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Escalation of conflict

Since Saturday 15 April 2023, 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.
 
Many people, including healthcare workers, are currently trapped and unable to move or reach health facilities due to the intensity of the conflict.  
 
 

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Sudan’s military takeover at the end of October 2021 prompted massive demonstrations across the country. In response to the violent crackdowns that ensued, we launched multiple mass-casualty plans to support hospitals.

Sudan was once the largest and most geographically diverse state in Africa, and was also home to one of the continent’s longest-running civil wars.

Fighting has displaced tens of thousands of people in Sudan, where we respond by providing medical care for malnutrition, diarrhoeal diseases and malaria.

Médecins Sans Frontières has been working in Sudan since 1979, and following the split between Sudan and its Southern counterpart in 2011, has continued to assist displaced people, carry out vaccination campaigns, and support local medical infrastructure. 

In 2021, we started a project in Mygoma orphanage, in Khartoum, supporting medical care and referrals for infants and young children and improving hygiene measures, while continuing to run our Omdurman project, providing basic healthcare and emergency services for refugees, displaced people and host communities. 

We also started running a nutrition ward for children with moderate to severe malnutrition in Ad-Damazine teaching hospital in the Blue Nile region. 

Since November 2020, we have been working in Al-Gedaref and Kassala states,  assisting both Ethiopian refugees and local communities with basic and maternal healthcare, vaccinations, malnutrition screening, water and sanitation, and treatment for neglected tropical diseases in health centres and in the camps.

Refugee Care in Sudan 

Many refugees arriving at border crossings are severely dehydrated and in need of emergency medical care.

MSF staff provide medical care and surgical services to displaced peoples in various Sudanese regions. Teams distribute relief items, improve water and sanitation, malnutrition screenings, and support intervention campaigns targeting diseases such as dengue fever through case management, vector control, and active surveillance.

Unsustainable Camp Conditions 

The cramped conditions and a lack of toilet facilities in refugee camps increases the risks of measles and gastrointestinal infections. MSF teams have focused on improving sanitation and hygiene in the region’s camps by constructing latrines, as well as running community health promotion activities.

The availability and purity of the water is a constant concern. The daily minimum amount of water needed for survival, per person, is 2.5 litres. Camps in Sudan are rarely able to offer more than a litre of water per person, per day, putting refugees at further risk of dehydration and related health issues. The supply of sanitation, shelters and non-food items (including plastic sheeting, and cooking and cleaning utensils) is not meeting demand. 

By far our biggest cause for concern is the sanitation and hygiene in the camp. People live so closely together and there aren't enough toilets and latrines. They are openly defecating near their shelters and those of their neighbours.

Mohamed Jibril
MSF project coordinator, White Nile State field hospital

MSF teams contribute to the upgrading of the sanitation standards with the construction of latrines, as well as organising community health promotion activities, with the aim of increasing the awareness on health behaviour.

In East Darfur, MSF is working in Kario refugee camp, which hosts some 20,000 refugees from South Sudan. Teams coordinate outbreaks, and organise vaccination campaigns against communicable diseases such as measles.

Tawila, in North Darfur, is home to almost 75,000 internally displaced people. MSF teams provide much-needed support in the overwhelmed health facility where malnutrition, diarrhoeal diseases and malaria are the common referrals.

Neglected Diseases 

Sudan has the highest rate of kala azar (visceral leishmaniasis) in East Africa, nearly 70% of national cases are concentrated in Al-Gedaref. This parasitic disease, which is transmitted by sandflies, has a 95 %mortality rate if left untreated.

MSF provides free diagnosis and case management support to hospitals in this region, organises awareness-raising activities in the community, and conducts training for local health professionals. 

In Al Kashafa,MSF's hospital functions as a referral point for other camps, and it has the only nutritional stabilisation centre in the area. The most serious medical cases are referred to Kosti hospital, 80 kilometres away.

Nearly half of all consultations are for local people living around Al Kashafa camp, which includes the host Sudanese community and refugees from the camps. Before MSF arrived, the local community had very few alternatives when it came to medical care and the MSF hospital has become a point of reference for the local population as well. MSF aims to encourage the local population to seek out professional medical care, rather than relying on traditional medicine, by providing free medical care. 

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