
WASHINGTON — Five months after the Trump administration . The World Food Program began cutting its food distribution and restricting rations to 50% to 70% of their original size. Save the Children Fund, a charity that provides health screenings and treatments for diseases, shuttered seven of its facilities.
Emaciated children were forced to search on foot for open health clinics after so many shut down in the area, AHPSS President Dr. Jack Hickel said.
Advertisement
“They walked to their deaths,” he said.
The White House did not immediately return a request for comment.
South Sudan is experiencing its worst cholera outbreak in the country’s 15-year history, according to the World Health Organization. The disease has killed over 1,500 in South Sudan since 2024, and there were at least 100,000 suspected cases in the country as of October.
Hickel, who has spent 10 years serving South Sudan and a lifetime studying tropical disease and hygiene, says that number is likely a low estimate.
“The ones that are really susceptible to these diarrheal diseases are the young, kids, the immunocompromised, and older people,” he said. “There are a lot of infant deaths going on because of this bad water.”
Advertisement
The exact number of deaths is hard to know, according to Damian Seal, a Water, Sanitation and Hygiene (WASH) Cluster Coordinator specialist for South Sudan. So many of the groups that track, report or share public health information have been hamstrung.

Photo by Alaska Health Project South Sudan
The lack of USAID funding for the region may have meant that “cholera spread more than it should have,” Seal said.
Advertisement
“You’ve got 85% of the country without access to safe sanitation, probably 65% and above that don’t access safe water,” he said.
According to the African Development Bank, 92% of people in South Sudan live under the poverty line.
Part of the rapid response team for sanitation and hygiene that had been cut from WASH Sector Capacity budget a year earlier was on the cusp of being brought back online in 2025. But when Trump yanked aid, Seal said, services were then reduced to a “critical, critical, critical” minimum. Plans for that rapid response team disappeared.
For years, the U.S. was a “funder of the core pipeline” for rapid response teams, which serve as a valuable tool in a crisis, said Seal. They’re nimble and mobile, and can put locals in contact with national or international partners.
Advertisement
After the attack on Old Fangak, the AHPSS team went looking to see where people they had provided assistance to in the region for years fled. They searched to see where those people had congregated so they could install water wells and distribute seeds and tools. They found them living on little patches of land barely peeking above floodwaters.
Hickel estimated one such “island” contained over 20,000 displaced people.
“It was so jam-packed with people … no access to clean water, no farmland. A lot of their cows had died, no access to reliable health care,” he said. “It was just a terrible, terrible situation.”

Photo by Alaska Health Project South Sudan
Advertisement
The team sees women and children foraging for lily pads, gathering the roots and pounding them into flour.
The flooding makes farming more challenging. In November, AHPSS distributed seeds to 600 families that are suitable for small plots of land. In years past, they envisioned larger-scale farms for onions, okra and tomatoes. Now the focus is shifting to aquatic farming methods that can be taught quickly and last the test of time.
‘Blood On Its Hands’
NGOs can be plagued with corruption, especially in nations like South Sudan where desperate conditions vastly limit oversight. Kapla has seen steel pipes for boreholes end up as private fencing on government property; he has seen NGOs secure contracts for thousands of dollars above what they need to complete a job, only to pocket the surplus. He has seen volunteers from well-known NGOs come to South Sudan only to rarely leave their compound, utterly failing to forge trust or relationships.
Advertisement
These problems need addressing if the U.S. wants to get the most bang for its buck when it extends a helping hand to the world.
“I can see a valid argument that it takes something to break the back of the aid industry [to fix it],” Kapla said.
But when one of the wealthiest nations in the world is snatching resources from some of the world’s poorest, hungriest and sickest people, he said, “You can’t tell me USAID being cut off was a valid use of budgets.”
Advertisement
“The direct effect is for people to starve and die because you didn’t send bags of food. Your administration has blood on its hands. That’s the blood of starvation, that’s the blood of dying of treatable diseases because medicines that were there for decades are gone,” he said.
Americans may not grasp the full “shame and humiliation” the cuts have caused on the international stage, he said, and how it eats into the trust and credibility that humanitarian workers or groups have on the ground.
But AHPSS has worked to build trust in the region by delivering what it promises: clean water and farming skills. They engage people and tribal leaders on their terms and network for resources. They farm together. They eat together. They camp together.
Advertisement
“They greet us like brothers. I’m far safer in this village than I am anywhere in the United States in terms of people watching my back,” Kapla said.
The South Sudanese work hard and aren’t simply waiting for a handout from the U.S., the AHPSS leaders said. But the funding cuts are heaping new obstacles atop old ones.
Advertisement
“These people from the villages that we’ve trained [to build wells or farm], they are the heroes… first displaced by fighting, then dispersed by flooding. They went to a new village and started a whole new compound, and within a couple of weeks, they’re in there punching bore wells. They’re heroes. They never missed a step,”Hickel said.
In December, Trump took away one more piece of hope for South Sudanese foreign nationals: He banned them from entering the U.S., citing fears of “widespread corruption.”
Reflecting on the administration’s actions, Kapla said they are pages ripped from the oldest playbook.
Advertisement
“Your governments will tell you the world is a scary place because fear controls. Your parents will tell you the world is a scary place because fear controls. But the world is not a scary place,” he said.

Photo by Alaska Health Project South Sudan
APHSS wants to keep doing the right thing while operating in the margins of suffering that Trump’s administration widened with its cuts.
Advertisement
Wells are being built fast, but not fast enough to keep up with demand. Private donors are APHSS’s only contributors, and 90% of the funds they receive are spent on their programs in South Sudan. Todd Hardesty, the executive director of APHSS, said last fiscal year, they had raised just $1.2 million. This year, they have raised just $830,000. (Hardesty has spent his own money, too: He just ordered materials for 10 flood-resilient platforms, 10 more water wells and two water yards. They are set to be delivered sometime in December.)
In the face of, and despite the challenges, Kapla knows until AHPSS returns next year, the suffering doesn’t stop.
“Kids are kids all over the world. These kids deserve not to die,” he said. “I keep coming back here because they deserve not to suffer. There’s more work to do, and I wish more people would do it.”
Advertisement
