Sudan: One year on, this humanitarian catastrophe must be addressed

15 Apr 2024

The crisis in Sudan is one of the worst the world has seen in decades, with more than 25 million people in dire need of humanitarian assistance—but the global response is a drop in the ocean. 

International humanitarian organisations and United Nations agencies must scale up their response, and the warring parties must stop obstructing humanitarian aid.


A rapid nutrition and mortality assessment carried out by MSF in Zamzam camp in January 2024 revealed a deadly situation that has unfolded over the previous nine months. Sudan 2024 © Mohamed Zakaria

Médecins Sans Frontières (MSF) is calling urgently on organisations and governments to scale up their response to the vast humanitarian needs caused by war in Sudan and on the warring parties to honour commitments to stop violence against humanitarian workers, stop blocking vital supplies and facilitate access to people in need.

In one of the world's worst crises in decades, Sudan is facing a colossal, man-made catastrophe one year into the ongoing war between the government-led Sudanese Armed Forces (SAF) and the paramilitary Rapid Support Forces (RSF). More than 8 million people have already been forced to flee their homes, and 25 million—half of the country’s population—are estimated to be in need of humanitarian assistance, yet the world is looking away as the warring parties intentionally block humanitarian access and the delivery of aid. The United Nations and member states must redouble their efforts to negotiate safe and unhindered access and scale up the humanitarian response to prevent this already desperate situation from deteriorating any further.

The situation in Sudan was already very fragile before the war and it has now become catastrophic.

Ozan Agbas
MSF emergency operations manager for Sudan

“People in Sudan are suffering immensely as heavy fighting persists—including bombardments, shelling, and ground operations in residential urban areas and in villages—and the health system and basic services have largely collapsed or have been damaged by the warring parties," says Jean Stowell, MSF head of mission in Sudan. 

"Only 20 to 30 per cent of health facilities remain functional in Sudan, meaning that there is extremely limited availability of health care for people across the country."

In areas close to hostilities, MSF teams treat women, men, and children who are directly wounded in the fighting and crossfire, including shrapnel, blast, and gunshot injuries. Since April 2023, MSF-supported facilities have received more than 22,800 patients with traumatic injuries and performed more than 4,600 surgeries, largely due to violence in Khartoum and Darfur. In Wad Madani, a city surrounded by active front lines, we see currently 200 patients per month with violence-related injuries.

Every day we see patients dying because of violence-related injuries, children perishing due to malnutrition and the lack of vaccines, women with complications after unsafe deliveries, patients who have experienced sexual violence, and people with chronic diseases who cannot access their medicines,” Stowell said. “Despite all this, there is an extremely disturbing humanitarian void.”

Although MSF works in good cooperation with the Ministry of Health, the Government of Sudan has persistently and deliberately obstructed access to humanitarian aid, especially in areas outside of their control. It has systematically denied travel permits for humanitarian staff and supplies to cross the front lines, restricted the use of border crossings, and established a highly restrictive process for obtaining humanitarian visas.

Sudan: What you should know

The crisis in Sudan is one of the worst in decades. More than 8 million people have already been forced to flee their homes, and 25 million—half of the country’s population—are estimated to be in need of humanitarian assistance

MSF currently works in and supports more than 30 health facilities in 10 states in Sudan: Khartoum, Al Jazirah, White and Blue Nile, Al Gedaref, West Darfur, North, South and Central Darfur, and Red Sea. Our teams have also recently intervened in Kassala. 

We run activities in both SAF- and RSF-controlled areas. We provide trauma care, maternal care and treat malnutrition alongside other healthcare services.

Between 70 and 80 per cent of hospitals in conflict-affected areas are no longer functioning. Many people have to travel long distances, often amid extreme insecurity, to seek medical care. 

The needs across the country are massive and largely unmet. Since April 2023, more than half a million people have sought medical consultations at our supported hospitals, health facilities and mobile clinics. 


MSF medical staff in Khartoum report that their biggest challenge is the scarcity of medical supplies, including for surgery, putting doctors on the brink of stopping all activities unless supplies arrive. Khartoum has been under a blockade for the past six months, and the city of Wad Madani has faced a similar situation since January.

In RSF-controlled areas, where many different militias and armed groups also operate, health facilities and warehouses were frequently looted in the first months of the conflict. Incidents such as carjackings continue on a regular basis and medical workers, particularly from the Ministry of Health, have been harassed and arrested.

In hard-to-reach areas like Darfur, Khartoum, or Al Jazirah, there are few international humanitarian organizations present, and MSF is sometimes the only one, while the needs far exceed MSF's capacity to respond. Even in more accessible areas such as White Nile, Blue Nile, Kassala, and Gedaref states, the overall response is negligible: a drop in the ocean.

One example is the catastrophic malnutrition crisis in Zamzam camp in North Darfur, where there have been no food distributions from the World Food Program since May 2023. In January 2024, an MSF team found extremely high rates of malnutrition among children and pregnant and breastfeeding women and a mortality rate of 2.5 per 10,000 people per day across the camp, which is beyond the threshold of a humanitarian emergency.


Khartouma and her six children fled extreme violence and clashes in her village of Ardamata, in West Darfur, Sudan, and found refuge in Adré, eastern Chad, where she has very limited access to basic essential services. Chad 2024 © MSF

“The situation in Sudan was already very fragile before the war and it has now become catastrophic," said Ozan Agbas, MSF emergency operations manager for Sudan. "In many of the areas where MSF has started emergency activities, we have not seen the return of the international humanitarian organisations that initially evacuated in April 2023. 

"The United Nations and their partners have persisted in self-imposed restrictions on accessing these regions and, as a result, they have not even pre-positioned themselves to intervene or establish teams on the ground when opportunities arise."

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