Since war broke out between the Sudanese Armed Forces (SAF) and Rapid Support Forces (RSF) on 15 April 2023, millions of people have lived through intense fighting, including airstrikes, bombing, shooting and assaults. Looting has been widespread and attacks on individuals, including sexual violence, remain a defining feature of the war. An estimated 8.5 million people have been forcibly displaced, according to the United Nations. Many of them are living in under-resourced, under-served camps in Sudan and neighbouring countries. The situation is extremely dire.
Huge medical needs
MSF currently works in and supports 30 health facilities in 11 states in Sudan: Khartoum state, Al Jazirah state, White and Blue Nile states, Al Gedaref state, West Darfur, North, South and Central Darfur states, and Red Sea state. Our teams have also intervened in Kassala state in response to the needs of displaced people.
Since April 2023, we have seen extremely high levels of medical need. In hotspots of violence, we have treated people directly injured in the fighting, including shrapnel wounds, blast injuries and gunshot injuries, including from stray bullets. We’ve received more than 22,800 cases of traumatic injuries and performed more than 4,600 surgical interventions.
The indirect health consequences of the war have been equally devastating. B etween 70 and 80% of hospitals in conflict-affected areas are no longer functioning. Many people have to travel long distances, often amid extreme insecurity, to seek medical care. More than half a million people have sought medical consultations from MSF and MSF-supported hospitals, health facilities and mobile clinics.
Poor living conditions, lack of access to clean water, lack of vaccinations and lack of access to healthcare combine to create conditions for outbreaks and exacerbate the prevalence of diseases significantly. MSF teams have seen over 100,000 malaria cases, treated more than 2,000 people for cholera and seen many thousands of measles cases.
Pregnant women are particularly affected by the lack of access to healthcare. Over the past year, MSF has assisted more than 8,400 deliveries and performed 1,600 caesarian sections.
Another critical and growing need is malnutrition. MSF has supported treatment for over 30,000 cases of acute malnutrition in a year. A recent nutritional assessment in one camp for displaced people in North Darfur found that almost a quarter of children screened during the assessment were acutely malnourished, with seven per cent having severe acute malnutrition (SAM). Among children aged six months to two years old, the figures were even more alarming with nearly 40 per cent of this age group malnourished – 15 per cent with SAM.
These are just a few medical indicators of the immense needs based on the few areas MSF is able to access and respond in. But we know that this is just the tip of the iceberg. The needs across the country are massive and largely unmet.
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Obstructions to humanitarian access
The humanitarian response is just a drop in this ocean of incredible need. Throughout the war, but particularly in the last six months, there has been a systematic obstruction of aid, including of staff and supplies, to areas of great need, particularly in RSF-controlled parts of the country. It has been difficult and time-consuming to get visas for humanitarian staff to enter the country and travel permits for them to move around Sudan. Permits to cross frontlines, for example from Port Sudan to RSF-controlled areas, have been repeatedly denied. Attempts have also been made to prevent aid from entering the country across borders, for example from Chad and South Sudan.
Overcoming these obstructions and navigating a situation of insecurity without adequate protection for civilians and humanitarian workers has been a constant struggle and remains a major focus for MSF.
Massive scale-up needed
Despite the difficulties, MSF’s presence and the medical care we have been able to provide demonstrate that it is possible to carry out humanitarian work in Sudan. Yet very often MSF teams find themselves the sole humanitarian actors in areas where we work.
In the face of the immense needs, a massive scale-up of the humanitarian response is desperately and urgently needed.
