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At the end of October 2021, the total number of refugees in South Sudan were estimated at 329,406 people — Sudanese (92.4%), DRC (5.4%), Ethiopian (1.4%), Central Africa Republic (0.8%) and others (0.1%) — of which more than 98% resides in camps. Females account for 52% of the refugees with women and children representing 83% of the total population. Most of the refugees have been hosted in Upper Nile State (50%) and Unity State (40%) in South Sudan. The rest of them have been hosted in Central Equatoria State (CES, 5%), Western Equatoria State (WES, 3%) and Jonglei State (1%).
The Joint Assessment Mission (JAM) was undertaken from 05 August – 22 October 2021, aimed at updating the food security and nutrition situation in the refugee operation areas, analyzing the effectiveness and appropriateness of ongoing food security and nutrition interventions in CES, WES, greater Unity and Upper Nile, and proposing the most appropriate food security, nutrition, and livelihood interventions for the next planning period (2022-2023). The assessment focused on the following selected thematic areas: (1) Food security and livelihoods, (2) Health, Nutrition and food security, and WASH, (3) Protection and education, (4) Energy and environment, (5) Logistics, warehouse, non-food items, shelter, and roads, and (6) Coordination and partnership.
Food security: Refugees living in camps have continued to rely on the general food distribution (GFD) that WFP provides as their main source of food, complementing the GFD with their own agricultural production and/or food purchase from the local markets, and only few of them reported other resources as the main source. The GFD has been provided to all registered refugees by using cash/voucher or in-kind modalities or a combination of. The in-kind assistance comprises dry cereals (sorghum or maize), pulses, oil and salt, while the amount of cash transfer or voucher is calculated according to the food ration and local market prices of selected food items. The refugees also have received cash for milling to cover the milling cost of sorghum or maize they received. Although the standard GFD was designed to provide 2100Kcal per person per day (PPPD) (100% ration), this was negatively impacted due to funding constraints; GFD was reduced to 70% ration since November 2015 and then further cut to 50% ration in April 2021. Accordingly, the minimum dietary diversity (MDD) of refugee households with young child have decreased from 34% in November 2020 to 22% in June 2021.
Livelihoods: the main livelihoods of refugee households include agriculture, petty trade (firewood and crop sale), tea and coffee houses and restaurants. The refugees have the right to access farming and grazing land in the hosting areas and the government authority, Commission for Refugee Affairs (CRA), oversees allocating the land for refugee households. Notwithstanding, the allocated land is not sufficient to meet their basic needs (crop production and grazing). The refugee farmers have cultivated one to three feddans of land (0.4 to 1.2 hectares) per family and produced 3 to 12 bags of 50kg sorghum or equivalent per year. The small land size accompanied with insecurity to access the land has stalled refugees from scaling up land-based livelihood interventions. The UNHCR and WFP need to further explore targeting approach to meet food and non-food assistance on needs based on the Joint Guidance on Targeting of Assistance to Meet Basic Needs2, accompanied by livelihood interventions to avoid inclusion and exclusion errors of targeted population from the short-and long-term assistances. Feasibility study for piloting targeting approach should be considered during 2022/23 in jointly selected camps, mainly in the sites where global acute malnutrition rate is <5%. The COVID-19 pandemic also brings additional challenges such as increase in the cost of goods and services.
Health: The UNHCR and health partners provide primary health care services to refugees in camps and settlements. The refugees also have access to the public secondary health care services. The primary health care center (PHCC) is available in each refugee camp and serves as first entry for the patients.
Some of the PHCCs / PHCUs are still in semi-permanent structure, notably in Maban. Since 2019, the crude mortality rate has declined in all refugee camps and reached the level of 0.24/10000 population (within acceptable ranges) in September 2021. As of the end of October 2021, about 445 refugees tested positive for COVID-19 but with no fatality and majority with mild illness. The pandemic related movement restriction has imposed challenges such as social stigma, fears to humanitarian workers, and difficulty to access referral secondary and tertiary health facilities. Refugees are included in the national COVID-19 preparedness and response plan as well as in the COVID-19 vaccination plan. Home based care contact tracing (especially among the host population), movements across borders, physical/social distancing, and to some extent hesitation to/myths on COVID-19 vaccines are among the challenges. There is a need to upgrade the health facilities with semipermanent structure to permanent ones to improve quality of services, mainly in Maban camp. Continued surveillance, increasing, intensifying RCCE, promoting COVID-19 vaccination, and IPC measures will be strengthened.
Nutrition: According to the standardized expanded nutrition survey (SENS) (November 2021) preliminary report, the nutrition situation among the refugee population varies among different locations, with divergent pattern of prevalence for acute malnutrition, chronic malnutrition (stunting), and anaemia, which indicate different features and challenges faced by refugees residing in different camps. The acute malnutrition prevalence ranges from 1.3% to 14.5% (acceptable to serious level); stunting rate range from 10.3% to 30.9% (medium to very high level); and anaemia rate from 37.0% to 69.5% (medium to high level) 3. A great improvement has been seen from 2016 to 2019 and keep persistent or slightly improved in 2021. Retaining the existing status and reducing the high level of malnutrition in camps would be key priorities. The partners (WFP, UNHCR, UNICEF and nutrition partners) have to continue to strengthen the implementation of Community Management of Acute-Malnutrition (CMAM) program through provisions of therapeutic and supplementary feeding programs for rehabilitation of identified acute malnourished children 6-59 months, PLW, people living with TB and HIV; and programs for malnutrition prevention such as blanket supplementary feeding programs (BSFP), infant and young child feeding (IYCF) programs, etc.
The admitted cases to CMAM programs in 2020 and 2021 were far less than in 2019 due to the impact of the COVID-19 pandemic. UNHCR and partners need to strengthen active case findings in the community to increase the enrollment rate into the CMAM program through mass screening and promotion of family MUAC screening.
WASH: The WASH program aims at ensuring refugees to have safe and adequate access to water supply, live in a satisfactory clean environment, have improved access to hygiene services, and have access to improved WASH services at institutions (schools, churches, mosques, marketplace, health facilities, etc.) through innovative and appropriate WASH projects implementation in close coordination and partnership with WASH stakeholders. The refugee camps have a constant water supply from safe sources, which is adequate for domestic use4. However, lack of water containers for storage at the household level has continued to be the main challenge to achieve the standard of at least 15 liters water per person per day (ltpppd) as per the emergency (SPHERE), and 20 ltpppd (UNHCR) standards for protracted situation. The UNHCR and WASH partners need to rehabilitate and improve water facilities, and timely maintain generators, and solar power to minimize water supply interruptions, and continue comprehensive sanitation and hygiene interventions.
Energy and Environment: Refugees are reliant on firewood and charcoal for fuel energy and about 90%-95% of energy needs are met from self-collection from surrounding environment5, few depend on purchasing wood and charcoal from the local market. Petty trade such as collecting and selling firewood and charcoal making are also means to earn additional income by refugees. This firwood collection activity was reported to lead to the environment deterioration in the hosting area, and cause competition and tension with host population. Refugees are commonly using a traditional open three-stones stove for cooking, which is subjected to high energy consumption/waste. The UNHCR and its partners are promoting fuel saving stoves, however, the achievement is sub-optimal. Thus, UNHCR and partners need to look for a multi-sectoral approach to respond to energy needs across the country including increasing access to renewable energy sources and clean cooking equipment, establishing coordination forum with UNFPA, and concerned agencies to jointly advocate for funding to support energy and environment interventions.
Protection: Insecurity is the main protection concern in all camps as reported in the 2018 JAM assessment6. The 2021 JAM assessment also identified growing incidences of Sexual and Gender-Based Violence (SGBV) and physical attacks affecting refugee girls and women. According to the host community, refugees were arrested when they violate local/government laws and regulations, but the SGBV incidences has been hidden or under reported. For instance, more than 70% of the refugees in Jamjang camps are female-headed households or child-headed households7 (unaccompanied minors and separated) with heightening risks and vulnerability. Notwithstanding, most of insecurity incidents are related to movement outside of the camp searching for livelihood activities. UNHCR, WFP, government authorities (camp management), and partners need to support economic needs of SGBV survivors, strengthen coordination among refugees and local community watch groups, and introduce measures to ensure the security during night. Provision of proper training for police forces and applying rotation on duties could help to minimize unnecessary incidences in refugee hosting areas.
Education: Refugee children education is considered an integral part of refugee protection. Primary and secondary schools are accessible in the hosting community for refugee children. However, school dropout increased since the introduction of 50% ration cuts in April 2021. Lack of sufficient food in the households forced boys and girls seeking for opportunities in the nearby towns to feed themselves. Given the 50% ration cut and high level of food insecurity in the camps, WFP and UNHCR need to implement school feeding programs for primary and nursery schools in the camps, as well as in the government supported school feeding program in accordance with the WFP and UNHCR MoU 2011.
Non-food items and shelter: UNHCR and its partners provide packages of non-food items (NFIs) for new arrivals. The NFI package comprising of plastic sheets for shelter, blankets, kitchen sets, jerry cans, soaps, and mats. All new arrivals receive a one-time standard NFI package comprising an emergency shelter and basic core relief items (CRI) to help them settle in the refugee camps, as governed by NFI distribution SOP. Replenishment or additional assistance could be provided based on the status of vulnerability and recommendations from the need-based assessments. The UNHCR and partners need to broaden the scope of NFI need assessments and address the needs of core items to prevent refugees from selling their resources to access culturally accepted NFI and shelter materials, which can be further supported using multi-purpose cash assistance in the area where market supply is feasible.
Logistics and road: The logistics related issues are the major challenges in remote areas such as Maban and Jamjang. The road infrastructures (mostly dirt roads) and its connectivity within and among neighboring countries are underdeveloped in South Sudan. The insecurity along the roadside with ambush and looting incidences are also nationwide. The road condition is even worse during rainy season, often resulted in landlock in remote areas which in turn lead to airlifting as the only accessing way. As a result, there is a high lead time for procurement and preposition with very high cost for transportation. Since 2019, delays in preposition for food and nutrition items and looting from warehouse have been another challenge for refugee operations. Maban camp has been affected by recurrent flooding which hampered the mobilization of food and other goods for the refugees. Limited power supply and its accessories are challenging for storage in camps. Most of health facility storge rooms don’t have power supply to ensure the optimal temperature for medical and food items.
Partnership and coordination: The WFP and UNHCR partnership in South Sudan is derived from the global MoU signed in January 2011. The country-level tripartite (WFP, UNHCR and NGOs) partnership agreements are reviewed and signed every year to address specific objectives and to ensure the partnership focus on jointly agreed strategic objectives essential to the success of the food security and nutrition program of refugees. The GFD and nutrition programs are the major areas of collaboration.
UNHCR and WFP are closely coordinated through meeting between senior management, technical counterparts, joint mission and assessment, and data sharing. Likewise, local level inter-agency coordination mechanisms were established and coordinated by UNHCR and government counterpart (camp management). Regular post/pre-distribution meeting and ad-hoc meetings are held to discuss any issues arising from the camps, with the inputs and participation of refugee leaders who act as a focal point in terms of community engagement, dissemination of information and community mobilizations.
The JAM recommends continuing and strengthening partnership on joint assessments and monitoring mission to support the coordination and collaboration at all levels. The joint mission needs to be broadened in terms of the scope of data sharing, analysis, project reviews, plan of actions, reporting and dissemination of information to concerned partners and refugees.
