Crisis in Sudan

Crisis in Sudan

On Saturday 15 April, intense fighting broke out across Sudan with a wave of gunfire, shelling and airstrikes.

The violence between the Sudanese Armed Forces (SAF) and the Rapid Support Forces (RSF) has trapped millions of people in the middle of an unexpected conflict. Many have been forced to flee their homes while access to essential services such as healthcare has become increasingly difficult.

Médecins Sans Frontières / Doctors Without Borders (MSF) teams already working in Sudan have been responding to the crisis since its first moments.

Our healthcare projects and hospitals – in some places the only medical facilities still open – have treated influxes of critical patients: the war-wounded, pregnant women in labour, and chronically ill people with nowhere else to go. At the same time, MSF teams in neighbouring Chad have received huge numbers of injured refugees who have travelled for miles to reach urgent care.

However, the wider international response is still inadequate, and Sudanese authorities have imposed restrictions on humanitarian organisations. This means that people in need are now further cut off from care.

MSF urges that Sudan must not become a forgotten crisis. 

• A specialist MSF surgical team deployed to Bashair Teaching Hospital in Khartoum in May. In July alone they performed 587 procedures while in the same month, the emergency room received 1,073 patients – more than 60 percent of whom had experienced violent trauma such as gunshot wounds and injuries caused by explosions.
   
• MSF teams helped to transform the Turkish Hospital in Khartoum from a paediatric and maternity hospital into a facility that could perform life-saving surgeries and treat the survivors of mass casualty events such as bombings. In July, the hospital treated 3,179 patients, 201 of which were children, and 214 of whom were treated for war injuries.
   
• At Adré Hospital, across the border in Chad, one MSF-supported hospital saw 348 injured patients in a single day, with a total of almost 900 wounded arriving over just four days. Many had sustained gunshot wounds while fleeing the under-siege city of El Geneina in West Darfur. With the hospital overwhelmed, we deployed our inflatable hospital on 27 June - providing an additional 170 beds and two operating theatres.
   
• In Wad Madani, we ran mobile clinics and provided clean drinking water for people who fled the intense fighting in Khartoum. Our teams have also supported the local maternity hospital, ER and orthopaedic trauma centre while providing care for displaced and local people. 
   
• Between 15 April and 30 September, MSF maternity teams have helped deliver 3,338 newborns, as well as a further 1,365 babies via caesarean section.
   
• Our teams have treated children for malnutrition in several states, with the team in remote, mountainous north Jebel Mara reporting that the seasonal increase in malnutrition occurred earlier than usual, in part because food supplies have been disrupted by the conflict. As of 30 September, we have admitted 2,493 malnourished children to our medical feeding centres since the crisis began.
   
• We are providing screening, rapid testing and vaccinations for infectious diseases – supporting Ministry of Health staff to respond to increasing needs. Across Sudan, MSF teams treated more than 21,000 cases of suspected malaria between 15 April and 30 September.
   
• Medical supplies are running critically low across Sudan. As well as supporting MSF hospitals, our logistics teams have delivered fuel and supplies to under-pressure hospitals across Khartoum, North, South and Central Darfur, Red Sea, River Nile, and Al-Jazeera states.

In some parts of Sudan, our teams have been unable to provide care due to intense fighting or intrusions and looting at our medical projects. At times, our colleagues and our patients have been trapped by the conflict. Importantly, however, MSF does not plan to leave Sudan.

The crisis: Explained

Following a military coup in 2021, most international aid to Sudan was frozen. This led to an economic crisis and increased food insecurity.

Sudan’s healthcare system was also extremely fragile even before the recent escalation in violence and access to basic medical services has been a challenge for most people.

This critical situation has been caused by a combination of recurring violence and conflict, the economic situation and the cost of healthcare, and an overall lack of medical staff and resources.

Added to this, the sharp decline in international aid has had consequences including reduced vaccination coverage and increased malnutrition among children.

Before the conflict, around 78,000 children under five were dying each year due to preventable causes such as malaria. In the first four months after 15 April, around 50,000 children with accurate malnutrition had their treatment disrupted.

Pregnancy and childbirth care is another vulnerable area – Sudan already had a high maternal mortality rate, with around 25 percent of births unattended by a skilled healthcare professional. At the start of the conflict, it was estimated that there were 219,000 pregnant women in Khartoum alone, with 24,000 due to give birth.

The stark reality is that Sudan’s healthcare system has been on the verge of collapse for decades. However, with the rapidly deteriorating humanitarian and security situation, low-running supplies and under-pressure staff, it is now at breaking point.

MSF in Sudan: Before the conflict

MSF has been working in Sudan since 1979. We have been providing medical aid throughout the civil war that led to the split with South Sudan in 2011, and the decade-long conflict in the Darfur region.

Before the recent escalation in violence on 15 April 2023, we were running 11 medical projects across 12 states. This included 24 healthcare facilities, from mobile clinics to hospitals.

In 2022, MSF teams in Sudan held 449,654 outpatient consultations, admitted 21,664 people to hospital, treated 5,621 children for malnutrition and assisted in 2,791 deliveries.

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