Sudan: 500 days of war, and a failing humanitarian response

Today marks 500 days since Sudan began enduring its worst humanitarian crisis yet. 

This is a shameful moment for international humanitarian organisations who, for over 16 months, have failed to provide an adequate response to the country’s escalating medical needs – from catastrophic child malnutrition to widespread disease outbreaks. 

At the same time, heavy restrictions from both warring parties have drastically limited the ability to deliver humanitarian aid says Médecins Sans Frontières / Doctors Without Borders (MSF)

Fighting between the Rapid Support Forces (RSF) and the Sudanese Armed Forces (SAF) started from the capital, Khartoum, on 15 April 2023. It has since raged across multiple parts of the country, triggering an unprecedented humanitarian crisis in Sudan.

The conflict has left tens of thousands of people killed and injured. Between April 2023 and June 2024, MSF treated 11,985 war-wounded at supported hospitals. 

At the same time, the violence has created the world’s largest displacement crisis. According to the UN, over 10 million people (or one in five people in Sudan) have been forced to flee their homes, many of them facing repeated displacement.

A malnutrition emergency

As political solutions for the crisis stagger, malnutrition is rising, food prices are increasing, and humanitarian supplies remain limited.

Beyond the catastrophic situation in North Darfur’s Zamzam camp, MSF’s medical feeding centres in other areas of Darfur like El Geneina, Nyala and Rokero are full of patients. It’s the same situation where we operate in the refugee camps of eastern Chad.

Since the onset of the war until June 2024, we have treated 34,751 acutely malnourished children in Sudan.

“Today children are dying of malnutrition across Sudan,” says Tuna Turkmen, MSF Emergency Coordinator in Darfur. 

“The help they most urgently need is barely coming and, when it does, it is often blocked.

“In July, for instance, trucks with MSF supplies in two different locations in Darfur were blocked from reaching their destination. Two trucks were held by RSF, and one was seized by unknown armed men.”

The situation is also challenging in east and central Sudan. 

“In south Khartoum, MSF has been blocked from bringing medical supplies and international staff to hospitals for many months,” says Claire San Filippo, MSF Emergency Coordinator for Sudan. 

“It is becoming increasingly difficult to provide the medical care our patients need, including maternity and emergency care.”

Attacks against healthcare

Meanwhile, the conflict has put nearly 80 percent of the health facilities in Sudan out of service, according to the World Health Organization. This has crippled an already struggling healthcare system. 

In El Fasher alone, MSF-supported facilities have been attacked 12 times since the fighting escalated in the city in May, while only one public hospital remains partially functional with the ability to perform surgery.

Most recently, on 22 August at around 4:40 am, shelling struck the house accommodating part of the MSF team working in El Fasher and Zamzam. 

Fortunately, the damage was only material and no one in the house was injured. However, this constitutes the 84th violent incident against MSF staff, vehicles and premises in Sudan since the start of this conflict – a war which has been characterised by a glaring disregard for the protection of civilians, as well as health personnel and facilities.
 

The situation is not much better in neighbouring countries, where about two million people have sought refuge, often separating from their loved ones along the way.

“My husband has been missing for over a year and I don't know where he is,” says Um Adel, a woman in Metche, a camp in eastern Chad. 

“[My son] Khalid was fine until the food started to diminish. After a day or two of not eating well, he developed a high fever. I don't feel comfortable here and the situation is not good, I want to go back to Sudan.”

A call for action

MSF is one of the few international organizations working on both sides of the conflict in Sudan. 

We currently run and support medical projects, including healthcare clinics and hospitals across eight of Sudan’s 18 states. 

Warring parties, and states with influence over them, must ensure the protection of civilians, healthcare personnel and medical facilities. 

Responsible authorities on both sides of the conflict must simplify the processes granting permissions for humanitarian aid through all available routes, across borders, states, and frontlines.

And, the United Nations, relevant agencies and anyone who has the power to help must employ all measures to ensure that available access routes are utilised to their fullest extent.

Sudan: The biggest humanitarian crisis on Earth

“MSF tries to fill some of the gaps,” says Esperanza Santos, MSF Emergency Coordinator in Port Sudan.

“In many places, we work we are the only international organisation operating, but we cannot tackle this huge crisis alone.

“We are also struggling to get supplies and staff to our projects. In tandem with access, securing sustained funding for UN agencies, as well as local organisations and responders, who are carrying the brunt of this response, is also essential.

“A meaningful response with aid reaching people who need it most must start now. There is no more time to waste.”