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A mother prepares food for her child at a United Nations camp, where more than 100,00 displaced people seek security and food, in Bentiu, People walk past a drainage ditch in the United Nations camp in Bentiu, Unity State, South Sudan.
A mother prepares food for her child at a United Nations camp, where more than 100,00 displaced people seek security and food, in Bentiu, People walk past a drainage ditch in the United Nations camp in Bentiu, Unity State, South Sudan.Dominic Nahr
A mother prepares food for her child at a United Nations camp, where more than 100,00 displaced people seek security and food, in Bentiu, People walk past a drainage ditch in the United Nations camp in Bentiu, Unity State, South Sudan.
People walk past a drainage ditch in the United Nations camp in Bentiu, Unity State, South Sudan.
After receiving food at a distribution site, a woman and her five children walk through the cold swamps at dusk to her hiding place on Kok Island, Unity State, South Sudan.
A child cries after walking through the cold swamps at night after collecting long awaited food distribution, Kok Island, Unity State, South Sudan.
Peter Gatlek, 50, sits on a hospital bed after receiving new bandages at the Doctors Without Borders hospital in Lankien, Jonglei State, South Sudan. He was shot in the head while trying to escape a raid by government forces in his home village near Leer in Unity State.
Per Chan, 60, rests inside the surgical ward in the Doctors Without Borders hospital in Lankien, Jonglei State, South Sudan. He was shot in the leg while trying to escape a raid by government forces in his village near Leer in Unity State.
A Doctors Without Borders worker writes the date and time that Koy Gotkuoth Riak, 40, died of sepsis at a camp for civilians in Bentiu, Unity State, South Sudan.
A Doctors Without Borders worker holds the body of a baby that died from malnutrition at a camp for civilians in Bentiu, Unity State, South Sudan.
An aerial view of the empty and completely destroyed town of Leer, Unity State, South Sudan.
Medical charts are scattered on the ground inside the looted and abandoned Doctors Without Borders hospital in Leer, Unity State, South Sudan.
An aerial view of thousands of people waiting in line for food distribution in the otherwise empty and destroyed town of Leer, Unity State, South Sudan.
A mother holds her baby inside an abandoned building covered in graffiti, where over a dozen families have sought refuge from fighting, in Bentiu, Unity State, South Sudan.
Two boys stand next to a plane that brought medical supplies to Doctors Without Borders in Leer, Unity State, South Sudan. Due to the continuing insecurity and lack of infrastructure, the only way to supply the rural hospital is by air.
Hundreds of people receive their first distribution of food for malnourished children in Koch, Unity State, South Sudan.
A staff worker with Doctors Without Borders helps a young boy cross a swamp at dusk to Kok Island, Unity State, South Sudan.
A mother prepares food for her child at a United Nations camp, where more than 100,00 displaced people seek security and
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Dominic Nahr
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Eyewitness to Hope and Hell in South Sudan

Mar 04, 2016

South Sudan keeps grim company. In the world of neglected conflicts it brushes shoulders with the likes of Central African Republic, among the continent's most unstable nations, and Yemen, where a Saudi-led air campaign against the Houthi rebels has taken a severe toll on civilians. But even then, South Sudan stands out. Its independence in 2011, after southerners overwhelmingly approved splitting from the north, came as a result of American backing. There was a big ceremony, and a lot of hope.

Fast forward to December 2013, when a political dispute in the capital, Juba, between President Salva Kiir and his Vice President Riek Machar led to a countrywide battle that reignited ethnic tensions between two tribes: the Dinka, loyal to Kiir, and the Nuer, loyal to Machar. Civilians have borne the brunt of it, according to human rights organizations, from arbitrary arrests and mass looting to atrocities like rape and targeted killings. Peace deals have been negotiated, signed and broken, with violence spreading to other parts of the country.

A senior U.N. official recently said at least 50,000 people had been killed, well above previous estimates. Nearly 3 million are severely food-insecure. And more than 2.2 million are internally displaced or have fled the country. The U.N.’s current humanitarian response plan, totaling some $1.3 billion, is only 3% funded.

Photographer Dominic Nahr was in South Sudan late last year, on assignment for Doctors Without Borders. He knows the region well, having moved to East Africa in 2009 after covering the war in Democratic Republic of Congo, and then documenting South Sudan before and after independence. It was his first time back since 2012.

He was there for a month, shuffling between towns like Leer Thonyor, Kok Island and Bentiu in Unity State, and Lankien in Jonglei State. He photographed at hospitals, displacement camps and sites where food or supplements were distributed. In a particularly powerful aerial photograph, Nahr captured thousands of people lining up for long-delayed food that had been dropped by an aid group. “Leer was completely empty before the food drops—nothing, nobody,” he recalls. “As soon as the food drops started, everybody came from all over.”

Working alongside the doctors and nurses had its effects. “There were days that I didn’t even pick up a camera, and I helped out,” Nahr says. “I didn’t want to be some invisible photographer.”

Nahr says he’s questioned the power of photography over the past few years. “Are we just all slapping each other on the back — ‘Good job, man. Good awards.’ Are we reaching the right people?” He wants to inform and influence those who aren’t as tapped into the news. “My belief when I started photography was just make pictures, just document everything and so later we can look back and figure this stuff out. I’m still kind of on that page. A history professor I once had said we cannot figure out our present until years later,” he says. “I used to agree with that statement, but in the past few years I've changed my mind: I think we should be able to change things now. I’m getting impatient.”

At a hospital in Lankien, Nahr met a six-year-old boy and his mother after he had been shot in the leg. The next day, before his flight to another area, Nahr photographed the amputation. The boy was quiet but “they trusted me,” he says. “I really struggled to say goodbye.”

But in a seemingly impossible coincidence, at a camp for internally displaced persons on Kok Island, Nahr again saw the boy with a bandaged leg. His mother shouted: “Lankien! Lankien! Lankien!” It had been three weeks since they had first met and somehow, in this movement of millions of people around the region, they had run into each other again. Excited to recognize one another, they each told those around them how they met. The boy was using crutches and “doing great.”

It was a poignant moment for Nahr. In his years covering conflict and its consequences, there were rarely, if ever, follow-ups. “To randomly bump into somebody is huge,” he says. The mother and son were in the camp for a night or two, just passing through, as they made their way home.

Dominic Nahr is a photographer working in Africa, Asia and the Middle East. Follow him on Instagram: @dominicnahr

Alice Gabriner, who edited this photo essay, is TIME's International Photo Editor.

Andrew Katz, who wrote this article, is TIME's International Multimedia Editor.

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