Letters to Sudan: Millions of children face hunger in a preventable crisis

The world is not moving fast enough to help Sudan or its children. In an effort to raise awareness about the country's plight, Fatma Naib has penned a four-part series on her experiences with Sudan and its people, as a journalist, a former UN employee and a friend. In this second part, she writes about Sudan's hungry children. Read the first part, about her journey from journalism to advocacy in Khartoum, here.

In the winter of 2019, I was on a field trip with the United Nations to Kadugli, the capital city of South Kordofan state in Sudan, which is known for its mountains and beautiful luscious greenery and waterfalls. It’s also an area which has witnessed several armed conflicts prior to the ongoing war, resulting in the displacement of thousands of people and a subsequent humanitarian crisis.

As we were driving through the main city, we reached a narrow road where we had to park and go by foot to reach our destination. The beautiful captivating scenery continued until we reached a house nestled within a field of tall sorghum plants.

We were greeted with typical Sudanese hospitality by Najwa Kafi Karakun. In front of her stood three-year-old Adib. He was slightly shorter than kids his age, and continued to look at us with a curious gaze that lasted for a few seconds before he ran with energy across the field to play.

It’s hard to imagine that a year prior, Adib was battling Severe Acute Malnutrition. Adib’s mother told us she would have lost him had she not received help in time.

Adib's mother rushed him to the health clinic after noticing a lump in his legs and weight loss. At the clinic Karakun was told Adib was severely malnourished.

He underwent treatment with Ready-to-Use Therapeutic Food (RUTF), a peanut-based paste. This life saving small sachet is administered to children experiencing malnutrition. After receiving RUTF and completing the treatment which typically takes between 6-8 weeks, they also received vitamins to support his overall growth.

Karakun became part of a community-based Mother Support Group. There, she learned malnutrition is preventable and treatable: Armed with the empowerment to make crucial changes in her family's daily life, especially in terms of nutrition, she was able to not only help Adib overcome severe acute malnutrition, but also watch him become an active, healthier child.

Malnutrition is when your diet does not contain the right amount of nutrients, which makes children especially more prone to disease and death. Severe Acute Malnutrition (SAM), which is what Adib had, is when children are extremely malnourished, the most extreme and visible form of malnutrition.

There are many children in Sudan that were in the same situation as Adib, and many who can also be treated like he was. However, we are at a crossroad now and at risk of losing strides made in the country prior to the war.

The ongoing conflict in Sudan is making it harder to tackle the malnutrition crisis. Humanitarian access is restricted in many parts of the country, which makes it difficult to deliver aid and other essential supplies to those who need it.

Malnutrition is preventable and treatable and according to studies for every $1 invested in nutrition provides $10 in returns, but without timely treatment many children will not survive.

A silent crisis

Before the ongoing war that started in April 2023, the situation of children was already alarming. Sudan had one of the highest rates of malnutrition among children in the world. More than 3 million children were acutely malnourished, of which over 610,000 were severely wasted.

In 2018 and 2019, around 14 percent of children under five years old in Sudan were malnourished. This is higher than the global average of 7.5 percent and even higher than the rate in Yemen, which is 12.1 percent.

Sudan was once called "the food basket of the Arab World," known for its fertile land rich in minerals, millets and sorghum. It’s also one of the world’s biggest agriculture exporters. So how can a country rich in natural resources have one of the highest rates in malnutrition globally?

There are many contributing factors such as poor feeding practices, lack of access to clean water, and conflicts that have prevented communities from accessing health and nutrition centres.

Some of these problems are easier to solve than others. Poor feeding practices sometimes linked to cultural practices were addressed through education and awareness campaigns. For example, mothers who did not know the benefits of breastfeeding their infants were taught more about this and coached on various nursing strategies.

According to the UN, malnutrition rates have not improved in Sudan over the past 30 years. The number of children who are stunted (too short for their age) and wasted (too thin for their height) has actually increased since 1987. Malnutrition, if untreated, can lead to death.

As a journalist who has reported on Sudan, I was already aware of the several pressing issues facing the country. But my work with the UN exposed me further to realities on the ground that don't get enough mention in local and international media.

So I was really shocked about these numbers and how dire the situation is in Sudan. The more I learned about this from my colleagues in the health and nutrition section, the more I learned about how preventable it is, and how a little investment can lead to long-lasting effects.

One important factor when creating advocacy and communication content for and with the communities we serve is to ensure we approach with respect, seek informed consent and ensure the mothers, children and entire communities are depicted and treated with dignity.

Sudanese people are very proud people. Even in their times of need and weakness they remain resilient, proud and content. Originating from Africa myself, I understood the importance of maintaining this pride and I used to always think before I write a story or take a picture.

What if this was my child or mother? How can I tell their story ethically and respectfully? I believe this is key when addressing any topic, especially sensitive topics like malnutrition.

The situation before the war was already dire, but since the war started in April 2023, humanitarian assistance has been further disrupted. This has made it harder for mothers to access needed support in health clinics.

While learning about these alarming numbers, I also learned malnutrition is preventable, and there is hope. But hope is fading due to the ongoing war, and the situation is urgent.

In addition to having access to health clinics and nutrition facilities, effective prevention strategies include the Infant and Young Child Feeding Practices (IYCF) and mother support groups.

These groups empower mothers and families by equipping them with the support and knowledge to live a healthy life. UNICEF and the Ministry of Health is training community volunteers across Sudan to provide counselling and supporting activities. This is key in preventing malnutrition.

During my time in Sudan, I came across many children like Adib with malnutrition and I was always touched by the strength and willingness of the parents, especially the mothers, to find a solution to help. I was in awe of my national and international colleagues in the health and nutrition section and ministry of health working tirelessly with the communities and partners to support.

My Sudanese friend and colleague Mai el Shoush is one of the key people who developed malnutrition content as part of our role in the communication section with the UN. In 2019, we started a video explainers series hosted by El Shoush. They were an effective and informative way to reach international audiences and partners for advocacy and fundraising purposes.

El Shoush is a former broadcast and print journalist who grew up in the United Kingdom, lived and worked in Dubai and was one of many from the Sudanese diaspora who chose to return home to live and support their country. We navigated many challenges during my time in Sudan, personal and professional.

I recall asking her why she chose to leave the UK and live in Sudan for a period of time. We discussed how every Sudanese person is like a mini-organisation - always rallying together to support families or communities in need. She added:

"I never lost the connection to Sudan and my sense of responsibility to support (it). So when I had the opportunity to live in Sudan, I did. What inspired me to continue to work in Sudan during multiple emergencies was being on the ground as part of a committed team to help provide life-saving services. It was also about seeing first-hand the profound resilience of the communities and young people specifically, despite facing unimaginable challenges.

Their strength continues to be a reminder of the importance of advocacy and change; of amplifying their voices and ensuring their fundamental human rights are met. Being part of such transformative grassroots work was truly humbling. I felt that it was a responsibility and a calling to take on the role."

El Shoush left Sudan before the war and during the COVID-19 pandemic, which disrupted many lives. But like many Sudanese people, she still has many internally displaced family members due to the ongoing conflict.

What I found interesting and admirable while working on malnutrition content was the willingness of communities to make the needed changes. This collaboration was critical, in addition to having access to health clinics and essential nutrition services to change cultural practices and create better nutritious choices.

I also learned that the solution is in working hand-in-hand with communities. Specifically, I strongly believe that empowering mothers will lead to sustainable solutions, which will inspire a generational change. Follow the women, achieve change.

These mothers, when empowered with knowledge and support, will in turn transfer that knowledge and information to their children. And these children will grow to be part of the change, bringing in a cycle of positive change.

The world cannot allow Sudan's children to become another deadly statistic. Behind every number is a child full of potential and dreams. If the war continues, these numbers will soar and an entire generation could be lost.