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South Sudan: Where is my chocolate?

16 Jun 2016

Alas, it’s true. There is a thief among us. What was once a friendly, tight knit group of well-intentioned humanitarians has now become a potential web of betrayal.  There is an unwritten but explicit rule in Médecins Sans Frontières that anyone heading to the field should provide the gift of food for their new team. 

Eager to gain immediate popularity, I decided to take cheese to South Sudan. Yes, cheese. I know it sounds bizarre but I was told by an experienced Médecins Sans Frontières nurse that cheese was a highly sought after food item in any project. For a new-comer, this anxiety-provoking obligation raised a number of questions. Firstly, what is the expectation of cheese quality in the developing world? And what exactly are the pairing options in this setting? Wine? Crackers? Olives? Should I, for example, include some cabanossi in my swag of delights? And, is luxury food actually important while being housed in a mud hut and living in a civil war zone?

"My panic rose as a brief search revealed the truth: somebody stole my chocolate"

As it turns out, yes, it is. But I decided against transporting cheese to Africa for fear of being put on the dreaded Australian customs watch list or worse, presenting a bizarre cheezy fungal growth to my new team. So instead I took chocolate, a crowd pleaser on any continent and upon my arrival dished out kilograms of sugary deliciousness – but also held onto one small block of 70% cocoa heavenly goodness. Years of living in shared houses has taught me how to hide treats in fridges. Exhibit A was placed in a zip lock bag, wrapped in a small camping stuff sack and stashed in a far flung corner of a moderately cold, poorly kept fridge. That block of chocolate was one month old, still in great condition, only half eaten and was a pure source of joy after a long day at work – until the day in question.  

That day, I casually opened the fridge but could not locate the stuff sack. My panic rose as a brief search revealed the truth: somebody stole my chocolate. What was once a sneaky delightful luxury was now in another expats digestive system. But a quick trip the hospital tends to cure even the sweetest tooth of melodrama and reveals the stark reality of what is happening within this South Sudanese community: the people here are hungry. Over the past three weeks we have seen a sudden and expected rise in malnutrition. The rise can be attributed to a number of factors. Primarily the region is experiencing a drought and as such, food cultivation over the past year has drastically reduced. In addition, Northern Bahr al-Gazal is one of the poorest states in South Sudan and has seen a threefold rate of inflation over the past year alone. What this means in practical terms is that without the help of home grown crops, it costs parents three times as much to feed their children.  

"without the help of home grown crops, it costs parents three times as much to feed their children"

The most vulnerable population are children aged six months to five years. We see many in our rapidly expanding therapeutic feeding centre. The management of malnutrition in children is medically complex. Simple infections that cause diarrhoea are potentially fatal because their small skeletal frames are unable to compensate for the sudden loss of fluid, they cannot tolerate rapid rehydration like adults, nor can they mount the immune response needed to fight infections. There has also been a number of unexpected challenges associated with food. Within the past few months we have seen an increase in limb fractures from children who are literally falling out of trees while searching for the last of the season’s fruit. Diabetic children who rely on a delicate balance of food and medication (insulin) to stay alive are difficult to safely discharge. And as for my chocolate: it’s unlikely the culprit will ever be found. But whoever they are, they have long been forgiven.