Two months after the world's youngest nation declared a famine amid its civil war, hunger has become more widespread than expected, aid workers say.
South Sudan's Northern Bahr el Ghazal region is on the brink of starvation, with 290,000 people at risk of dying without sustained food assistance. Humanitarian workers say conditions will only deteriorate as the lean season approaches.
In February, South Sudan and the United Nations formally declared a famine in two counties in Unity State. Northern Bahr el Ghazal's five counties now face the same fate.
Northern Bahr el Ghazal and its 1.4m residents have remained relatively peaceful during South Sudan's three-year civil war. But due to soaring inflation fuelled by the conflict, harsh climate conditions and its remoteness, this region has become severely affected by hunger.
World Vision last week rolled out the first phase of a program to provide 65,000 people in Aweil East county with food during the month of April. The aim is to start with 17,000 of the most severely malnourished and vulnerable people.
Aid workers said they weren't prepared for the level of despair.
"I was shocked by the number of malnourished kids here," said the aid group's South Sudan communications manager, Rose Ogola. "And the looks of desperation on the mothers."
In the small town of Malualkuel alone, where the food was distributed, local leaders said 4,000 out of the town's 6,000 people are facing extreme starvation.
"It's the worst I've ever seen it in 12 years in terms of food security and hunger-related deaths," said James Maywien Aror, Aweil East county's relief and rehabilitation commissioner. "I feel sad. I'm not happy to see people die."
During a food and security review meeting last week in Aweil town, aid workers and government officials estimated an increase of 3 to 5% in the number of people in Northern Bahr el Ghazal who will face extreme hunger in the coming months.
The UN's refugee agency said Tuesday the "risk of mass deaths from starvation" is growing in South Sudan.
With the onset of the lean season in June and July, the fear is there won't be enough food to meet the growing demand. Local community leaders said 200,000 metric tons of food is still needed for Northern Bahr el Ghazal.