Evidence to International Development Committee inquiry on “Instability and the Humanitarian Response in South Sudan” from the International Committee of the Red Cross

Current situation

Over the past three years, conflict and violence in South Sudan has caused severe humanitarian consequences both immediate and cumulative. Attacks have resulted in civilians being displaced, wounded or killed. Millions of people have been forced to leave their homes and many live in extremely difficult conditions, lacking food, water and access to healthcare.

While the situation of close to 200,000 IDPs in UN PoC sites remains preoccupying, the population of these camps represents only 10% of those displaced within South Sudan and across the borders of neighbouring countries. Many of these remain in remote and isolated places, in swamps and away from roads and rivers, because this is where they feel safe. Reaching and assisting these 90% in need is a major challenge, but a priority for the ICRC.

Years of violence have led to the deterioration of basic services, life chances and livelihoods and have had disastrous consequences on the economy, undermining people’s capacity to meet their most basic needs.  The conflict stands in the way of the country’s development and gradually degrades infrastructure, services, living conditions and, with them, human dignity.

The effects of the conflict are felt far beyond South Sudan’s borders. Violence has pushed tens of thousands of people to cross borders in search of safety. In the chaos families often get separated and people live in the uncertainty and anguish of not knowing what happened to their loved ones.  Being forced to flee their country, far from their habitual way of life and social networks, makes people extremely vulnerable and often dependent on external assistance. In addition, the massive flow of people across the borders puts economic and social pressure on neighboring countries, some of which have been struggling to overcome a number of internal challenges. 

People’s needs in South Sudan cut across many different sectors and extend over many years. This creates new challenges for humanitarian action to provide sustainable services to the most vulnerable. It is not just urgent life-saving action that is needed, but also ensuring people’s means of survival and their right to a life with dignity. This requires commitment and continuity by humanitarian actors.

Since the beginning of the conflict, the ICRC, together with the South Sudan Red Cross has been working to address the most pressing humanitarian needs across South Sudan. This includes the provision of food, water, health care and the protection of the civilian population. Between January and September this year, the ICRC in South Sudan distributed more than 750,000 food rations and provided access to clean water for 145,000 people. 7,000 women received antenatal care, 700 had safe deliveries in ICRC-supported medical facilities, and 11,900 children under one were vaccinated. Tens of thousands of displaced people were given the chance to contact family members from whom they had become separated via calls facilitated by the ICRC and the South Sudan Red Cross. More than 2,000 members of armed groups from both sides of the conflict were also trained in international humanitarian law (IHL).

In 2016, the conflict has spread to the west and south of the country, engulfing regions that had previously been spared. The current humanitarian situation in the Equatorias region remains particularly worrying. The ICRC is putting much effort into developing dialogue with all arms carriers present on the ground and finding the most adequate humanitarian response in this complex and changing environment. Since July this year, we have evacuated 73 wounded from Equatorias region and provided emergency food assistance for some 3,200 displaced families in Yei town.

The situation in Unity region, where fighting is ongoing, is also of great concern. Here as well we maintain dialogue with all those involved in the fighting to open the humanitarian space and be able to respond to people’s most urgent needs. 

Sexual violence

Besides numerous deprivations, civilians have suffered terrible abuse, including acts of sexual violence. This phenomenon has taken alarming proportions over the last few years, affecting particularly women and children.

Sexual violence is significantly under-reported because of cultural taboos, a lack of awareness and a lack of assistance. There were probably hundreds of conflict-related rapes last year in areas where the fighting was fiercest, but any figures can only be rough estimates.

Such acts constitute a terrible violation of International Humanitarian Law.

In medical facilities supported by the ICRC, our first objective is to prepare medical staff to provide respectful and supportive care to victims and create a safe space for them. Privacy and confidentiality are essential if we want to build trust and promote services that do no additional harm. Depending on the partners present on the ground, we may provide both medical and psycho-social care. We also refer people to existing medical services for care where possible and appropriate. A lot of effort is also put into community awareness in order to ensure that victims and their children are neither stigmatized nor excluded.

In our dialogue with arms carriers participating in the ongoing hostilities, the prohibition of all forms of sexual violence under international law and the devastating consequences it has on victims and communities figures high on the agenda. Progress is however hard to both achieve and quantify given the nature of the problem and weak chains of command that characterize all groups involved in the fighting.

Health care

Decades of violence in South Sudan have shattered hopes for a functional medical system. Many health centers across the country have closed down because of violence or a lack of funding. To reach the nearest clinic, people often have to walk for hours and sometimes days. The insufficient number of medical structures and medical personnel is made worse by the absence of roads. When a patient has to reach the hospital in an emergency this can be a death sentence.

Maternal mortality is one of the consequences of the lack of access to healthcare. Preventative measures can improve a mother’s chances for a safe delivery, but a lack of awareness and difficult access mean a limited number of women reach assistance. The ICRC works with traditional birth attendants who try to persuade women to do prenatal checkups at the early stages of pregnancy. But advanced medical devices like ultra-sound machines are extremely rare and health workers’ abilities to detect abnormalities are limited.

In 2017, the ICRC will further expand its support to hospitals and primary health clinics in the Upper Nile, Bahr el Ghazal and Equatoria regions, to provide communities in the most conflict-affected areas with vital health care, including surgical care for weapon wounded patients. More must be done to seriously develop South Sudan’s fragile health system to cope with the needs of a population which requires both routine and non-conflict related healthcare, as well as the skills and capacity to deal with an influx of injured people hurt in fighting.

Authorities

It is of paramount importance that International Humanitarian Law is known and respected by all. Sparing civilians, caring for the wounded and the sick, respecting medical facilities and personnel are the basic principles of humanity and respecting them can pave the way for long awaited peace in South Sudan. Respect for IHL is a vital lifeline that can ensure that people receive assistance at the time when they need it most and that they can survive the very difficult times.

The ICRC’s role goes beyond delivering urgent humanitarian assistance in conflict-affected areas. Our mandate seeks to ensure civilians are first and foremost spared from harm. In the case of South Sudan, the passing of the Geneva Conventions Act (2012) was proof of the government’s willingness to embrace these obligations following Independence. Current revisions of the Penal Code as well as the Legislative Assembly’s ongoing review of the Kampala Convention (ratification and domestication stages), continue to indicate the Government’s openness to the protection of civilians from a legislative framework perspective. But more needs to be done. Where possible a constructive dialogue should take place between the UK and South Sudanese authorities on how to better protect civilians in war time in both law and operational practice.

UK engagement

The ICRC maintains a strong working relationship with DFID and UK Embassy representatives in Juba. Thanks to its historic role in helping to create an independent South Sudan and as a major donor, the UK has significant leverage on government policies and the way humanitarian aid is being deployed. The ICRC maintains a constructive dialogue with UK representatives at ground level on its reading of the evolving humanitarian needs and how best to respond to them.

Parties to the conflict in South Sudan remain dependent on both political and material support from third parties. Making support conditional to them on respecting IHL and other relevant minimum rules has been put forward as a means to increase the protection of civilians. To be beneficial, any such engagement needs however to be perceived as constructive and not interfering with national sovereignty. The UK military has decided to commit troops for deployment in South Sudan as part of the peacekeeping force. Its experience from other theatres on how to operate in complex and hostile environments will be helpful in this context while working towards a better protection of civilians from the impact of hostilities.