South Sudan Research Articles

Famine and food security: new trends and systems or politics as usual? An introduction.

Over the past decade, famine and food insecurity have increased, yet there have been few articles with a critical analysis of their social and political dynamics. This special issue of Disasters aims to revive such analysis and to provide new insights. The special issue contains eight articles, with topics ranging from the role of global politics and neoliberal strategies, to sanctions, war, settler-colonialism, elite capture and inequalities, actions of resistance and resilience, and the challenges of famine prevention in today's global political context. The papers provide both global and local analysis, with the latter covering Kashmir, South Africa, South Sudan, Sudan, and Syria.

Quality of care in South Sudan and its associated factors, a facility-based cross-sectional study in public health facilities in Yambio County, Western Equatoria State.

The patient's experience of care is critical in determining how satisfied the client is with the quality of health services offered by the health facility. Understanding health needs aids in identifying gaps in service provision as well as potential avenues for planning and improving health care services. The primary goal of this study was to explore the attributes of quality healthcare in South Sudan from the perspective of healthcare recipients. Nonetheless, South Sudan's health system has remained inadequate since the country's independence in 2011, with 85% of deliveries performed by unskilled health personnel, high maternal and child death rates, and a lack of vital lifesaving drugs in health facilities. Political unrest, natural disasters, poor infrastructure, and budgetary limits are among the additional factors impeding the provision of high-quality care services to the population in need. However, the South Sudan government, with the support of international health partners, continues to work towards ensuring that basic health needs are met in accordance with SDG-3 recommendations. This was a facility-based cross-sectional descriptive study conducted in four selected health facilities in Yambio County, Western Equatoria State, from July 1st to September 30th, 2023. A sample size of 422 was included, and a randomized sampling procedure was used, with 60% of public health facilities supported by non-governmental organizations utilizing the lottery method. Data were collected and entered into SPSS version 25 for descriptive and regression analysis. A total of 422 participants were solicited for the study, with a response rate of 99.81 percent. Of the 421 responders, 72% (303/421) were female and 28% (118/421) were male. The overall satisfaction with the experience of quality of health care delivered was 84.8%. A preliminary analysis found that the assumption of multicollinearity was met (Age, sex, feeling of having chance to fully explain a problem to care provider, physical examination, provider's technical capacity in diagnosis and treatment, provider attitude, client respect) among others, were all associated with the client's experience of care and satisfaction with the quality of health care. The clients who sought health care at the public health facilities in Western Equatorial State were quite satisfied with the quality of health services (84.8%). Provider's behaviors, attitudes, and technical skills, among other major factors, were found to be associated with the client's positive experience of care. To uphold health ethics, the study recommends including medical ethics training and client center care into continuing medical educations at health facilities.

Temporal Patterns in Migration Flows Evidence from South Sudan

ABSTRACTWhat explains the variation in migration flows over time and space? Existing work has contributed to a rich understanding of the factors that affect why and when people leave. What is less understood are the dynamics of migration flows over time. Existing work typically focuses on static variables at the country‐year level and ignores the temporal dynamics. Are there recurring temporal patterns in migration flows? And can we use these patterns to improve our forecasts of the number of migrants? Here, we introduce new methods to uncover temporal sequences—motifs—in the number of migrants over time and use these motifs for forecasting. By developing a multivariable shape similarity‐based model, we show that temporal patterns do exist. Moreover, using these patterns results in better out‐of‐sample forecasts than a benchmark of statistical and neural networks models. We apply the new method to the case of South Sudan.

Dispersing into the ether: a discourse on how the Ugandan government banished the LRA to the shadow realm

ABSTRACT When Yoweri Museveni took power in Uganda in 1986, the NRM administration was faced with a press of problems. Of the plethora of insurgencies that emerged, the LRA perdured staging a virulent guerrilla campaign. Its leader, Joseph Kony, has long been one of Africa’s notorious warlords. For over three decades, his group has struck terror. Today, Kony’s firm grip on the rebellion is loosening. Recent defectors have suggested that he no longer enjoys absolute control. Short of declaring the end of the LRA menace, this article establishes that the prospects of this group overthrowing Museveni from distant bases in the remotest Kafia Kingi enclave in western South Sudan, where they collect and sell honey and alluvial gold, are unfeasible. What led to this outcome in the Ugandan civil war? Inasmuch as the government’s counterinsurgency efforts were focused on the pacification of Acholiland through population concentration; and, elimination and containment approaches of the LRA; Museveni also managed to build a network of regional and international coalitions. This strategy isolated the LRA and allowed for overt military interventions in Southern Sudan, DRC, and CAR. It is the meld of these strategies which combined to expel the LRA from Uganda.

Progress Toward Global Dracunculiasis (Guinea Worm Disease) Eradication, January 2023-June 2024.

The effort to eradicate Dracunculus medinensis, the etiologic agent of dracunculiasis, or Guinea worm disease, began at CDC in 1980. In 1986, with an estimated 3.5 million global cases in 20 African and Asian countries, the World Health Assembly called for dracunculiasis elimination. The Guinea Worm Eradication Program (GWEP) was established to help countries with endemic dracunculiasis reach this goal. GWEP is led by The Carter Center and supported by partners, including the countries with endemic disease, CDC, UNICEF, and the World Health Organization. Since 2012, infections in dogs, cats, and baboons have posed a new challenge for GWEP, as have ongoing civil unrest and insecurity in some areas. As of June 2024, dracunculiasis remained endemic in five countries (Angola, Chad, Ethiopia, Mali, and South Sudan). Fourteen human cases and 886 animal infections occurred, including 407 dogs in Chad and 248 dogs in Cameroon, reported in 2023, and three human cases and 297 animal infections reported during January-June 2024. Animal infections, primarily in dogs in Cameroon and Chad, and impeded access due to civil unrest and insecurity in Mali, threaten the near-term possibility of global eradication. Nevertheless, countries appear poised to reach zero cases.

Cost effectiveness and return on investment analysis for surgical care in a conflict-affected region of Sudan.

The delivery of healthcare in conflict-affected regions places tremendous strains to health systems, and the economic value of surgical care in conflict settings remains poorly understood. Our aims were to evaluate the cost-effectiveness, societal economic benefits, and return on investment (ROI) for surgical care in a conflict-affected region in Sudan. We conducted a retrospective study of surgical care from January to December 2022 at the Mother of Mercy-Gidel Hospital (MMH) in the Nuba Mountains of Sudan, a semi-autonomous region characterized by chronic and cyclical conflict. We collected data on all patients undergoing surgical procedures (n = 3016), including age, condition, and procedure. We used the MMH budget and financial statements to measure direct medical and non-medical expenditures (costs) for care. We estimated the proportion of expenditures for surgical care through a survey of surgical vs non-surgical beds. The benefits of care were calculated as averted disability-adjusted life-years (DALYa) based on predicted outcomes for the most common 81% of procedures, and then extrapolated to the overall cohort. We calculated the average cost-effectiveness ratio (CER) of care. The societal economic benefits of surgical care were modeled using a human capital approach, and we performed a ROI analysis. Uncertainty was estimated using sensitivity analysis. We found that the CER for all surgical care was $72.54/DALYa. This CER is far less than the gross domestic product per capita in the comparator economy of South Sudan ($585), qualifying it as very cost-effective by World Health Organization standards. The total societal economic impact of surgical care was $9,124,686, yielding a greater than 14:1 ROI ratio. Sensitivity analysis confirmed confidence in all output models. Surgical care in this conflict-affected region of Sudan is very cost-effective, provides substantial societal economic benefits, and a high return on investment.

The indispensable function of agricultural cooperatives in South Sudan

AbstractMost of South Sudan's rural population ekes out a living from farming in a fragile context characterized by compounding and interrelated shocks. The productivity of maize, a key staple, has remained comparatively low. South Sudan is currently transforming its agricultural sector to be at the centre of its economic activity. Programming has zoomed in on seed‐related interventions. Cooperatives, which are longstanding and widespread in the country, are leveraged to distribute seed and, by mitigating production risk, could contribute to resilient development. To shed light on the key functions of cooperatives and how their role can be enhanced, we analysed recent data from 1247 maize‐producing households and 126 agricultural cooperatives from South Sudan. We find that through their services cooperatives contribute to both increasing maize yields and reducing their variability. Yield increases associated with seed production and/or distribution services are substantial but exclusive to members. Managerial capital in the form of a hired manager instead also generates spillover effects to the broader community. Our findings point to the relevance of cooperatives as indispensable stakeholders for the resilient development of the country and the need for investments to strengthen their managerial capital and enhance the provision of services related to seed production and/or distribution.

Returning to fund refugeehood: dispersal and survival between Uganda and South Sudan

ABSTRACT Return movements of refugees, even when gradual or temporary, are typically understood as part of a process of full repatriation or as a ‘strategy’ for leveraging socio-economic opportunities across borders. However, for some refugees, return is neither a step towards repatriation nor an empowering strategy. Drawing on qualitative and quantitative data from Uganda and South Sudan, this article shows how, due to gradual reductions in aid and the lack of livelihood opportunities in Uganda, South Sudanese refugees travel back to their homeland in order to financially support their relatives who remain in exile. These return movements and the phenomenon of split households among South Sudanese are responses to severe hardship and, paradoxically, are deployed to sustain their life in Uganda. While cross-border migration enables refugees to access subsistence opportunities, this article argues that it underscores how refugees must now find their own means to ‘fund’ their refugeehood, given ongoing reductions in international assistance for protracted displacement.

Safety of hepatitis E vaccine in pregnancy: an emulated target trial following a mass reactive vaccination campaign in Bentiu internally displaced persons camp, South Sudan

Epidemic forms of hepatitis E cause high mortality among pregnant people, with case fatality risks over 30% and adverse fetal outcomes. In 2022, the first mass reactive vaccination campaign against hepatitis E was conducted in South Sudan with the HEV239 vaccine. We aimed to assess whether vaccination against hepatitis E in pregnancy increases the risk of fetal loss in a cohort of vaccinated and unvaccinated pregnant people. In this emulated target trial, an exhaustive pregnancy census was conducted in Bentiu internally displaced persons camp after the second of three vaccination rounds. Women and girls aged 14-45 years with no current jaundice or acute illness were eligible for participation. Individuals who consented were revisited 28 days after their delivery date to document the pregnancy outcome. We used an emulated target trial framework to address biases inherent in observational studies. We matched vaccinated to unvaccinated participants on age, gestational age, and vaccination propensity score and estimated cumulative incidence functions for fetal loss in vaccinated compared to unvaccinated women in a competing risks framework using the Aalen-Johansen estimator. Between May 16 and June 30, 2022, 3421 participants were enrolled and followed up for inclusion in analysis. Among 2741 women who had a pregnancy outcome after the start of the vaccination campaign, 67 (2·4%) were vaccinated before conception, 2036 (74·3%) were vaccinated during pregnancy, and 638 (23·2%) were not vaccinated. Among the 2407 women retained in the matched analyses, the cumulative risk of fetal loss among individuals vaccinated during pregnancy was 7·2% (95% CI 5·6-8·7) compared with 6·1% (3·7-9·2) among unvaccinated individuals, implying a risk ratio of 1·2 (95% CI 0·7-1·9). No evidence of increased risk of fetal loss was found among individuals vaccinated during pregnancy. Médecins Sans Frontières.

The Role Of Informal Intercommunal Dialogue On Sustainable Conflict Management In The Ilemi Triangle

Peace continues to be elusive in the Ilemi Triangle, which is located at the intersection of Ethiopia, Kenya and South Sudan. This study focused on the Dassanech and Turkana communities due to the increased frequency and intensity of violent conflicts between them. Drawing from the Systems Theory, the study explored how the local social organising through intercommunal dialogue impacts on how people respond to the conflict. Using qualitative case study methods, the study involved in-depth interviews with members of the Dassanech and Turkana communities who were purposively selected to include different members of the community structure who engage in intercommunal dialogue. These in-depth interviews were supplemented by focus group discussions (FGD) of participants through quota sampling. Each FGD had members who were immediately affected by the conflict from four kraals/kebele on either side of the conflict line. The data was subjected to a thematic analysis and organised into themes and sub-themes, from which patterns were identified and used for further research and reporting. There is compelling evidence these communities are familiar with each other, and during peacetime the acquaintance is characterized by friendship, visitation, and economic activity, which can facilitate and be a catalyst to sustainable conflict management.

The challenge of triple intestinal parasite infections in immigrants-A call for comprehensive differential diagnosis.

Screening for parasitic infections among displaced populations including migrants, refugees, and internally displaced persons is crucial to prevent long-term complications associated with untreated infections. Additionally, prompt treatment with appropriate medications like praziquantel and albendazole can lead to significant improvement and successful patient outcomes. This case highlights the necessity of heightened awareness, early detection, and effective management of parasitic infections to enhance public health efforts and minimize the spread of these diseases. Implementing multisectoral One Health will improve human, animal, and environmental health globally using limited resources. Parasitic infections including Schistosoma spp., hookworm, and Strongyloides spp. are commonly co-existing diseases in underdeveloped countries including South Sudan and Sudan. These infections are often presented with no specific symptoms, therefore they remain undetected and eventually leading to long-term complications. Latent parasitic infections among adults particularly displaced population like migrants and refugees have recently gained global attention. In this case report, we present the case of a young male immigrant from South Sudan with multi-parasitic infections. The patient was admitted to a hospital complaining of gastrointestinal symptoms of hematemesis and melena, which were accompanied by signs of liver and spleen enlargement, coupled with low blood cell counts. While liver function tests showed no abnormalities, stool examinations confirmed the presence of S. mansoni, hook worm eggs, and Rhabditiform first-stage larvae of S. stercoralis. The patient was treated with medications such as praziquantel and albendazole, which resulted in full recovery and discharge from the hospital. This case highlights the importance of considering multiple infections among patients with gastrointestinal symptoms, especially in endemic areas. Cost-effective prevention and control strategy require the implementation of a multisectoral One Health strategy for the surveillance, prevention, and control of parasitic infections in human, animals, and the environment.

Pre- and post-harvest aflatoxin contamination and management strategies of Aspergillus spoilage in East African Community maize: review of etiology and climatic susceptibility.

Globally, maize (Zea mays L.) is deemed an important cereal that serves as a staple food and feed for humans and animals, respectively. Across the East African Community, maize is the staple food responsible for providing over one-third of calories in diets. Ideally, stored maize functions as man-made grain ecosystems, with nutritive quality changes influenced predominantly by chemical, biological, and physical factors. Food spoilage and fungal contamination are convergent reasons that contribute to the exacerbation of mycotoxins prevalence, particularly when storage conditions have deteriorated. In Kenya, aflatoxins are known to be endemic with the 2004 acute aflatoxicosis outbreak being described as one of the most ravaging epidemics in the history of human mycotoxin poisoning. In Tanzania, the worst aflatoxin outbreak occurred in 2016 with case fatalities reaching 50%. Similar cases of aflatoxicoses have also been reported in Uganda, scenarios that depict the severity of mycotoxin contamination across this region. Rwanda, Burundi, and South Sudan seemingly have minimal occurrences and fatalities of aflatoxicoses and aflatoxin contamination. Low diet diversity tends to aggravate human exposure to aflatoxins since maize, as a dietetic staple, is highly aflatoxin-prone. In light of this, it becomes imperative to formulate and develop workable control frameworks that can be embraced in minimizing aflatoxin contamination throughout the food chain. This review evaluates the scope and magnitude of aflatoxin contamination in post-harvest maize and climate susceptibility within an East African Community context. The paper also treats the potential green control strategies against Aspergillus spoilage including biocontrol-prophylactic handling for better and durable maize production.

E-Tendering and Performance of Humanitarian United Nations Agencies and Non-Governmental Organizations in South Sudan

Purpose: Manual procurement processes are expensive in terms of human resource cost, purchasing cost, wastage due to errors of commission or omissions, cause of delays in delivery of goods, services, and works which accounts for 40% of losses due to inefficiencies, and attracts corruption in the system amongst others. The study aimed to assess the effect of e-tendering on performance of humanitarian United Nations agencies and non-governmental organizations in South Sudan. Methodology: The study methodology adopted an explanatory research design of cross-sectional type for the population under study. There were over 235 National Non-governmental organizations, 150 International organizations in addition to over 15 United Nations agencies, bringing the total target population to 400 organizations. This study targeted 400 humanitarian organizations operating in South Sudan. Therefore, the sample size of 200 humanitarian organizations operating in South Sudan was selected using a stratified random sampling technique. Data was collected using structured questionnaires and analyzed using descriptive and inferential statistics. Results: Reliability findings indicated that e-tendering had a Cronbach Alpha Coefficient of 0.873, and performance had 0.859. The study established that e-tendering had a positive and significant relationship with performance significant (β=0.282, P=0.000). Conclusion: The study concluded that e-tendering has a positive and significant effect on performance of humanitarian United Nations agencies and non-governmental organizations. This study hence suggested that all NGOs and humanitarian agencies should ensure they adopt the use of e-tendering in their solicitation and sourcing processes in conducting procurement activities. The study cited advantages such saving time, wide coverage of markets and reaching more potential suppliers and finally save environment from printing more paper works attaining sustainable procurement practice.

Checklist and prioritization of crop wild relatives in Sudan and South Sudan

Crop wild relatives (CWR) encompass wild plant species or subspecies closely related to domesticated crops. This study presents the first comprehensive checklist and prioritized inventory of CWR for Sudan and South Sudan. Building on the regional CWR list for Northeast Africa, we identified 499 CWR taxa belonging to 44 families, with 90% of these being native species. The most prominently represented families were Poaceae (148), Fabaceace (72) and Convolvulaceae (43), while Panicum (32), Eragrostis (27), Ficus (24) and Pennisetum (20) were the most frequent genera. A prioritized inventory of 85 CWR taxa was developed based on three criteria: economic value, utilization potential and threat status. The prioritized CWR are predominately native (78%) and encompass 12 families dominated by Poaceae (38), followed by Solanaceae (9), Fabaceae (6) and Cucurbitaceae (6). Priority genera included 27, with Digitaria (17), Solanum (9) and Cucumis (5) emerging as key genera for conservation attention. This comprehensive national CWR inventory provides a crucial foundation for developing targeted conservation strategies in Sudan and South Sudan.

Reading Comprehension Activities in the Ugandan English as a Foreign Language Classroom

The study examines the reading comprehension activities in the Ugandan English as a Foreign Language (EFL) classroom. It particularly analyses the activities that the learners of EFL participate in as part of their reading comprehension lessons. The study focusses on EFL learners from countries such as Congo, Eritrea, South Sudan, and Ethiopia, among others studying in Ugandan adult language schools. The specific objectives of the study were to identify the reading comprehension activities in the Ugandan EFL classroom and to establish the learners’ response to the reading comprehension activities used in the EFL class. Drawing on the transactional theory, the study analyses the reading comprehension activities and the learners’ response to them. The findings indicate that the most profound activities in the classes were pre-reading activities. In their order of frequency, pre-reading activities were the most profound in the classes observed, followed by while-reading and the post-reading activities, which were the least used. In the classes where reading activities were used, they excited the majority of the EFL learners and they paid attention to the lesson. The learners’ response to the activities was diverse with the majority expressing interest in the activities as others chose not to participate at all. The study recommends the use of more reading comprehension activities especially at the while- and post-reading comprehension stages of the lessons which were lacking in most of the classes observed. It further recommends involving the learners and putting into consideration their views during the identification and selection of reading comprehension activities to ensure their maximum participation in the reading comprehension activities

Luo Cultural Shrines: The Hembko of Got Ramogi, Kenya

Got Ramogi in Kenya is a hill shrouded with many mysteries and awe-inspiring cultural beliefs and practices. He hill has attracted the interests of archeologists, geologists, historians, ethnographers, foresters, herbalists, worshippers, politicians and tourists in equal measure. Ramogi Ajwang’, the founder father of the Luo nation, is believed to have settled on the strategichill when his people arrived in Kenya through Uganda from the southern Sudan. The objective ofthe study was to establish the number of cultural sites and shrines (hembko) at the hill, the cultural beliefs and practices associated with them, and the spiritual significance of each shrine on the spirituality and he future of the Luo community in Kenya and the diaspora. The information discussed in his paper was obtained through internet library research using the Google search engine. Google is considered to be the most popular and the best search engine due to its advanced algorithms and vast database. The search was able to identify nine (9) cultural shrines or hembko in Dholuo. Each of these shrines had unique name and function in the cultural and spiritual heritage of the people. The Luo offered spotless animal rituals to their God Nyasaye to propitiate or placate the supernatural world for continued prosperity and posterity. Further research should be conducted on Ramogi Hill to discover even more unearthed shrines.

Renewable energy: A way out for South Sudan’s electricity crisis

South Sudan is one of the least electrified countries in the world, despite having abundant renewable energy resources that could be exploited to generate electricity. The country relies on imported diesel for electricity generation, besides having limited focus on renewable energy development. This policy brief sheds light on the potential of renewable energy as a solution to South Sudan’s ongoing electricity crisis. It examines the key factors hindering the development of renewable energy resources for electricity generation in the country. The brief also provides recommendations to the Government of South Sudan, policymakers, experts, and funding institutions on how to improve electricity access in the country. It is stressing on the importance of prioritising the development of diverse renewable energy resources, such as solar, wind, and small hydropower, as an immediate solution to the electricity access challenges in the country.

Breaking from the past? Environmental narratives, logics of power, and the (re)production of food insecurity in South Sudan.

Skyrocketing commodity prices and conflict-induced mass hunger in recent years have resuscitated discussions about why famines frequently reoccur in specific spaces of vulnerability. Intervention efforts still too often isolate food (in)security from its interwovenness in the political economy of water and energy and from the role of ideas in forging these interconnections across long time periods. Using (South) Sudanese history to rethink the causes of recurrent food insecurity, we underscore the need to analyse how political elites imagine the role of the water-energy-food nexus and associated environmental narratives in consolidating power. South Sudan's 2011 secession (from Sudan) marked the culmination of a struggle against a state that insurgents regarded as having starved its citizens. However, since independence, its leaders have replicated the nostrum they once combatted: Sudanese resources must 'feed the world'. A fixation with inserting water, energy, and food resources into global markets infuses their strategy, even if such an approach will not engender food abundance.

Politics of International Oil Companies (IOCs): Understanding PETRONAS Carigali Nile Ltd Exit From South Sudanese Oilfields

The study has examined the politics of the International Oil Companies (IOCs), the case study of PETRONAS Carigali Nile Ltd. It does this by appraising the legal violations of PETRONAS Carigali Nile Ltd exit and farming out from South Sudanese oilfields. The study explains the politics of IOCs and particularly, PETRONAS Carigali Nile Ltd as dependent variable and independent variables such as legal violations of Petronas Carigali Nile Ltd, types of residual liabilities and responsibility of these liabilities.The study was subjected to stringent empirical literature review and the gaps in the literature were filled through fieldwork. During fieldwork, the methodology of research tools and instruments such as questionnaires and interview guides/schedules were deployed with target of 52 respondents. Persuasive and cluster type of sampling amongst the senior staff of Ministry of Petroleum (MOP), Nile Petroleum Corporation (NILEPET), Dar Petroleum Operating Company (DPOC), Sudd Petroleum Operating Company (SPOC) and Greater Pioneer Operating Company (GPOC) were applied. The study findings indicate that PETRONAS Carigali Nile Ltd has politicized and violated sections 12, 22, 23, 24, 41 & 42 of the Petroleum Act 2012. Various types of liabilities such as cost recovery audits, environmental audit, petroleum taxes, surface rentals, and cash calls should be taken care off by Petronas Carigali Nile Ltd or by a company that farms into its shares. While the study concludes that PETRONAS Carigali Nile Ltd exit and farming out has been politicized and violated the laws of the Republic of South Sudan, the study recommends that the Ministry of Petroleum should be held responsible for all the legal violations Petronas Carigali Nile Ltd have committed in South Sudan without any action. Whether Savannah Energy Ltd farms into Petronas Carigali Nile Ltd shares or not after the PETRONAS has exited, consequences should be rolled out for such violations so that no any other IOC can do it again in the near future in this volatile oil and gas industry.

Environmental changes in South Sudan are changing the fabric of people’s lives and steering humanitarian operations

Environmental changes in South Sudan are changing the fabric of people’s lives and steering humanitarian operations