Severe humanitarian needs after half a million people flee violence in Wad Madani

The chaos following the evolving conflict dynamics and the severe insecurity and widespread violence created an environment in which Médecins Sans Frontières (MSF) could no longer operate in Wad Madani. 

As a result, MSF had to suspend all activities and evacuate its staff from Wad Madani on 19 December, leaving behind a population with even less access to basic medical services. We also had to evacuate staff from Damazine, Um Rakuba in Gedaref state, and Doka. In Damazine, we reduced activities.

Our teams had been present in Wad Madani since May 2023. Conditions were already dire for the half a million internally displaced people living there, which made up 8 per cent of all internally displaced people in Sudan—already the world’s largest internal displacement crisis, with more than 6 million forced from their homes within the country in addition to more than 1.4  million who have fled across borders.

Between May and November, MSF teams performed 18,390 medical consultations (40 per cent of them for children under 15 years old) in several of the hundreds of locations hosting displaced people across the state, some in schools or old public buildings.  

“Through its mobile clinics, MSF diagnosed and referred 66 children suffering from severe acute malnutrition with serious complications in the past six months—cases that could be fatal if not treated in a hospital urgently,” says Slaymen Ammar, MSF medical coordinator for Sudan. 

“But health facilities were overwhelmed. As the population of the city had increased by 30 per cent, there were more and more patients, but considerable supply and staffing challenges. And as prices soared for all goods, access to lifesaving services was an obstacle for both displaced people and regular residents. Nowadays, with the departure of most international organisations—and despite efforts of local volunteer health workers—we can only assume it has worsened.”

During the last month, MSF teams in Gedaref and Kassala states—where MSF has been operational since 2021 in response to the Ethiopian Tigray crisis—witnessed the arrival of thousands of people from Wad Madani , and are currently assessing and responding to the escalating health and humanitarian needs. 

In Tanideba (Gedaref), we have started a short-term emergency intervention for newly displaced Ethiopian refugees and newly displaced Sudanese citizens, covering basic healthcare, water and sanitation, as well as food rations. This included one-off distributions and donations. However, activities in Tanideba were temporarily reduced due to the escalation of conflict in Wad Madani.
 

The conflict in Sudan has caused immeasurable suffering, displaced millions, killed thousands, and injured countless others. For many displaced people, Gedaref and Kassala are just the latest stops in a long journey to seek safety, during which they have suffered violence and have endured a lack of essential needs such as food, clean water, sanitation, and access to medical care.  

“We are originally from Darfur, but because of the violent clashes and the crisis over there, we went to Khartoum. But the war followed us to Khartoum, so we went to Wad Madani. And then, the story continues,” says Salem* a displaced man who arrived with his family in a gathering site in the Al Mufaza locality, Gedaref, two weeks ago from Wad Madani. 

Salem’s family fled Khartoum eight months ago, after a shelling hit their house and severely injured one of their children.  

“We were six people in the house, and at that time and my wife was pregnant. Our house was destroyed. I was hit on my arm, but my child got a much worse injury on his head,” says Maha.

“We managed to take him to the hospital because he needed urgent lifesaving surgery. But as soon as he was discharged, we had to flee the city because of insecurity. We arrived to the camp in Wad Madani, and I delivered there,” he says.

In mid-December, he and his family fled once again to Gedaref: “Clashes started, and we started hearing sounds of fires and those armed men fighting again. Immediately, we decided to leave. I started thinking where we should go now. Nowhere was safe at that time.”

“At the gathering sites in Kassala city, people who have been displaced told our teams they haven’t received any assistance since their arrival in mid to late December,” says Pauline Lenglart, MSF emergency project coordinator in Sudan.  

“Families are sleeping on the ground, access to healthcare is still severely restricted, there are few working medical facilities and medicines aren't provided for free,” says Lenglart.

“Many people have told us that they are unable to afford items like food and medicine, forcing them to choose between these necessities. Our team is constantly evaluating the needs at new sites that are opening to house recently displaced people.

“In all these places, we see that the amount of humanitarian assistance provided is still woefully inadequate to meet people’s basic needs and ensure dignified living conditions,” says Lenglart.

*Name changed to protect identity.