49,252 people.
No hospital.
No clinic.
Until AFAA.
In Panyijiar alone, there are no hospitals, no passable roads, and no other health providers.
AFAA is there as the only provider, delivering integrated healthcare and emergency services.
As of October 2025: over 1 million people affected by flooding in South Sudan. Panyijiar is among the worst-hit counties. AFAA has not stopped. - OCHA, 2025
PANYIJIAR COUNTY, UNITY STATE
Five consecutive years of severe flooding have cut communities off from the world
53,003
pEOPLE REACHED
PER YEAR
March 2023 - March 2024
21,827
consultaTions in
7 months (2024-25)
Panyijar County Dec 2024 - June 2025
31%
drop in maternal mortality
in nyal since 2023
2023 - June 2025
23%
BETTER UNDER-5 SURVIVAL
THAN NATIONAL AVERAGE
Great Nyal: 76 vs 98.7 per 1,000
- THE SITUATION RIGHT NOW
Flooding. Conflict. Disease. Displacement.
This is South Sudan in 2025 -
and Unity State is at its centre.
In 2026, over 10 million people, two thirds of South Sudan's population, require humanitarian assistance. Conflict, flooding, and disease outbreaks have converged into one of the most pressing emergencies in the world. 7.7 million face severe food insecurity. 2.1 million children under five face acute malnutrition. And the 2025 humanitarian response plan was only 28.5% funded, meaning the international system is covering less than a third of documented need.
Sources: ACAPS 2025; OCHA October 2025
Within Unity State, one of South Sudan's most conflict-affected and flood-prone states, AFAA works across two counties. In Panyijiar, it is the Ministry of Health's appointed lead for the entire primary health system. In Rubkona, it delivers livelihoods, peace-building, and protection programmes alongside GOAL's FCDO-funded SSHARP-THRIVE initiative. Each flood season in Panyijiar alone, over 40,000 people are displaced in Ganyiel Town. The town largely submerges, roads and the airstrip become inaccessible, and canoes become the only means of transport.
Source: OCHA Flash Update, September 2025
AFAA's staff are still working. As of July 2025, some are doing so without pay.
People requiring humanitarian assistance in South Sudan in 2026 — two thirds of the entire population
Children under five facing acute malnutrition in South Sudan in 2025 — a figure rising year on year
Of South Sudan's population facing Crisis-level food insecurity or worse between April–July 2025
Of the 2025 humanitarian response plan funded — less than a third of documented need covered by the international system
10M+
2.1M
57%
28.5%
AFAA is the only healthcare provider in Panyijiar County, officially appointed by South Sudan's Ministry of Health as lead organisation for the county's entire primary health system.
- WHO WE ARE
When the last international NGO withdrew in June 2024, leaving 49,252 people without a functioning health centre, AFAA stepped in.
Alliance for Action Aid was founded in 2016 by Michael Gatluak Tuok, a South Sudanese Clinical Officer who has worked in Panyijiar for decades, alongside community elders and health professionals who had witnessed conflict, flooding, and the chronic absence of sustainable healthcare.
​
AFAA was built from within Panyijiar. Its deep community relationships mean interventions are shaped by what communities actually need. Local knowledge means resources are not wasted on approaches that don't fit their context.
- WHAT WE DO
Four programmes.
One integrated approach.
Food Security & Livelihoods
Fish preservation training, agricultural inputs, VSLA savings groups, cold chain infrastructure for fish markets, and flood-protection dykes across Panyijiar and Rubkona Counties. Food security and health are inseparable in a county where annual flooding destroys crops and cuts supply routes.
Protection Mainstreaming & Peacebuilding
Clinical care for survivors of violence. Peace clubs in schools. Conflict early warning systems. Women's economic empowerment. In Panyijiar, insecurity displaces communities, destroys health facilities and prevents people from accessing care. This work builds a base for successful health outcomes.
150
342
Emergency surgical procedures including 64 caesarean sections
Births safely delivered at facility or mobile outreach
13,145
4,332
OUR IMPACT
THE EVIDENCE
In just seven months between December 2024 and June 2025, during a cholera epidemic, active flooding, insecurity and a health system under severe funding pressure, AFAA delivered the following across Panyijiar County.
Malaria cases treated -
leading cause of death in South Sudan
Childhood illness cases
were managed at community level
MATERNAL MORTALITY - PER 100,000 WOMEN
NATIONAL AVERAGE,
WORLD'S WORST RATE
South Sudan has the highest maternal mortality rate in the world.
Panyijiar is one of the most remote and flood-prone counties in the country.
AFAA has driven the maternal mortality rate 31% below where it was in 2023,
and 36% below the national average.
1,223
1,136
NYAL BEFORE AFAA
END OF 2023
784
NYAL NOW
JUNE 2025
- THE SITUATION IN UNITY STATE
"Roads and the airstrip are inaccessible. Canoes are the only means of transport."
That is the UN's description of Panyijiar County in September 2025. Over 40,000 people displaced in Ganyiel Town alone. Homes, markets, schools, and health facilities submerged. This is the context in which AFAA operates every year.
OCHA South Sudan Flash Update, September 2025
South Sudan has the highest maternal mortality rate in the world. Less than 2% of the national budget goes to health. There is one doctor for every 65,574 people. The health system runs almost entirely on international funding and that funding is being cut.
AFAA is not a temporary fix. It is a sustainable, long-term, locally-led answer operating in one of the most under-resourced corners of the world.
#1
2%
90%+
Highest maternal mortality rate in the world:
South Sudan
Of South Sudan’s budget allocated to health
Of health services funded by international donors
Nationally: 1,581 cholera deaths.
In Panyijiar, with AFAA: Zero.
Since September 2024, South Sudan's cholera outbreak has caused 95,423 cases and 1,581 deaths across 55 counties.
In Panyijiar, a flood-prone, isolated county with no hospitals and one of the worst-affected regions in the country, AFAA managed 257 cholera cases at its treatment unit in Nyal. As of June 2025, zero deaths had been recorded.
AFAA's work proves the power that a functioning, community-rooted health system can have. AFAA keeps crises from becoming catastrophes.
1,581
0
CHOLERA DEATHS NATIONALLY
South Sudan, Sept 2024–Oct 2025 (OCHA)
CHOLERA DEATHS IN PANYIJIAR
Under AFAA management, as of June 2025
95,423
257
CASES NATIONALLY
Across 55 counties (OCHA)
CASES MANAGED IN PANYIJIAR
All treated. All survived.
Over 10 million people need humanitarian assistance,
in South Sudan in 2026.
AFAA is still there.
AFAA is the only healthcare provider in Panyijiar County, officially appointed by South Sudan's Ministry of Health. Every dollar goes directly to services delivered by South Sudanese professionals, in the communities that need them most.