Amid escalating fighting, children and families in Jonglei State and other parts of South Sudan are facing severe hunger, forcing them to survive on leaves and water lilies, according to a new report by Save the Children International.

The report, released on Tuesday by the non-governmental organisation, described the development as an “extreme coping mechanism,” warning that the country is gradually sliding towards famine following violence that escalated in March.

The organisation said families in Jonglei, in the northeast of Juba, the country’s capital, have been living without essential life-saving services following the suspension of humanitarian aid and government evacuation orders to aid agencies.

“In some parts of the state, families and children are surviving on leaves and water lilies collected from swamps and seeds reserved for planting, while mothers walk for hours through floodplains to find anything edible for their children,” it said.

The report cited an analysis by the Integrated Phase Classification (IPC), which showed that Nyirol and Akobo in Jonglei State, along with two other counties, are at risk of famine.

It added that more than 7.8 million people are facing acute food insecurity, while 2.2 million children under the age of five are suffering from malnutrition and require treatment, according to the IPC. It is also estimated that 700,000 children are suffering from severe acute malnutrition.

“Health workers have reported children arriving at nutrition centres severely malnourished after surviving for weeks on diluted porridge or a mix of salt and flour,” Save the Children said.

Tabisa Ajer, 31, a health care worker at Bor Hospital in Jonglei State’s Bor County, said more than 60 malnourished children are currently being treated at the facility, with the number expected to rise during the rainy season.

“We are just at the start of the rainy season now, and from June to August the hunger situation usually worsens,” Ms Ajer said. “This year is more dangerous than previous years. Insecurity is impacting food cultivation.”

According to the report, as families struggle for survival, thousands of children are out of school, while others have been forced into child labour and early marriage.

“In areas where schools remain accessible, some children have stopped attending because they are too weak from hunger,” it said.

The country director for Save the Children in South Sudan, Chris Nyamandi, urged political will to mitigate hunger and strengthen social protection systems to prevent further violence.

“In an already hyper-prioritised humanitarian system, international aid cuts continue to disproportionately impact those most vulnerable in one of the world’s most fragile states,” Mr Nyamandi said.

Save the Children called for more flexible resources to meet the needs of displaced communities in South Sudan.

The organisation’s suspension of aid in Jonglei and relocation of staff followed looting and vandalism of its office and carting away of its three vehicles, including the destruction of a healthcare centre.