Statement delivered in writing by Médecins Sans Frontières (MSF) director of operations Dr Ahmed Abd-elrahman for the high-level ministerial event on Sudan at the United Nations General Assembly on 20 September. The event on the Cost of Inaction in Sudan was convened by the UN with the governments of Egypt, Qatar, Saudi Arabia, plus the European Union, and the African Union.
Excellencies, distinguished guests,
A catastrophic health crisis is upon us in Sudan. Yet our collective ability to address it head-on is in question.
MSF is currently working in 10 states in Sudan on both sides of the frontlines, providing a range of healthcare services including trauma care for war wounded, maternal and paediatric care, and treatment for malnutrition. What our teams are witnessing is some of the most intense urban conflict of any context we are currently working in.
The health system is buckling under the weight of devastating violence and overwhelming needs.
Health workers and health facilities across the country are struggling to keep their doors open. Meanwhile, extreme violence and insecurity are simultaneously driving greater health needs and preventing patients from seeking the care they desperately require.
In areas where violence is most intense, MSF's teams are constantly responding to mass-casualty incidents - a lamentable testament to the brutality of the conflict and the total failure to protect civilians.
The health system is buckling under the weight of devastating violence and overwhelming needs.
Since the beginning of the conflict, MSF teams have conducted over 1,500 major surgical interventions in a single hospital in Khartoum, 90 per cent of which were to treat gunshot and blast wounds. During the month of August alone, in a single MSF-supported hospital in Omdurman, our teams treated over 2,100 trauma cases, almost half of the total emergency room consultations of that facility.
Even in more secure areas, shortages in medical staff and supplies, and demands driven by ever-growing displacement, have meant that the health system cannot begin to keep up with the needs of local communities.
Vaccinations have been interrupted. Living conditions - including access to water and sanitation - have plummeted. Food insecurity has spiked to unprecedented levels. Across many of MSF's projects, we are seeing a disturbing rise in the number of patients suffering from measles, acute watery diarrhoea, malaria, and malnutrition.
In Sudan, our medical teams see people dying by bullets and bombs. But many people are also losing their lives due to a pervasive lack of access to medical care and humanitarian assistance.
MSF is mounting a major humanitarian response in Sudan, and maintaining our principles of independence and neutrality. Unfortunately, we are operating today with fewer staff on the ground than prior to the surge of conflict in April. Meanwhile the needs have ballooned to unprecedented levels.
What the humanitarian response in Sudan demands today, are system-wide, stable solutions to these issues, not one-off or temporary fixes.
As people living in Sudan have slipped further and further into the depths of calamity, we have been unable to fully mobilise in their support to meet the needs. While widespread insecurity has predictably hindered the response, we did not anticipate having to regularly navigate a dizzying and ever-changing maze of bureaucratic and administrative procedures. It is undeniable today that these bureaucratic restrictions are constraining a humanitarian response that urgently needs to be bolstered.
The health response in Sudan can and must go much further to meet the extent of the needs. MSF stands ready to send essential staff to help reinforce and grow the health response.
What the humanitarian response in Sudan demands today, are system-wide, stable solutions to these issues, not one-off or temporary fixes.
We are confident that the Sudanese authorities can do more to support the humanitarian response, and we urge them to systematically fast-track visa processing, ease travel restrictions, and expedite the clearance of medical and humanitarian supplies.
More broadly, the parties to the conflict must recommit to their obligations under international humanitarian law, as they did under the Jeddah Declaration. Civilians must be protected. Principled humanitarian action must be facilitated.