Conflict in Sudan

Escalation of conflict in Sudan

Conflict escalation

Since Saturday 15 April, intense fighting has been taking place between the Sudanese Armed Forces (SAF - the military forces of the Republic of the Sudan) and the Rapid Support Forces (RSF – a powerful paramilitary  group) in the capital Khartoum and other parts of Sudan

 

Safety risks accessing healthcare

 Many people, including healthcare workers, are currently trapped and unable to move or reach health facilities due to the intensity of the conflict. 

Since Saturday 15 April 2023, intense fighting has been taking place between the Sudanese Armed Forces (SAF) and the Rapid Support Forces (RSF) in Khartoum and other parts of Sudan. Many people, including healthcare workers, are currently trapped.

As of 4 May, Médecins Sans Frontières / Doctors Without Borders (MSF), received 4427 wounded people at South Hospital – the hospital we support in El Fasher. There have been 89 deaths.

We urge all parties to the conflict to guarantee safety for patients and medical staff, so that they can access healthcare facilities without fearing for their lives.

The current situation

Large parts of Sudan have experienced ongoing violence, including intense urban warfare, gunfire, shelling and airstrikes. MSF teams report that hospitals are overwhelmed, and in some areas, people are unable or too afraid to get to facilities because the fighting is too intense and/or the facilities have been damaged in the fighting. This means that many people are cut off from medical care at a time when they need it most. 

Many people, including healthcare workers, are trapped. Due to the ongoing violence and fear that they will be risking their safety, many cannot reach any of the small number of health facilities that are still functional and open. 

Access to basic medical services has been a major issue for the majority of people living in Sudan due to recurrent violence, conflict, the dire economic situation, under-resourcing, lack of medical supplies, brain drain of medical personnel, and costs of healthcare. The decline in funding and the freeze on international aid has caused direct and indirect consequences, such as vaccination ruptures, increased food insecurity and malnutrition among young children. An estimated 50,000 acutely malnourished children have had their treatment disrupted due to the conflict, according to UNOCHA. 

According to UNHCR one million people have been displaced by almost five weeks of fighting in Sudan. Around a quarter of a million have crossed borders into neighbouring countries. The rest are displaced within Sudan. Refugees have streamed into Sudan's neighbours, including Chad, Ethiopia and South Sudan – countries that are facing their own, poorly funded, humanitarian crises. Egypt has so far received the highest number of Sudanese refugees with around 110,000. 

As things stand, the hospital is rapidly running out of medical supplies to treat survivors. It is running out of blood for transfusions. Fuel supplies for the hospital generator are also running low. It’s important to mention that, without those vital supplies, there will be further loss of lives.

Ghazali Babiker
Country director for MSF in Sudan

How is MSF responding

MSF supported facilities continue to provide medical care in Kreinik, West Darfur, in Rokero, Central Darfur, in Um Rakuba and Tinedba, Al-Gedaref state and in Damazin in Blue Nile State.    

Before the escalation of violence on 15 April 2023, MSF worked in 12 states of the country and ran many different activities, including primary and secondary healthcare, support to hospitals and other health facilities, mobile clinics, outpatient and inpatient nutrition activities, reproductive and mental health care, vaccination campaigns, health promotion and WASH activities. We adapted and launched emergency responses in other areas to address the most acute humanitarian and medical needs in an impartial manner and to the best of our abilities. 

We remain committed to providing much needed healthcare to people in Sudan, especially during these challenging moments. 

msb154269.jpg
North Darfur
  • The MSF-supported hospital in El Fasher, North Darfur, was originally a maternity hospital with no surgical capacity. It was rapidly repurposed to provide urgent trauma care after receiving a huge influx of wounded patients. Since the conflict broke out on April 15, the hospital has carried out over 600 surgical operations for both the wounded and for women requiring emergency obstetric surgery.  
  • MSF has reopened its health clinic in Zamzam camp in North Darfur state, the largest camp for displaced people in Sudan with a population of 120,000. Since we reopened, we have been seeing ~160 patients per day. Some have required urgent medical attention.   
  • An MSF truck carrying 10 tons of medical supplies for South Hospital and Zamzam camp arrived in El Fasher on Monday 15 May 
Central Darfur

In Rokero, Central Darfur state, locally hired MSF staff and MoH staff continue to provide medical assistance. The supplies they have are likely to last for another two to three months. We currently do not have the option to refer patients for higher levels of treatment due to the ongoing fighting, either because hospitals are no longer functional, or roads are too insecure.

West Dafur
  • In the hospitals supported by MSF in Kreinik, West Darfur state, locally hired MSF staff and MoH staff continue to provide medical assistance. We suspended mobile clinics and outreach activities for nomadic communities in West Darfur. The situation remains calm in Kreinik. The hospital is open, running and receiving higher numbers of patients.
  • The market is open and accessible for nomadic communities, who are able to access the hospital. In the past two weeks the maternity ward has received and treated 41 women, the team helped 258 pregnant women with antenatal care, the paediatric ward admitted 32 children. The biggest challenge is supplies that usually come from El-Geneina where intense fighting and violence continues. With the current consumption the medical stocks will run thin on many essential items in 3 weeks’ time.
Khartoum

In the capital Khartoum, a surgical team is working in a hospital in south Khartoum, alongside Sudanese medical staff and volunteers, providing emergency and surgical care. We’re now running 24/7 operations. We have our operating theatre, post-op, we’ve built up an intensive care unit. And we’re working, day-by-day, to increase the quality of care. The team performed more than 400 surgical procedures’ since they started working in the Bashair Teaching Hospital in Khartoum on 9 May. MSF is working in collaboration with community volunteers – doctors and nurses but also young people from the area and the community who made a decision to try to restart this hospital after it had closed. Staff had left for their own safety.  
 

While MSF has been able to secure enough medical supplies to work in the Bashair Teaching Hospital for now, drawing on pre-positioned stocks in Khartoum and some donations from others, stocks will run out at some point. A shipment of medical and other supplies landed in Port Sudan on 16 May 2023 and will be moved to Khartoum and another area to the south, Wad Madani, where teams are running mobile clinics for displaced people. 

Al-Jazeera

In Wad Madani the capital of Al-Jazeera state, are running mobile clinics for people who have been displaced from Khartoum and supporting health facilities dealing with the influx of patients. We have also distributed hygiene and non-food items and food staples in Wad Madani, prioritising the most vulnerable who are currently sheltering in public buildings, and carrying out WASH activities. 

Red Sea

In Port Sudan, the capital of Red Sea state, MSF started implementing some water, sanitation and hygiene (WASH) activities in IDP and other collective sites. We are desludging latrines, trucking water, and distributing hygiene items. We have also provided training at local emergency room on MCP and emergency triage.

Blue Nile

In El-Damazin in Blue Nile State, our team continues to support the El-Damazin hospital, including the malnutrition programme, and to run mobile clinics. 

Al-Gedaref
  • In Taneidba camp in Al-Gedaref State, MSF is running a hospital for refugees and host communities providing medical services including ER, maternity and mental health.  
  • In Um Rakuba refugee camp in Al-Gedaref, MSF is also responding to support the Ethiopian refugees and host communities, though due to the current conflict, our admission criteria have been restricted. The focus has shifted to emergency lifesaving activities, mostly for paediatrics, malnutrition, and maternity. 
Suspended activities
  • An MSF compound and warehouse, and were looted in Nyala, South Darfur. Equipment, vehicles and medical supplies were all taken. The team in South Darfur was unable to continue its healthcare services as they had no supplies, consequently the MSF team was evacuated to South Sudan. 
  • The MSF supported El Geneina Teaching Hospital in West Darfur was looted during the violence on 26 April. MSF has supported the Ministry of Health in the paediatric department, providing emergency and inpatient care. The hospital has been closed due to the violence, making it impossible for our teams to continue working on paediatrics or in the neonatology and maternity departments. 
  • In Kassala we are planning to hand over our activities to the Ministry of Health.  

MSF assistance to refugees in neighbouring countries

Hundreds of thousands are fleeing to safer areas. People face shortages of food and drinking water, forcing them to be on the move to try to meet their basic needs. 

Chad
  • It is estimated that over 75,000 people, including refugees and Chadian returnees, have fled to Chad’s eastern provinces according to the UNHCR – mostly in Ouaddai province but also in Sila and Wadi Fira provinces. These three provinces were already hosting the bigger part of refugees in Chad, with more than 400,000 Sudanese refugees settled in eastern Chad prior to the eruption of the recent violence, often in overcrowded camps with inadequate sanitation facilities and a shrinking access to food assistance in a region gripped by food insecurity, child malnutrition and recurrent preventable outbreaks.  
  • We are currently working at the border with Sudan, in collaboration with health authorities, to run mobile clinics, vaccination, malnutrition screening, referrals and other activities in temporary refugee camps in places like Koufroun, Borota and Goungour in Ouaddaï province. Our teams continue to support Adre hospital and three health centres, where we’ve been working since 2021, and in addition we have recently strengthened surgical capacities to help stabilize and treat the wounded. We refer the most severe cases to Abeche.  

  • We are running mobile clinics in Sila province, in the refugee reception sites of Mogororo and Anderessa, only 500 metres from the border with Sudan, and supporting the health centre in the areas of Daguessa. Our teams provide medical care, including sexual reproductive healthcare, malnutrition screening for children under the age of 5, as well as referrals to secondary health care and for psychosocial support. 

Central African Republic
  • In Birao we are providing medical care, supplying water daily, and constructing a temporary health facility for all those arriving, and providing pediatric care and vaccination.
  • We are also working in the local hospital, to support the Ministry of Health to provide pediatric care, intensive nutritional care for those suffering with acute malnutrition, medical-surgical emergencies, and mental health care to those who have fled the conflict.
South Sudan
  • We have launched emergency responses in Upper Nile and Northern Bahr El Ghazal states, running three mobile clinics in Renk and one in Aweil.
  • In Renk, our water and sanitation teams are treating river water to provide safe drinking water for displaced people, while medical teams are screening children for malnutrition and have set up a measles isolation ward.
  • We are also providing referrals for people in need of specialist medical care, as well as mental health support and health education. 

Will you support our emergency response work?

As an independent, impartial medical humanitarian organisation, Médecins Sans Frontières can respond rapidly to emergency situations and deliver urgent medical treatment.
 
At the moment our impact is limited due to the restricted movement possible under the dangerous circumstances. As the situation evolves, we continue to work on ways we can support local health systems and provide direct medical care to those affected by the conflict, and take all measures possible to ensure the safety of our teams.
 
By making a donation, you can help ensure that we can be there to provide medical assistance during times of crisis like intense fighting in Sudan.
 

DONATE NOW