“Sudan is one of the worst crises the world has seen for decades. There are extreme levels of suffering across the country; the needs are growing by the day, but the humanitarian response is deeply inadequate. We have responded to multiple mass casualty events and emergencies over the past year. We have performed life-saving surgical procedures, assisted women to give birth – including with emergency C-sections – and treated children in our paediatric wards and inpatient therapeutic feeding centres, trying to save their lives.
In refugee camps and locations hosting displaced people, we have improved water and sanitation conditions, run mobile clinics and vaccinated children. But in many of the areas where we work, we are the sole humanitarian organisation there. Before the start of the war, there were dozens of international organisations responding across the country. Now, there are almost none. For a crisis of this scale, this is unfathomable and unacceptable, and it cannot be allowed to continue.
Devastating stories of violence in Sudan
Dr Christos Christou, MSF International President, visits Zalengie in Darfur, Sudan, where he recounts the devastating stories of violence within the area's only remaining medical facility. Zalengei Teaching Hospital, Sudan, is the only functioning hospital in Central Darfur. After several lootings, MSF teams support rebuilding and equipping the hospital.
“There is no doubt that there are enormous challenges in Sudan, but they are not insurmountable. It is possible to respond – and we know this because we are there. A major issue is the systematic blockage of the delivery of humanitarian assistance that has been imposed by the Sudanese Armed Forces for the past six months. It means that we cannot send medical supplies or personnel across the frontlines into areas controlled by the Rapid Support Forces, and recently, we have seen increasing attempts to block humanitarian supplies and staff crossing from neighbouring countries into Sudan.
Many of our facilities are perilously low on supplies – in the Turkish Hospital in Khartoum, for example, we have just 20 per cent of our stock remaining. We have already run out of artesunate, which is vital for treating malaria. The blockade amounts to a deliberate obstruction of the provision of humanitarian assistance and it is having a devastating impact on the lives of millions of people across the country. Only 20 to 30 per cent of health facilities remain functional in Sudan as it is. Without supplies reaching these facilities, people’s ability to get treatment when they need it is becoming even more limited.
Dr Christos visiting the MSF hospital in Chad where Sudan refugees who fled violence are receiving medical aid.
“Patients are dying due to violence-related injuries and preventable illnesses, children are perishing due to malnutrition. Vaccines are running out, and there have already been outbreaks of deadly diseases such as cholera and measles.
One example is the catastrophic malnutrition crisis in Zamzam camp in North Darfur, where there have been no food distributions from WFP since May 2023. 25 per cent of children we screened there in a rapid assessment in January were found to be suffering from acute malnutrition – seven per cent were severe cases. 40 per cent of pregnant and breastfeeding women were suffering from malnutrition, and there was a devastating mortality rate across the camp of 2.5 deaths per 10,000 people per day. These are extremely alarming figures, and we expect the situation to deteriorate. There are also extremely concerning food insecurity predictions for the rest of the country.
We called for health providers to return and provide treatment. But no one came and – two months later – we remain almost completely alone there.
“In February, we called urgently for an immediate, coordinated and rapid scale-up of the humanitarian response in North Darfur – led by the UN – in order to save lives. We called for food distributions to resume as a matter of urgency. We called for cash distributions so that people could buy food in the markets. We called for health providers to return and provide treatment. And we called for the provision of clean water so that people no longer had to go to the swamps and rivers to quench their thirst. But no one came and – two months later – we remain almost completely alone there.
We currently supply 75% of the water provided to refugee camps in Eastern Chad. These camps host about 600 000 people fleeing the conflict in Sudan. "We still don't supply enough. We would like to see [more] actors supply water to the people, so we can focus more on the medical conditions of the population," says Dr Christos Christou, MSF's International President.
“This is not acceptable and this level of international neglect is shocking. Across Sudan, women are dying because of complications during pregnancy or childbirth, and patients with chronic diseases are dying because they are running out of medication. This can all be prevented if humanitarian actors scale up and have sufficient safe access. The vast needs, the known atrocities that are being committed – these are all reasons why we urge the UN and humanitarian organisations to redouble their efforts to provide assistance to people in Sudan.
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We navigate an extremely insecure context in order to provide health care and it is vital that the warring parties adhere to International Humanitarian Law and the humanitarian resolutions of the Jeddah accord they signed in May last year to protect civilians and ensure safe humanitarian access to all areas of Sudan – this includes lifting the blockade as a matter of urgency, opening the borders and opening the airports.
“We urge the UN to use their influence and leadership in this crisis to ensure the parties to the conflict fulfil these obligations, and to initiate a rapid scale-up of the humanitarian response as a matter of urgency. We also urge donors to increase funding for the humanitarian response in Sudan. Without these three vital commitments, a humanitarian response on the scale that is required to prevent this colossal crisis from deteriorating any further will not be possible.”
