AWEIL, South Sudan (AP) -- The mother faced an anguished decision: choosing which of her children to save.
With hunger gripping this remote region of South Sudan, Elizabeth Athiel could either get urgent medical attention for her 8-month-old daughter, Anger, or make sure her other five children could eat.
The little girl was shockingly thin, but the medical clinic was a half-day's walk away, and she would have to wait there for days until recovery. "I can't leave the others alone here," Athiel said, holding Anger in her arms.
The baby is another casualty of South Sudan's civil war — in a part of the country that hasn't even seen fighting.
Here in the government stronghold of Northern Bahr el Ghazal region, there are indications of famine. One-third of children in the region are estimated to be acutely malnourished. If resources remain limited, more children will die, said Mahimbo Mdoe, the UNICEF representative in South Sudan.
The food crisis is evidence of how the conflict has devastated South Sudan's ability to function. Since December 2013, tens of thousands of people have been killed. More than one million refugees have fled. The U.N. calls South Sudan one of the world's worst humanitarian crises.
Even as President Salva Kiir and his government have repeatedly promised full humanitarian access to this and other areas, South Sudanese officials have restricted aid amid hostility at the international community over its attempts to calm the fighting and protect civilians.
During a visit by The Associated Press to Aweil in mid-September, aid airdrops by the World Food Program had been suspended because the government imposed what it called additional security requirements. They later resumed but were suspended again this week.
Minister of Information Michael Makuei recently told reporters that WFP had been "intransigent" with his government.
"Did they come here for humanitarian services? They came there for their own ulterior objectives," Makuei said, reflecting some officials' view that the U.N., with its peacekeeping mission and aid agencies, had too much authority.
Meanwhile, South Sudan's government spends 44 percent of its budget on military and security, but just 11 percent on health, education and humanitarian affairs, according to the finance ministry.
"The government knows that it doesn't have to spend money on health care and education because the international community is always going to do it for them, and they can spend it on weapons instead," one diplomat said on condition of anonymity because they were not authorized to speak to the media.
South Sudan has long suffered from periods of hunger. The fighting has only made it worse.
Between 4 and 5 million people are at risk of death if they do not receive food assistance, according to WFP, and Northern Bahr el Ghazal has been hit hardest. Roughly 60 percent of the population faces levels of hunger described as "crisis," ''emergency" or "catastrophic," according to U.N. agencies.
"I used to eat three times per day. Now I eat once," said Nyibol Dut, a mother who said the price of two liters of grain had reached 350 South Sudanese pounds, compared to 20 pounds two years ago.
Aweil's dusty streets were lined with ripe tomatoes, onions, and watermelon, but most are unaffordable. Here, food prices are 10 times higher than they were last year, according to the government.
Civil war has "affected trade seriously," said Aweil Governor Ronald Ruay Deng as he sat under a tree in his walled compound. But he defended government restrictions on aid delivery, calling security crucial for any humanitarian response.
At times, aid workers in South Sudan hardly know who to deal with for permission to operate. They described a dizzying web of middlemen from the government, opposition and local defense militias that is the source of many delays.
"In a country that doesn't act like a country, permission from the president just isn't sufficient," one humanitarian official said, speaking on condition of anonymity for fear of retribution from the government.
Amid the hunger crisis, some South Sudanese are doing the unthinkable. They have fled by the tens of thousands into neighboring Sudan, the country they fought for years before achieving South Sudan's independence in 2011 as the world's youngest country.
At least 50,000 South Sudanese have even moved to Sudan's conflict-ridden Darfur region this year, the U.N. has said.
Taril Tong confirmed that many in his village have moved to Sudan after heavy rains destroyed crops, but he said he won't join them.
"This is our country," he said proudly.