets without mattresses or beds. Many of them complain of chronic diseases and high costs of medicine and food, and some of them depend for food on subsidies from charitable people or organizations, but the aid is not enough. The profession of begging has spread in the Kordofan areas."

Child labour is rampant as families are forced to take desperate measures to get their hands on whatever food they can to stay alive, Save the Children said, with children toiling in temperatures as high as 45 degrees C.

In South Kordofan, children younger than 15 are doing manual labour such as carrying heavy jerry cans full of water, washing carts, unloading heavy goods from trucks, construction and even driving rickshaws. In Central Darfur, Save the Children staff have come across children who have been completely separated from their parents and are now working in a local market [6].

Meanwhile, the number of people seeking treatment at Save the Children health facilities in Central Darfur nearly doubled in the year to June 2024 [7]. Staff in Darfur are also overwhelmed themselves, with some having lost family members including children, their homes and their belongings.

Dr Arif Noor, Country Director of Save the Children in Sudan, said: " In Sudan, time is running out to keep children alive. And yet parties to the conflict and those with international influence have failed to put an end to the fighting over and over again.

"Some children who are surviving are forced to work in unimaginable conditions, some separated from family members and vulnerable to exploitation and abuse.

"We have been saying it for 15 months and we will keep saying it until we no longer need to - it is time for an immediate and lasting ceasefire, and for a mammoth surge of support for the 14 million children in Sudan whose lives have been shattered."

Recent Save the Children analysis of IPC figures found that 16.4 million children, or three in every four children, faced "crisis", "emergency" or "catastrophe" levels of hunger - almost double the figure of 8.3 million from last December [8].

The humanitarian response for Sudan is significantly underfunded, with donors contributing just 32.3% to a $2.7 billion UN response plan.

Save the Children is calling for an immediate ceasefire and meaningful progress towards a lasting peace agreement. In the meantime, the child rights organisation is pushing for safe, unimpeded humanitarian access to civilians across border routes and fighting lines inside Sudan; the safeguarding of vital infrastructure essential for food systems, such as markets, agricultural land, and storage facilities; and immediate intervention from the international community to fully fund the Sudan Humanitarian Response Plan to save children’s lives.

Save the Children has worked in Sudan since 1983 and is currently supporting children and their families across Sudan providing health, nutrition, education, child protection and food security and livelihoods support. Save the Children is also supporting refugees from Sudan in Egypt and South Sudan.

- name has been changed to protect anonymity

[1] In a clinic in South Kordofan state, the planned annual target for treating SAM in children under 5 was 1474 cases, and during June 2024 Save the Children staff admitted 1457 SAM cases in children under 5. Out of this total 626 SAM cases have been treated, cured, and discharged, and 831 SAM cases are still receiving treatment.

[2] In one clinic, admissions for SAM in children was 395 in June and 1457 in June 2024.

[3] FRC has determined that it is plausible that IPC Phase 5 (Famine) conditions, the worst form of hunger, are currently present and are likely to continue through the end of October 2024 in the Zamzam Internally Displaced Persons (IDP) camp in North Darfur. Famine, the highest IPC Phase, is an IPC classification at the area level. Areas are classified in IPC Phase 5 (Famine) when at least one in five (or 20 percent) people or households have an extreme lack of food and face starvation and destitution, resulting in extremely critical levels of acute malnutrition and death.

[4] Save the Children analysis of latest IOM data shows an estimated 6.7 million children are displaced either internally or across borders. DTM Sudan Mobility Update (04) | Displacement Tracking Matrix (iom.int)

[5] The total number of ARI cases during January-June 2023 in Save the Children’s health facilities in South Kordofan was 28,279 cases, of which 19,775 (70%) were children. In 2024, cases increased to 32,989 cases, of which 23,070 (70%) were children.

[6] Save the Children staff registered these children in case management and are now working to respond to their needs.

[7] The number of people admitted in June 2023 was 6,817 and in June 2024 it was 11,665.

[8] To make this calculation, Save the Children applied UN data on child share of population in Sudan (47.1%) to the IPC Partnership’s figures showing 25.6 million people are facing IPC Phase 3 and above. Save the Children estimates that this amounts to 16,355,605 children, up from 8,336,700 in December.

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