Another hot day dawns in the dusty, sprawling Tierkadi Refugee Camp in Gambella, Western Ethiopia, just 50km from the border with South Sudan.
Eight years after gaining independence South Sudan should be full of hope. Instead, it’s in the grip of a massive humanitarian crisis with political turmoil, violence, drought, and dire food shortages causing the displacement of 3.7million people.
More than 400,000 of those displaced have crossed the border to Gambella, enduring long and arduous journeys, with homes, livelihoods and loved ones left behind.
Tierkadi, where Irish humanitarian aid agency GOAL is running life-saving nutrition programmes, is temporary home to over 58,000 of those forced to flee South Sudan.
"Six out of the ten fleeing population are children.
The picture in Tierkadi is bleak. The camp is situated in a remote, underdeveloped location with difficult terrain.
Refugees are dependent on aid, with virtually no livelihood opportunities. They lack proper shelter, clean water, fresh food, health support and fuel for cooking. One thing that strikes you is the lack of men. It is mainly women, ambling gracefully in their brightly-coloured dresses with infants in their arms and children scampering at their heels.Their homes are straw huts, the only furnishings mats on the ground and a few utensils. But they are immaculately clean.
Despite the seeming hopelessness of their lives there is some laughter. One small boy wearing dirty red shorts is busy trying to repair his unravelling “football” made from old rags. He has a big smile plastered across his face as he goes about his task with determination. Two little girls play tag as they circle around their mother with a baby in her arms and carrying a bag of food cereal, distributed by GOAL, on her head.
But the biggest issue facing the refugee population is malnutrition, especially amongst babies and children. Cries ring out as we approach the nutrition centre in the camp.
Here, dozens of mothers and young children are attending a GOAL clinic providing nutrition support including supplementary feeding for malnourished babies through its innovative C-MAMI (Community Management of At-Risk Mothers and Infants) programme supported by Irish Aid and others.
"Refugees are dependent on aid, with virtually no livelihood opportunities. They lack proper shelter, clean water, fresh food, health support and fuel for cooking."
At today’s clinic is Nyanil. The 35-year-old is tall, dignified but world-weary. She cradles her five-week-old twin daughters, Nyanwir and Nyamoch, one in each arm. The twin girls were born in the camp with no complications, weighing 2.9kg and 3.1kg each.
However, Nyamoch lost a lot of weight in her first weeks and after an assessment by GOAL was found to be at risk of malnutrition.
She has been on the C-MAMI programme for two weeks, and is putting on weight and beginning to thrive – catching up on her twin sister.
She will be monitored by GOAL until she reaches her target weight. Reticent at first to share her story, Nyanil tells how she walked for days from her home in the Upper Nile Region in South Sudan to Gambella to reach safety.
“Life in my village was hard. There was fighting and people were killed so we had to leave. It took four days of walking to reach Gambella.
It was very tough. We had little food. Along the way we saw violence. A lot of people were on the move. I thought I would never reach safety.
Here in Gambella I feel safe but I long for my home. I hope one day to go back. I am happy now my baby is getting healthy. I want a good future for my daughters.”
Mary T Murphy, GOAL’s refugee programme manager in Ethiopia, said there are lots of success stories, such as Nyamoch’s, thanks in particular to the roll out of the C-MAMI programme in Tierkadi and Kule Refugee camps.
It supports more than 20,000 beneficiaries with its comprehensive nutrition scheme across the two camps. She added: “The need is huge.”
GOAL was the first International NGO to trial C-MAMI targeting infants from birth to aged six months. Since it was introduced in 2015 thousands of infants under six months have been screened with hundreds of cases of malnutrition successfully treated.
“Without this so many children would have died. Malnutrition is a major cause of death in children under five years old.
The UN estimates severe acute malnutrition alone kills at least one million children under five every year, with the WFP saying approximately 23% of that number under six months.
It had been thought children under six months were less vulnerable to malnutrition due to the assumption that they would be protected by exclusive breastfeeding.
However, studies found that global prevalence of exclusive breastfeeding was not as high as previously thought, with millions of infants exposed to risky feeding practices.”
Mary T, as she is fondly known by all, says what drives her is the fact she is part of a team making a difference to people’s lives. She introduces me to another set of twins, aged one year, who are also receiving nutrition support from GOAL in Tierkadi.
Boumkuoth and his sister Nyamam are being reared by their grandmothers, Nyabuok Deng, 45, and Noyaluak Chon, 65. Noyaluak explains that the twins’ mother, her daughter, died in childbirth aged only 15 years.
They fled South Sudan and took sanctuary in Tierkidi four years ago. Noyaluak said:
“This was tragic and we are now responsible for these babies. They were ailing, but thanks to GOAL they are doing well. Without them I don’t know what we would do.”