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A displaced child holds clay model toys of a peacekeeper and a rifle, in a United Nations camp in the capital Juba, South Sudan, Jan. 19, 2016.

Jason Patinkin/The Associated Press

South Sudan’s brutal war, almost unnoticed by the world, has become one of the deadliest conflicts of the past three decades, causing the deaths of nearly 400,000 people in less than five years, a new study has found.

The estimate is far higher than any previous estimate of the death toll in South Sudan’s civil war, which erupted in late 2013 and reached a peak in 2016 and 2017 after a failed peace agreement.

It is believed to be the first reliable estimate of South Sudan’s death toll since early 2016, when the United Nations estimated that 50,000 had been killed in the conflict.

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South Sudan, with a smaller population than Syria, has always lacked the geopolitical and superpower attention that the Syrian conflict has generated. Yet its death toll might be close to that of the Syrian war, where about 500,000 are believed to have died.

The new study, published on Wednesday, was conducted by experts from the London School of Hygiene and Tropical Medicine, one of the world’s top research universities. The authors are specialists in humanitarian crises, health information and statistical analysis. The study was financed by the U.S. Institute of Peace in partnership with the U.S. State Department.

The study estimates that about 383,000 South Sudanese have died as a result of the civil war, although it also found that the true number could be considerably higher.

The death toll included about 190,000 people who were killed and a similar number who died because the war has caused disruptions in health services, a worsening of incomes and food security, a rise in homelessness, overcrowding in emergency camps and other war-related factors.

“The world has struggled to respond to the enormity of South Sudan’s crisis, and until now was dramatically underestimating how deadly this war has been,” John Prendergast, a former U.S. State Department adviser who heads the Enough Project, an Africa-focused human-rights group, said in a statement on Wednesday.

Brian Adeba, deputy director of policy at the Enough Project, said the absence of a death estimate had “sanitized the horrors of the war” for far too long.

South Sudan, the world’s youngest country, gained independence from Sudan in 2011 with strong support from the United States, Canada and other Western countries. Barely two years later, it was engulfed in civil war, sparked by a political power struggle and ethnic tensions.

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In addition to the huge number of deaths, the war has forced about 4.5 million people to flee their homes. More than six million South Sudanese are suffering from acute food insecurity, according to United Nations estimates.

To estimate the death toll, the London-based researchers used census projections, migration data, mortality data from household surveys and a range of other data.

“Calculating death tolls of the South Sudan war means leaders cannot simply brush away the ‘unimaginable carnage,’” said Peter Martell, author of a newly published book on South Sudan.

“It makes the mass killings concrete. It is crucial to recognizing the loss – and for the hope of justice in the future.”

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