Five years of war in South Sudan has likely led to nearly 400,000 excess deaths, about half of them directly because of the violence, according to a new report by the London School of Hygiene & Tropical Medicine.

The research team used census and migration data to estimate population figures, and all mortality data previously collected from 210 county-based surveys conducted as part of the humanitarian response. They added data on factors including climate, armed conflict intensity, food security and public health, and used a statistical approach that predicted deaths tied to crisis for every month at the county level.

Their results showed an estimated 1,177,600 deaths due to any cause occurred among people living within South Sudan during the period. About 794,600 deaths would have occurred in the absence of the war, yielding an excess of 382,900. Nearly 190,000 people were estimated to have died of violent injuries.

Most of the deaths occurred in the northeast and southern regions of South Sudan, peaking in 2016 and 2017. Adult males accounted for most of the deaths, which also included women and children, but the researchers were surprised to find no spike in infant mortality or in deaths among children under five.

“Whether through violence or indirectly through increased risk of disease and reduced access to healthcare, protracted armed conflicts lead to an increase in death rate,” said lead study author Francesco Checchi, a professor of epidemiology and international health at LSHTM. “Information on this excess mortality can inform the ongoing humanitarian response, provide evidence for resource mobilization and support conflict resolution.”

Image: OHCHR file