Marilena Chatziantoniou, is a South Sudan-based expert for the European Commission Humanitarian Aid and Civil Protection (ECHO), which has a €131 million programme in Sudan. She has been monitoring the humanitarian situation.

Question: You have been monitoring projects in South Sudan in these last weeks; what is the humanitarian situation?

Marilena Chatziantoniou: Humanitarian needs in South Sudan are high and have been tremendously so for a long time. This is one of the poorest and most underdeveloped regions in Africa. For instance, 126 children in every 1,000 die before reaching the age of five; more than half of the population does not have access to safe drinking water; health services are inadequate, food insecurity is high, basic infrastructure is minimal and a big population is profoundly poor.

On top of this, persistent tribal conflicts, poor rains in 2009, and floods this year, have only added to the problems in South Sudan. Though the number of people displaced due to conflict has reduced almost by half; conflicts have significantly increased making humanitarian work much more difficult.

Q: Many southerners are expected to return and settle in the south; are the returnees likely to pose a humanitarian challenge?

MC: In the last two months some 50,000 people have returned to the south. Unity State has so far received the highest number of returnees. About 150,000 people are expected to return and settle in South Sudan by the end of March 2011. I visited Bentiu in Unity State, and the majority of the people previously stranded due to flooding have already settled; most are staying with family and relatives. Humanitarian agencies are providing assistance to the stranded returnees in schools and town centres; and a further three-month food ration at their final destination.

However, for many of the returnees, it will be their fist time settling in the south, some having been born and raised in the north. Many of them have not been exposed to the harsh living conditions of the south, or spoken their native language in many years; they have not encountered diseases like malaria or kala-azar (visceral leishmaniasis), and this makes them vulnerable. Most are coming from urban centres and settling in remote rural areas; they are used to basic facilities such as toilets, and in most villages in the rural south, there are either very few or no toilets at all. The returnees will certainly require support to smoothly reintegrate with the local population.

Q: What is the biggest humanitarian concern in the South so far?

MC: One of the biggest challenges in South Sudan right now is limited access to needy populations. Numerous tribal conflicts in addition to non-existent or extremely poor road networks curtail movement. Many parts of the south are inaccessible for up to six months a year due to heavy flooding. Some villages are then only reachable by boat, and sometimes these routes are also unsafe. In South Sudan, it is necessary where possible, to move supplies across the region during the dry months. In a region bigger than France, this definitely poses a big challenge.

Q: There are not many doctors working in South Sudan and hospitals are few; is the health sector particularly worrying?

MC: Indeed, the health sector is particularly worrying. Most of the health services in South Sudan are being offered by non-governmental organisations and humanitarian agencies. For example, I visited Nasir County in Upper Nile State and most health services are being offered by Doctors Without Borders (MSF).

There are very few qualified Southern Sudanese medical professionals working in the different states, and even less working in remote areas. For many people in South Sudan, reaching a health centre means hours or days of walking. When it rains, villages are completely cut off by floods and people cannot reach the health facility. Also, traditional beliefs and poor levels of education often make people choose a traditional healer over modern medicine.

Q: Will the January referendum on self determination affect the humanitarian needs in South Sudan?

MC: Humanitarian needs in South Sudan are already incredibly high and this affects all sectors including health, food, nutrition, water, and sanitation. The coming months pose an additional uncertainty of a possible increase of needs due to localised conflicts and ensuing population movements of either the conflict displaced people or a sudden increase in numbers of returnees.

Humanitarian agencies are placing essential supplies such as food, water, and medicine strategically so as to reach people quickly whatever the eventuality. The European Commission Humanitarian Aid and Civil Protection (ECHO) increased its funding in 2010 to give prior support to its partners to beef up supplies before the referendum vote. Ultimately, aid workers will only be able to work if the environment remains secure.