Nyal, South Sudan - Nyaluak Elizabeth watches over her tiny baby son, after trekking for three hours to reach the remote clinic at Nyal, a rare medical outpost in South Sudan's giant Sudd swamplands.
Flies buzz around his face, but baby Daniel's eyes barely blink, while his tiny fist, squeezed tight shakes from the affects of an intense malarial fever.
“My baby had convulsions, he was being sick, coughing, and he wasn't breast feeding,” Elizabeth said. Her son's heart and kidney's were failing when he was brought in.
In the world's youngest nation, a land devastated by years of war, children face death from easily preventable diseases such as malaria. One in seven children here die before their fifth birthday, according to UN figures.
In this remote village, alongside one of the world's largest freshwater marshes, the mosquito-borne disease hits with often deadly effect.
“It's the main problem here,” said Amos Gichaba Oyaro, who heads the area's crowded clinic, funded by the German aid agency Sign of Hope.
Elizabeth's baby Daniel is lucky: after three days of treatment he is no longer on the critical list, and Oyaro is confident about his chances of survival.
But the clinic's ward is crowded with other sick children. Four are suffering from the intense fever of malaria, which can easily kill without treatment.
When South Sudan won full independence from its civil-war era enemies in the north in July, the oil-rich but grossly impoverished land joined an unenviable club of states such as Afghanistan and Somalia at the bottom of the global rankings for health and social indicators.
Malaria is “hyper-endemic” here, according to the UN, accounting for 40 percent of patient visits to health facilities, while some 80 percent of households do not have insecticide-treated nets, according to UN figures.
Massive efforts are being made to improve the lives of the impoverished people, but for villages like Nyal, cut off by road for much of the year during the rainy season, little has improved.
“If it rains, airplanes can come, but they go back without landing... the airstrip is not good,” Oyaro added.
As one of the least developed regions in Africa, South Sudan faces colossal challenges as it begins forging its way as a fully-fledged nation.
In Nyal, the marshes are also sources of diarrhoea and schistosomiasis, a parasitic disease that can also kill without treatment.
And in a region with a desperate lack of health facilities, the small medical team here is often overwhelmed.
In the courtyard of the hospital, dozens of patients wait, many after walking for several hours for treatment.
“There are no other facilities in the area,” said Elizabeth, watching over her still sickly child.
Malaria not only threatens young children, it also complicates pregnancies.
“The biggest cause of miscarriage is malaria,” said Alex Ndoni, a nurse-midwife at the clinic.
However the drugs that can save the life of the mother can risk the health of the unborn child.
“We give lower dose of quinine...but we are sometimes in situations where we have to give drugs that can lead to miscarriage,” he explained. - Sapa-AFP