Achol Ri, a one-and-a-half year-old child with severe malnutrition, cries at a clinic run by Doctors Without Borders (MSF) in Aweil, South Sudan - AFP
Panthou - 14 June 2017: South Sudan's northwest is untouched by civil war, yet hunger still wreaks havoc: here food shortages are cyclical and the annual "hunger gap" is about to begin.
About 800 kilometres (500 miles) from Juba, where a new conflict erupted in late 2013, the northern state of Bahr el Ghazal has some of the highest levels of malnutrition in the country. Two of its five counties are classified by the UN as being in a food emergency, the stage preceding famine, which was declared in February in two parts other of the country.
The so-called "hunger gap" is the period between a lean last season and the next harvest which, if the rains are good and security maintains, will only come in September. Until then people must survive on their meagre and fast-dwindling stores.
In the fields between the town of Aweil and the village of Panthou about 60 km away, people are readying for the rains: adults and children kneel to hoe the soil with rough-bladed tools, prepared fields are waiting to be planted by families living in nearby mud huts with skillfully-made thatched roofs.
But a dangerous cocktail of failed crops and galloping inflation has plunged the state's million residents into a situation of severe food shortage.
- 'Diarrhoea, vomiting' -
It is the children, especially those under five, who suffer the worst, like Nyibol Lual Lual, a two-year-old girl.
"I took the child to the health facility because the child was having diarrhoea, he was vomiting and his state was worsening," said her mother Achol Ayup, who does not know her own age.
"I have five children. Last year I tried to farm but the flooding washed away my crops. So there is nothing in the garden. Sometimes when I don't get anything from the neighbours, I go and look for leaves," she said of the Lalop tree that commonly grows wild in the area, and produces a leaf low in nutrients that, at best, keeps hunger at bay.
For the last few weeks Nyibol has been given "plumpy nut", a high protein peanut paste to counter malnutrition, distributed by an international charity in Panthou.
But for the rest of the household, the situation is bleak.
"Last year, the rains were not very good so the harvest was poor. This year, they have planted but some plots are already flooded," said Judy Juru Michael, a nutrition officer for UNICEF, the UN children's agency.
Until the September harvest, people will depend on the markets for food, but prices have exploded due to rocketing inflation caused by the civil war ravaging much of the rest of the country.
- Hunger and malaria -
For those who can afford it, there is food in the markets of Aweil, the regional town, but those in the countryside are often entirely dependent on their crops and the current food crisis is soon predicted to be overtaken by yet another one, also annual: the malaria season.
In the Aweil referral hospital, teams from Doctors Without Borders (known by its French acronym, MSF) are preparing to receive the worst-affected children, in particular those requiring blood transfusions because of anaemia. The MSF unit for malnourished children suffering from complications, such as acute respiratory infections or diarrhoea, is already full.
Last year, the charity had to open 120 additional beds, on top of the 155 it had in the hospital, to deal with the severe, seasonal increase in malaria.
"The malaria season is important because this is an endemic zone, but in addition, children suffering malaria are already weakened by malnutrition," said Aline Serin, MSF's project coordinator in Aweil.
According to several aid workers on the ground, the coming months will again be very difficult in Northern Bahr el Ghazal with one conceding that the humanitarian response will do no more than "stabilise the situation".