SOUTH SUDAN Annual Report 2017 SOUTH SUDAN REPRESENTATIVE’S MESSAGE UNICEF South Sudan continued to deliver for children in 2017. Faced with growing humanitarian needs, we and our partners responded to multiple crises, providing aid to 2.3 million people, 2.1 million of whom were children. The year began with a declaration of famine in two conflict-affected counties. And even in more stable areas – including the capital, Juba – families continued to struggle to feed themselves as spiralling inflation pushed the prices of basic foodstuffs beyond their reach. Consequently, the number of children under five admitted to therapeutic feeding programmes to treat severe acute malnutrition climbed, with more than 208,000 having received treatment by the end of the year. An estimated 19,000 children remained in the ranks of armed forces and groups, with not one release taking place in 2017. Fortunately, as we approached the end of the year, preparations were made for the release of some 700 children in Yambio, with the first phase (311 children), successfully taking place in February 2018. Violations of children’s rights were perpetrated by all sides to the conflict, with denial of humanitarian access accounting for the majority. Children and their families also continued to flee their homes, with many seeking shelter in neighbouring countries. In 2017, the grim milestone of the one-millionth child refugee from South Sudan was passed. But despite these challenges, and in response to them, humanitarian aid continued to save lives, reaching millions of people in urgent need: 1.8 million children were vaccinated against measles; nearly 80,000 people were provided with access to safe water; more than 300,000 children were given opportunities to learn; and nearly a quarter of a million received psychosocial support. By the end of the year, the country’s most severe and long-running cholera epidemic since independence had been contained. The famine response also shows what can be done when humanitarian organizations have access and funding and can work together: four months after it was declared the famine was over. None of this would have been possible without the hard work of our partners and the vital support of our donors. Through them, and together with sister UN agencies and non-governmental organizations, we were able to alleviate the suffering of the most vulnerable victims of a conflict now in its fifth year. But a long-term solution to anguish caused by this crisis requires peace. May 2018 be the year in which it arrives. 2 Annual Report 2017 UNICEF South Sudan 3 CONTENTS 2 6 8 REPRESENTATIVE’S MESSAGE SITUATION FOR CHILDREN RESPONSE STRATEGY 10 12 14 RAPID RESPONSE MECHANISM HEALTH NUTRITION 16 18 20 WASH CHILD PROTECTION EDUCATION 22 24 SOCIAL PROTECTION WAY FORWARD 4 Annual Report 2017 UNICEF South Sudan 5 SITUATION FOR CHILDREN In a context of deepened humanitarian crisis – including indicative of a system that lacks adequate resources to a localized famine, sporadic conflict, increased food ensure adequate training, supportive supervision and insecurity, a protracted cholera outbreak in much of the oversight of staff conducting immunization. country and sustained economic decline – 2017 has been very challenging for children and families in South Sudan. Over 1.1 million under-five children are estimated to be Large-scale displacement left many children separated acutely malnourished in South Sudan in 2018. Analysis from their families, in psychosocial distress and released in October painted a bleak picture of the vulnerable to further violence, abuse and exploitation. country’s food security situation, especially during the Gender-based violence, affecting primarily women and harvest when households are expected to consume girls, has been intensified by the crisis and is reportedly their own produce. About six million people (56 per perpetrated by all parties to the conflict. cent of the population) were severely food insecure in September, of whom 40,000 were in humanitarian Between June and September, an estimated six million catastrophe. An earlier-than-normal start to the lean people were severely food insecure, the greatest number season was predicted, which will result in 6.3 million of people ever recorded to have experienced severe severely food insecure people in February-April 2018, food insecurity in South Sudan at one time. The cholera and 50,000 in humanitarian catastrophe. Of the food outbreak that began on 18 June 2016 lasted longer than insecure population, an estimated 21 per cent are under- any had before (until November 2017), although the five children and another 8 per cent are pregnant and number of cases drastically declined in the second half of lactating women. 2017. In total, there were 20,438 cholera cases with 436 deaths, during the outbreak. The surge in insecurity has also undermined the provision of education services. Almost two million school-aged Denial of humanitarian access accounted for 58 per children are out of school, and about 1.3 million children cent of all documented incidents of grave violations of are at risk of dropping out due to conflict and food children’s rights, followed by recruitment and use of insecurity. Continued deterioration of the economy, children (17 per cent). Most incidents were documented non-payment of teachers’ salaries, and limited support in Greater Equatoria (42 per cent) and Greater Upper Nile for schools have contributed to the negative impact on (40 per cent). Children were killed in crossfire during the education. A fresh outbreak of violence further increased active hostilities, children were observed in the fighting dropout rates and caused a fall in primary school forces of both parties to the conflict, and humanitarian enrolment rates. Boys faced increased chances of being compounds and supplies were looted. While 42 per recruited into armed groups, and girls into child marriage. cent of all documented grave violations occurred in Greater Equatoria, the real number of incidents and South Sudan has very low water supply and sanitation children affected in the area is likely to be higher, as the coverage. According to the UNICEF-WHO 2017 Joint United Nations does not have access to all populations Monitoring Programme report, only 50 per cent of the in need and affected civilians have been displaced to population has access to safe water coverage, 10 per neighbouring countries where the United Nations does cent have access to basic sanitation and over 61 per not yet conduct monitoring and reporting. cent practice open defecation. The continued conflict and displacement aggravated the already poor access to safe Forty-eight per cent of all reported cholera cases have water supply and improved sanitation. An estimated 40 affected children aged 0 to 14 years. Nomadic pastoralists per cent of existing water points are believed to be non- moving from cattle camps to villages have become a functional, because of damage of infrastructure due to notable risk factor for spread of the disease. the conflict or poor operation and maintenance. The situation is aggravated by limited capacity to respond in the context of multiple health emergencies, and limited knowledge and skills among health workers. The potential for spread of vaccine-preventable diseases, such as measles, is large. A 2017 national measles immunization campaign in all 10 states reached 1,795,046 children aged six months to 15 years. However, preparations are still ongoing for the remaining counties in Jonglei, Upper Nile and Unity. Despite this coverage, the quality of care remains a concern. The 15 deaths that followed vaccination in Eastern Equatoria in May 2017 are 6 Annual Report 2017 RESPONSE STRATEGY UNICEF has been in the forefront of providing a multi- 106,250). Of these, 86.7 per cent were discharged cured. sector response to the multiple humanitarian crises in A total of 938,918 mothers and caregivers acquired South Sudan. As of 31 October, it had helped deliver aid knowledge and skills on appropriate maternal, infant and to 2.3 million people, of whom 2.1 million were children. young child feeding practices in targeted communities. UNICEF’s 11 Field Offices have been strengthened with With UNICEF support, the National Maternal, Infant and personnel, information and communication technology, Young Child Nutrition Strategy, Guidelines and Training security and accommodation. packages were launched in early 2017. Though space for development programming has been In 2017, UNICEF and partners provided education even further limited. UNICEF continued to train frontline services for 519,962 children, and built the capacity of professionals and government staff on social protection, 13,007 education personnel and community members justice for children, maternal and child health and to effectively deliver quality, age-appropriate learning education. It has advocated for policies and made the opportunities, and inclusive education services. ‘Pro- case for providing free essential social services to all, in girl' policies and plans have advanced girls’ education, order to promote equity, peace, stability, and long-term including through the 2018-2022 Girls’ Education development. Strategy. In 2017, 878,081 children and 262,271 caregivers and women continued benefitting from critical child protection services. This includes psychosocial support (247,062 children); family tracing and reunification (13,899 children receiving family tracing support); mine risk education (121,040 beneficiaries);