By the time he was brought into the remote clinic in northeastern South Sudan, two-year-old Nyachoat was already convulsing from the malaria attacking his brain.
After being given medication he lies fast asleep, naked and feverish, attached to a drip, his anxious mother sitting on the bed next to him.
Nyachoat could be saved, but others are not so lucky.
In South Sudan mind-bending horrors abound of war, ethnic violence, rape, hunger and displacement.
But for civilians living in the shadow of conflict, the greatest danger is often being cut off from health services, whether due to violence or lack of development in the vast, remote areas that make up much of the country.
According to the International Committee of the Red Cross (ICRC), which supports the tiny clinic where Nyachoat is recovering in Udier village, 70 percent of all illness deaths are due to easily treatable malaria, acute watery diarrhoea and respiratory infections.
In case of more serious illness there is “no place” to go, said Nyachoat’s 22-year-old mother Buk Gader.
A study by the London School of Hygiene and Tropical Medicine (LSHTM) last year showed almost 400,000 people had died as a result of South Sudan’s nearly six-year war.
Half of these were due to violent deaths, and half because of the increased risk of disease and reduced access to healthcare as a result of the conflict.
ICRC health field officer Irene Oyenya said the Upper Nile region was particularly affected.
“There were (aid) organisations which were supplying primary healthcare, but then during the war, most of the organisations got evacuated” and pulled out of the country, she said.
Blocked by swamps
Udier is a village with a dirt airstrip whose sun-baked sand, which when not used by twice weekly ICRC flights bringing medicine and supplies, serves as a football pitch for youths. It is also a pedestrian highway for those who come from far flung huts and cattle camps to market.
In the tiny market, there is little fresh food available. Villagers can buy red onions or sit for a strong Sudanese coffee, infused with ginger, while in the dry season nomadic Falata herdswomen in flowing dresses sell milk from their cattle.
A brick building next to the airstrip, its roof long blown off in a storm, is the village school, but for several days in a row no teacher shows up.
In the surrounding villages, women are hard at work mudding their huts and re-thatching the roof in anticipation of the rains to come within weeks.
When they do come, swelling the swampy marshlands and rivers for miles around, roads will become impassable.