For a year, fighting between the Sudanese Armed Forces and paramilitary group the Rapid Support Forces has wrought devastation across Sudan, forcing millions of people from their homes and driving the country’s health care system to collapse.
One year on, more than 15,000 people have been killed and Sudan has become the largest internal displacement crisis in the world, with more than 6.6 million people displaced within its borders. Two million more have fled to neighboring countries like Chad and South Sudan.
Doctors Without Borders/Médecins Sans Frontières (MSF) has been providing medical humanitarian aid in Sudan since 1979, and our teams continue to work across the country amidst the current conflict. Over the past year, they have borne witness to a massive crisis that is unfolding largely outside the world’s headlines while humanitarian aid is falling far short of meeting the spiraling needs.
Sudan 2023 © MSF
Fighting breaks out in Khartoum
Violence erupts between the Sudanese Armed Forces and the Rapid Support Forces in Khartoum and other parts of Sudan. Over the next 48 hours, MSF receives 136 wounded patients at the hospital we support in El Fasher, North Darfur, 11 of whom die from their injuries.
Armed group raids MSF compound in Nyala
Looting of El Geneina Teaching Hospital
Parts of the MSF-supported El Geneina Teaching Hospital in West Darfur are looted during a violent intrusion. Widespread looting and destruction are reported across the city of El Geneina, including burning property and attacks at the central market, gathering sites, and camps where displaced people are sheltering.
MSF returns to Zamzam camp after fighting disrupts medical care
The residents of Zamzam camp in North Darfur went several weeks without any access to health care due to intense fighting and insecurity in and around El Fasher, which prevented MSF's team from being able to return to the camp until May 7.
A car stripped of its tires during the looting in Khartoum. Sudan 2023 © MSF
MSF warehouse in Khartoum looted
“People are in a desperate situation, and the need for health care is critical. These attacks make it so much harder for health care workers to help. It’s senseless.”
MSF joins local health care workers to treat trauma patients in Khartoum
MSF medical and surgical teams at Bashair Teaching Hospital in Khartoum work closely with local Sudanese medical professionals and volunteers.
“When we arrived, the situation was chaotic,” said Dr. Hisham Eid, a member of the MSF team. “The hospital was not operational. A few doctors and volunteers were doing their best to attend to the big number of patients despite the shortage of all forms of supplies including electricity. It is getting better now and we are able to attend to many patients efficiently.”
Governor of West Darfur is killed
“On Wednesday night, the governor of West Darfur was killed,” said Nour, a 25-year-old from El Geneina who arrived at Adré hospital on June 15, 2023, after being shot in the face. “We knew that the situation would get even worse, and it was a collective decision of the people of El Geneina to leave. The only solution was to head west."
Over 1,000 ER patients received at Bashair Teaching Hospital
Of more than 1,150 ER patients MSF receives, 906 have violent trauma. "I cannot recall any time in recent years when MSF has treated anything like the number of trauma cases or done as many major surgeries as we have done in Khartoum," said Raphael Veicht, MSF emergency coordinator.
Adré hospital sees 600+ war-wounded refugees in just three days
A large number of the wounded are from the capital of West Darfur, El Geneina, and the surrounding area. Local sources report that at least 1,100 people have been killed in El Geneina since the conflict began. Approximately 430 of these refugees need surgical care for injuries like gunshot wounds.
MSF urges armed groups in and around El Geneina to spare civilians and allow people to safely flee
After nearly two months of blockade and large-scale violence in El Geneina, thousands of people attempt a perilous escape to seek refuge in Chad.
MSF teams turn an inflatable tent into an emergency field hospital
To handle the arrival of wounded patients in Adré, Chad, MSF teams set up an emergency field hospital using a modular kit made up of inflatable tents, with bed capacity for 170 patients, two operating theaters, and X-ray technology.
MSF staff threatened and beaten in Khartoum
A team of 18 people working for MSF are violently assaulted by a group of armed men while transporting medical supplies to the Turkish Hospital in southern Khartoum. After arguing about the reasons for MSF’s presence, the armed men assaulted the MSF team, beating and whipping them. They detained the driver of an MSF vehicle, threatened his life before releasing him, and stole the vehicle.
MSF calls for visas for surgeons, nurses, and other staff
If long-awaited visas are not granted to new staff, including surgeons, nurses, and other specialists, MSF may soon be forced to withdraw much-needed medical support.
Turkish Hospital receives casualties from Khartoum market strike
A strike on a market in south Khartoum kills 21 and severely injures six people arriving at the Turkish Hospital, where an MSF team is working.
Renewed fighting in Umbada, Omdurman
Medical teams in Omdurman treat more than 50 patients for violence-related injuries following renewed fighting in Umbada. Eight patients die due to injuries from bullets or explosions.
MSF responds following explosion in Khartoum and Darfur fighting
The residential neighborhood of Al Haj Youssef is struck by a deadly explosion that damages houses and leaves people with severe shrapnel wounds. A nearby hospital supported by MSF staff, Alban Al-Jadeed, receives 45 people wounded in the blast, including six who were dead on arrival.
"Our teams heard a loud explosion, so they rushed to prepare for the emergency," said Christian Mas Bouilloud, MSF medical coordinator in Khartoum. "Soon after that, patients started arriving in groups. Most had shrapnel wounds, many of them critical. It's horrific that residential areas, such as homes and markets, are being hit."
Explosion in Khartoum market kills 43
An explosion in Khartoum's Gorro market kills 43 people and wounds more than 60 who were treated at Bashair Teaching Hospital in south Khartoum. "The horror of the day was overwhelming," said Marie Burton, MSF emergency coordinator in Khartoum. Horrific attacks in residential areas of Khartoum have resulted in some of the city’s highest death tolls since the conflict began.
MSF director of operations addresses United Nations General Assembly
In a statement delivered in writing for the high-level ministerial event on Sudan at the UNGA, MSF director of operations Ahmed Abd-elrahman calls for urgent action: “Excellencies, distinguished guests, a catastrophic health crisis is upon us in Sudan. Yet our collective ability to address it head-on is in question.”
Sudanese authorities block lifesaving surgical supplies from hospitals in parts of Khartoum controlled by RSF
The ban contravenes the international laws of war—to which SAF and RSF reconfirmed their commitment in the Jeddah declaration in May. In addition, it goes against medical ethics to refuse lifesaving treatment for someone with war wounds—no matter whether they have been fighting or caught in the crossfire. MSF treats people based on their medical needs alone, without discrimination. The policy is intended to prevent wounded opposition soldiers from receiving treatment, and it also prevents women and children from receiving lifesaving surgeries, including cesarean sections.
Al Nao Hospital shelling leaves four dead
Around 7:20 a.m., shelling strikes the MSF-supported Al Nao Hospital, one of the last functioning hospitals in Omdurman. The shells hit its emergency department, killing two patient caretakers and injuring five people who were immediately referred to other facilities. The hospital was treating patients at the time it was hit.
MSF suspends surgery in Khartoum hospital as supplies are blocked
MSF continues to provide and support medical care at three other major hospitals in Khartoum and Omdurman, but some of these hospitals are running out of supplies as well.
7,000 people cross the border to Adré
From November 1 – 3, about 7,000 people crossed the border near the city of Adré, in eastern Chad, where MSF teams treated 36 wounded people on Nov. 4 and 5. “In the first three days of November, we have seen more new arrivals of Sudanese refugees than during the whole previous month,” said Stephanie Hoffmann, MSF outreach coordinator in Adré.
MSF calls for an end to the ban on lifesaving surgical supplies
If MSF is not able to bring in more supplies, the operating theater in the Turkish Hospital will have to close its doors and there is no doubt that the death toll of the war will rise further, as women, children, and men in need of lifesaving surgery will be unable to receive treatment. The ban on surgical supplies is unconscionable, it violates the laws of war, and it must be immediately reversed.
RSF takes control in Wad Madani
The Rapid Support Forces take control of large swathes of the south and east of Sudan, including areas that had been spared from active fighting, such as Al Jazirah state and its capital of Wad Madani. Active frontlines remain in Al Fao and Sennar.
MSF compound attacked and looted
Due to the security deterioration, MSF suspends all medical activities in Wad Madani and evacuates staff to safer areas of Sudan and neighboring countries. Following the escalation of violence and RSF takeover, about 300,000 people flee the city, according to the UN. Many of those who sought safety in Wad Madani undergo an arduous second displacement as a result of the continuing violence.
Rapid nutrition and mortality assessment in Zamzam camp
MSF conducts rapid nutrition and mortality assessment of 400 households in Zamzam camp, where a catastrophic malnutrition and mortality crisis is unfolding due to the almost complete absence of humanitarian actors.
Also in January, MSF teams provide support to approximately 49 sites that shelter more than 5,000 displaced people in Port Sudan, predominantly on school premises. Our teams focus on providing emergency medical care and hygiene while advocating for adequate water supply and food distribution from other humanitarian partners.
MSF report exposes spiraling ethnic violence against people in Darfur
A retrospective mortality survey carried out by MSF finds that deaths in the region increased dramatically among communities that were targeted by attacks since the eruption of war. Refugees who have fled West Darfur over the last six months describe looting, sexual violence, and massacres targeting the Masalit people.
Teams travel to hard-to-reach communities who live in the mountains by camel, since roads are not accessible for cars (left); staff at the MSF Primary Health Care Cooperation in Torung Tonga, Jebel Marra (right).
MSF returns to Wad Madani
As a result of discussions with the government of Sudan and the Rapid Support Forces to assure staff access and the impartiality of our medical mission, an MSF team returns to Wad Madani to assess the needs and evaluate the feasibility of carrying out activities in the city.
MSF calls on Sudanese authorities not to reinstate travel restrictions on humanitarian workers
MSF warns that health care is on the verge of collapse in Khartoum, calling on Sudanese authorities not to reinstate travel restrictions on humanitarian workers who are needed to sustain vital medical services.
Malnutrition assessment finds alarming rate of child deaths
MSF’s rapid assessment finds that malnutrition is causing children to die at a catastrophic rate in Zamzam camp for people displaced by violence in the North Darfur region. MSF calls for an urgent international humanitarian response.
MSF holds Mapathon to map El Geneina area
Mapping remote locations is key to responding effectively to humanitarian emergencies—that's why MSF and Missing Maps volunteers held a virtual Mapathon focusing on the area around El Geneina, capital of Sudan's West Darfur state, from which thousands have fled since the start of the war.
MSF concludes emergency response in Kassala
The MSF intervention in Kassala included the provision of primary health care services, sexual and reproductive health care, mental health care, and health promotion initiatives. Mobile clinics were also deployed to reach remote gathering sites, ensuring that people could access essential medical care.
MSF teams treated more than 2,100 patients for respiratory infections in the different gathering sites for displaced people in Kassala. Respiratory infections are common in cold temperatures but are made worse when people have no choice but to sleep in shelters that do not sufficiently protect them from the cold and wind.
Dr. Christou: Sudan among worst crises in decades
Dr. Christos Christou, international president of MSF, calls on UN member states to use their influence and initiate a rapid scale-up of the humanitarian response to the crisis in Sudan and to increase funding.
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