A displaced family next to a makeshift home at the U.N. base in Malakal. Footpaths are submerged for five months of the year during the rainy season. Many of the children here suffer from acute malnutrition and diseases such as tuberculosis. When it rains, homes are flooded with trash and human waste.James Sprankle/For The Washington Post
The most severe cases of malnutrition are treated in the Doctors Without Borders facility at the U.N. base. Symptoms of malnutrition include distended bellies, ulcers and edema. The skin can fill with water and can break, causing burnlike lesions.James Sprankle/For The Washington Post
Makeshift refugee camps in Malakal, South Sudan. (James Sprankle/For the Washington Post)
Malnutrition is rampant in the outlying areas of Malakal. Because of fighting, many families fled to the bush where access to food and medical care is limited or nonexistent. Forced to eat roots and drink dirty water, many suffer from kwashiorkor, a type of malnutrition that causes ulcers, organ failure and edema.James Sprankle/For The Washington Post
A skull is discovered in the tall grass at the Malakal Teaching Hospital. A man who works at the facility says that they find human remains everyday.
Bandages and other medical supplies at the teaching hospital in Malakal had to be burned because they were no long sterile. They were damaged during an attack on the hospital.James Sprankle/For The Washington Post
This burned out bed used to belong to the pediatric ward at the Malakal Teaching Hospital.
The last teacher in Wau Shilluk. Many residents of Malakal fled to this village on the banks of the Nile.
Local men carry wood from burned out huts.
Living conditions in the Malakal POC.
A boy at the Malakal camp. The humanitarian situation in South Sudan is “getting [more] desperate by the day,” said Cosmos Chanda, the representative for the U.N. High Commissioner for Refugees. The fighting, he said, “has totally suffocated our ability to reach a lot of these locations” where people are at risk of starvation.James Sprankle/For The Washington Post
A child this month in Wau Shiluk in South Sudan, about a 30-minute boat ride from the northern city of Malakal. According to UNICEF and the World Food Program, close to a third of South Sudan’s population faces “acute” or “emergency” levels of hunger and malnutrition. Thousands of children remain stranded in remote parts of the country, where they are at risk of starvation.James Sprankle/For The Washington Post
The Malakal hospital bone collector protects the photographer from wild dogs.