Trump made a perfect storm even more deadly and the

WASHINGTON – Five months after the Trump administration withdrew $8 billion in American foreign aid from the world, a Sudanese National Army helicopter bombed a hospital, pharmacy and market in a remote South Sudanese village known as Old Fangak.

Located in a deep, grassy swamp area formed by Nile floods that have not receded in five years thanks to climate change, Old Fangak was home to thousands of internally displaced South Sudanese women and children, including many former child soldiers, fleeing the civil war in the region.

At least seven people died in the May attack. Doctors Without Borders reported that its medical supplies had been destroyed. Refugees scattered wherever they could find higher or drier ground. The man-made dikes that had prevented floods from consuming Old Fangak fell into disrepair and then broke, sweeping away the makeshift homes and meager belongings of the people living in the village.

“It was a perfect humanitarian crisis,” Dan Pisegna, program director for the Alaska Health Project in South Sudan, told News themezone earlier this month. “Multiple aggravated emergencies were occurring at the same time.”

Since 2009, volunteers from South Sudan (and some Americans from Alaska) have created access to clean water by drilling and maintaining wells, or holes dug into the ground to access water. Their effort is responsible for approximately 75% of Fangak County’s wells. It is a vital service as most of South Sudan lacks access to clean water, driving up mortality rates and increasing the spread of diseases such as cholera, typhoid, hepatitis, brucellosis and giardiasis. AHPSS also teaches local women how to farm sustainably.

Photo from Alaska Health Project South Sudan

AHPSS has not received any direct funding from USAID, the independent US government agency that until this year had provided assistance to foreign and developing countries. But over the years, the small nonprofit has partnered with other humanitarian organizations that relied on USAID, using private money AHPSS raised to subsidize those groups’ efforts to address crises in the region when public grants were limited or a rapid response was needed.

It was a win-win situation, Pisegna said.

But as soon as he took office again, President Donald Trump cut public spending, including on USAID. The cuts decimated food, health, medical and other services around the world. Humanitarian networks that once had the ability to turn to organizations like AHPSS for certain services are now operating on reduced budgets. When their funds run out, smaller organizations like AHPSS must step up.

“We have the conflict and the flooding, but what has really exacerbated the emergency has been the general lack of funding,” Pisegna said. “I think when USAID pulled out, there was a sense that someone might step in to fill that void. So far, it hasn’t really come to fruition.”

Photo from Alaska Health Project South Sudan

As a result, around two dozen South Sudanese people and some AHPSS workers have been redoubling their efforts to build and maintain access to clean water in an area that has been hit by tragedies time and time again.

Do more with less

“The amount of sweat is crazy,” said David Kapla, a survivor, bushman and longtime AHPSS volunteer.

To drill water wells for thousands of displaced people, a 60-foot-long, 10-ton steel canoe, along with other heavy equipment, is first transported on a donkey cart over rocky terrain. No car can travel to the canoe departure points because there are no roads. In November of this year, when Kapla and his team were installing wells, the average temperature was 90 degrees.

By hand, they carry a 1,000-pound drill rig that must be assembled in the field from 200 to 300 individual pieces. They add 500 pounds of cement, 500 pounds of rock, and a couple thousand pounds of steel. Those materials are for elevated platforms where gravity-fed “taps” can pump water for 1,500 people per stall. A platform can contain at least two tap stands and the pumps can be used even if the well is submerged in several feet of contaminated flood water.

The team navigates through swamps with head-high grass and mosquito-filled air. Water levels often exceed 4 feet, but they ebb and flow, forcing volunteers to drag the loaded canoe by rope under a scorching sun.

South Sudanese working with AHPSS are taking on hard work despite having little access to food.

“They were losing 20 pounds in those months after the [USAID] “Cuts,” Kapla said. “You’re talking about regional famines, hunger and malnutrition caused simply by that cut in that aid.”

The Trump administration’s cuts to USAID resulted in Action Against Hunger cutting its programming in half. The World Food Program began cutting its food distribution and restricting rations to 50% to 70% of its original size. Save the Children Fund, a charity that provides health screenings and treatments for illnesses, closed seven of its facilities.

The emaciated children were forced to Look on foot for open health clinics after so many closed in the area, said AHPSS President Dr. Jack Hickel.

“They walked toward death,” he said.

The White House did not immediately respond to 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 more than 1,500 people in South Sudan since 2024, and as of October there were at least 100,000 suspected cases in the country.

Hickel, who has spent 10 years serving South Sudan and a lifetime studying tropical diseases and hygiene, says that figure is likely a low estimate.

“Those who are really susceptible to these diarrheal diseases are the young, children, the immunocompromised and the elderly,” he said. “There are many child deaths due to this bad water.”

It is difficult to know the exact number of deaths, according to Damian Seal, UNICEF water, sanitation and hygiene (WASH) specialist for South Sudan. Many of the groups that track, report or share public health information have been paralyzed.

Photo from Alaska Health Project South Sudan

The lack of USAID funding for the region may have meant that “cholera has spread more than it should have,” Seal said.

“85% of the country does not have access to safe health services, probably 65% ​​or more does not have access to drinking water,” he said.

According to the African Development Bank92% of South Sudan’s population lives below the poverty line.

Part of the rapid response team for sanitation and hygiene that had been cut from UNICEF The previous year’s budget was on track to become available again in 2025. But when Trump withdrew aid, Seal said, services were reduced to a “critical, critical, critical” minimum. Plans for that rapid response team disappeared.

For years, the United States was a “core project funder” of rapid response teams, which serve as a valuable tool in a crisis, Seal said. They are agile and mobile, and can put locals in contact with national or international partners.

After the attack on Old Fangak, the AHPSS team went to search where people they had provided assistance to in the region for years fled. They looked for where these people had gathered so they could install water wells and distribute seeds and tools. They were found living on small plots of land that barely peeked above the floodwaters.

Hickel estimated that on one of those “islands” there were more than 20,000 displaced people.

“It was so crowded with people… no access to clean water, no farmland. Many of their cows had died, no access to reliable medical care,” he said. “It was just a terrible, terrible situation.”

Photo from Alaska Health Project South Sudan

The team sees women and children searching for water lilies, collecting the roots and pounding them into flour.

Floods make farming more difficult. In November, AHPSS distributed seeds to 600 families that are suitable for small plots of land. In the past, they envisioned larger-scale onion, okra and tomato farms. The focus is now on aquatic farming methods that can be taught quickly and last over time.

‘Blood on his hands’

NGOs can be plagued by corruptionespecially in countries like South Sudan, where desperate conditions greatly limit oversight. Kapla has seen steel well pipes end up as private fences on government property; He has seen NGOs get 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 arrive in South Sudan and rarely leave their compound, failing to build trust and relationships.

These issues need to be addressed if the United States is to get the most bang for its buck when extending a helping hand to the world.

“I can see a valid argument that something is needed to break the back of the aid industry. [to fix it]”Kapla said.

But when one of the richest nations in the world is grabbing resources to some of the poorest, hungriest and sickest people in the world, said: “You can’t tell me that cutting USAID was a valid use of budgets.”

“The direct effect is that people are starving and dying because they did not send bags of food. Your administration has blood on its hands. That is the blood of hunger, it is the blood of dying from treatable diseases because the medications that were there for decades “They’re gone,” he said.

Americans may not understand all the “shame and humiliation” the cuts have caused on the international stage, he said, and how they erode 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 agricultural skills. They engage people and tribal leaders on their terms and establish networks to obtain resources. They farm together. They eat together. They camp together.

“They greet us like brothers. I’m much safer in this town than anywhere else in the United States in terms of people watching my back,” Kapla said.

South Sudanese work hard and are not simply waiting for help from the United States, AHPSS leaders said. But funding cuts are adding new obstacles to old ones. some.

“These people from the villages that we have trained [to build wells or farm]they are the heroes… first displaced by fighting, then dispersed by floods. They went to a new village and started a whole new complex, and within a couple of weeks, they were there drilling wells. They are heroes. They never missed a step,” Hickel said.

In December, Trump took one more hope away from foreign citizens of South Sudan: He banned them from entering the United States, citing fears of “widespread corruption.”

Reflecting on the administration’s actions, Kapla said they are pages torn from the oldest playbook.

“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 from Alaska Health Project South Sudan

APHSS wants to continue doing the right thing while operating within the margins of suffering that the Trump administration widened with its cuts.

Wells are being built quickly, but not enough to meet demand. Private donors are the only contributors to APHSS and 90% of the funds they receive are spent on their programs in South Sudan. Todd Hardesty, executive director of APHSS, said they had raised only $1.2 million last fiscal year. This year, they have raised only $830,000. (Hardesty has also spent his own money: he just ordered materials for 10 flood-resistant platforms, 10 more water wells and two water patios. They will be delivered in December.)

In the face of and despite the challenges, Kapla knows that until AHPSS returns next year, the suffering will not stop.

“Children are children everywhere. These children deserve not to die,” he said. “I keep coming back here because they deserve not to suffer. There is more work to do and I wish more people would do it.”