War in Sudan
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Thomas Kauffmann
General Director
MSF Luxembourg
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Last update: November 6, 2024
The world's worst humanitarian crisis
Since war broke out between the Sudanese Armed Forces (SAF) and the Rapid Support Forces (RSF) on 15 April 2023, millions of people have experienced intense fighting. In large parts of Sudan, particularly Darfur, the population has been the victim of ongoing violence, including intense urban warfare, shootings, bombings and air strikes. Our teams are treating patients injured by explosions, bullets and stab wounds. Health staff and facilities have been attacked and looted.
11 million people have been forcibly displaced from their homes, 8.1 million inside the country and the rest across borders, particularly into South Sudan, Chad and Egypt, as of 6 October according to UNHCR. According to the World Health Organisation, 70 to 80 per cent of the country’s health facilities are not operating at full capacity.
The IDP camps lack adequate health care and humanitarian aid, and malnutrition levels are catastrophic.
Our call for Sudan
All armed groups and those with influence over them MUST ENSURE that humanitarian aid can move freely to all areas of the country. Parties to the conflict continue to impose deliberate blockages to stop medical and humanitarian supplies reaching places where they are desperately needed, and this prevents people from receiving the medical care they desperately need.
Civilians, humanitarian workers and health structures must be spared in the fighting. Bombing health facilities, deliberate harassment and attacks on healthcare workers MUST STOP.
The humanitarian response MUST IMMEDIATELY SCALE UP to meet the massive needs of the population and end this suffering.
Claire San Filippo, coordinatrice d'urgence de MSF, s'est récemment rendue au Tchad et au Darfour, au Soudan. Elle nous fait part de son témoignage.
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The human cost of conflict and violence
The report, ‘A war on people – The human cost of conflict and violence in Sudan’ describes how both the Sudanese Armed Forces (SAF) and the Rapid Support Forces (RSF) and their supporters are inflicting horrendous violence on people across the country. The war has wrought a catastrophic toll since fighting began in April 2023 with hospitals attacked, markets bombed, and houses razed to the ground.
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Driven to oblivion
Driven to oblivion: the toll of conflict and neglect on the health of mothers and children in South Darfur reveals the number of maternal deaths in just two MSF-supported hospitals in South Darfur between January and August to be more than seven per cent of the total number of maternal deaths in all MSF facilities worldwide in 2023. A screening of children for malnutrition also found rates well beyond emergency thresholds.
MSF's response in Sudan
In Sudan, MSF is present in 11 of the country's 18 states.
Our 1483 Sudanese and 233 international staff are currently working and/or supporting 21 hospitals and 12 basic healthcare centres or mobile clinics.
Despite the difficulties, MSF's presence and the medical care we have been able to provide demonstrate that it is possible to carry out humanitarian work in Sudan. However, very often MSF teams are the only humanitarian actors in the areas where we work.
In Sudan, MSF teams provide :
- Emergency care and surgery, including trauma care for war wounded and non-war related injuries, and caesarean sections
- Maternal and paediatric healthcare
- Malnutrition screening and in-hospital and at-home treatment for acutely malnourished children and pregnant mothers
- Outpatient care and mobile clinics, including in sites hosting displaced people and refugees
- Routine- and catch-up vaccination campaigns
- Responses to outbreaks of diseases - cholera, measles etc.
- Donations of medicines and medical supplies to healthcare facilities
- Incentives, training, and logistical support to Ministry of Health staff
- Water and sanitation activities (WATSAN), including setting up and restoring/cleaning latrines and water points.
MSF emergency response (January-June 2024)
external consultations
Emergency admissions
Cases of malnutrition treated
MSF's response in border countries
Chad
Prior to the current war, the country was already hosting several hundreds of thousands of Sudanese refugees. Since mid-April 2023, 899 000 displaced refugees and returnees have crossed the border to eastern Chad (according to UN data), and hundreds more keep arriving every day.
MSF teams work in 3 border regions which have been hosting most of the new arrivals: Ouaddaï, Wadi Fira and Sila, supporting refugees, returnees and host communities. MSF provides a wide range of medical services: primary healthcare, malnutrition screening and treatment, vaccination, sexual and reproductive healthcare; through a wide range of modalities: supporting existing local health structures, setting-up hospitals, clinics and Integrated Community Case Management (ICCM) and referral systems, in addition of mobile clinics allowing to reach the most vulnerable communities. We are also playing a key-part in large-scale public health initiatives such as responses vaccination campaign, or SCP (seasonal chemoprophylaxis) on the benefits refugee communities.
As populations often struggle to acquire water in enough quantity and quality – what increase the risks of water-borne diseases outbreaks and spreading – MSF is constantly working at improving the access to water and sanitation. Over the past year, our organisation has been digging boreholes, building and connecting waterpoints in the camps, brought its technical support to other actors, set-up hundreds of latrines, rehabilitated water-pump in host-communities, distributed hundreds of thousands of soap bars. An intervention, that among other, contribute to decrease the number of cases of hepatitis E, which is currently an epidemic in the east of the country.
Finally, where other competent organisations don’t have the capacity to do so, MSF keeps providing refugee communities with non-food items, such as plastic sheeting, mosquito nets or soap bars which, during the rainy season, are crucial to prevent additional heath troubles and to regain a minimum of dignity.
Despite our relentless efforts, the humanitarian response in eastern Chad has been hampered by insufficient funding for humanitarian organisations on the ground, leaving critical gaps in the provision of food, shelter, water, and sanitation.
South Sudan
As of September 2024, over 820,000 people have crossed into South Sudan from Sudan since the conflict erupted in April 2023. While daily arrivals have recently declined to an average of 600 to 700, the influx overwhelmed the already dire humanitarian situation in the country.
Many people arrive injured and acutely malnourished, facing an equally desperate situation with little food, water, or shelter; People going through transit centres for refugees and returnees from Sudan are grappling with worsening conditions, including overcrowding and limited access to services.
MSF is particularly concerned about the lack of proper water, sanitation, and hygiene facilities in the transit centres, which are crucial as cases of acute watery diarrhoea (AWD) are increasingly common. On 28 October 2024, the South Sudan Ministry of Health declared a cholera outbreak in Renk County, one of the main transit centres, caused largely by poor sanitation and overcrowded conditions.
Currently, MSF runs a stabilisation centre in Joda, Renk county at the border with Sudan, and provides healthcare services in facilities in Renk and Bulukat in the Upper Nile state, providing primary care including mental health, vaccinations, treatment for malnutrition, and maternal and child health services among others. In Abyei Special Administrative Area, the arrival of returnees through Amiet Market entry point has continued to strain the limited resources, especially water and sanitation facilities.
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