Sudan conflict: Operating under fire

The green areas indicate MSF presence as of 26 June 2023

The green areas indicate MSF presence as of 26 June 2023

Providing medical care despite major challenges

On 15 April 2023, intense fighting broke out between the Sudanese military and the Rapid Support Forces (RSF) in Khartoum and across most of Sudan. Since then, the fighting has killed and injured thousands of people.

Despite major challenges, MSF is providing lifesaving medical care to people affected by the conflict.

In the capital, Khartoum, MSF medical teams are witnessing one of the most intense urban conflicts currently taking place worldwide. Large numbers of injured people are arriving at the hospitals with life-threatening wounds, often leaving medical staff with no choice but to amputate.

Our teams have provided live-saving medical supplies and care at health facilities in Khartoum, as well as performing surgeries and supporting a diverse range of services provided by different networks of local medical volunteers.

The teams on the ground report that hospitals are overwhelmed and thousands are fleeing to safer areas. We are witnessing immense medical and humanitarian needs.

Access to healthcare

In Sudan, the health system was extremely fragile before the escalation of violence in April, with health indicators being consistently low. 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, the “brain drain” of medical personnel, and costs of healthcare.

Millions of children under 5 years of age have not been able to access essential and lifesaving services in past years according to UNICEF. Before the current escalation, access to a health facility within reach was already a major challenge, and even when a health facility was reached, care was often of insufficient quality and not provided by a skilled health worker.

Since the escalation of violence, MSF has been working in 12 states: Khartoum, Kassala, Al-Jazeera, West Darfur, North Darfur, Central Darfur, South Darfur, Red Sea, El-Gedaref, Blue Nile, White Nile, and River Nile.

Caught in the crossfire

At the MSF-supported hospital in El Fasher, North Darfur, medical teams have carried out over 600 surgical operations for both the wounded and for women requiring emergency obstetric surgery since the conflict began.

The majority of the wounded are civilians who were caught in the crossfire – among them are many children.

“There are so many patients that they are being treated on the floor in the corridors because there simply aren’t enough beds to accommodate the vast number of wounded.”
Cyrus Paye, MSF Project Coordinator, El Fasher

As well as receiving patients wounded in the conflict, the El Fasher hospital continues to receive other cases, people with other chronic diseases, morbidities and more.

Emergency Surgical Team at Bashair Hospital Khartoum, Sudan

On 12 May MSF succeeded to bring in fresh supplies from El-Fasher, North Darfur to MSF supported Rokero hospital.

Wounded people are coming in waves to Adré hospital in Chad, where they are being treated by MSF and Ministry of Health teams.

An MSF nurse aide Barnaba performs the MUAC measurement test on a child during a screening in an MSF mobile clinic at the Riverside transit site in Renk town, Upper Nile State, South Sudan.

Emergency Surgical Team at Bashair Hospital Khartoum, Sudan

On 12 May MSF succeeded to bring in fresh supplies from El-Fasher, North Darfur to MSF supported Rokero hospital.

Wounded people are coming in waves to Adré hospital in Chad, where they are being treated by MSF and Ministry of Health teams.

An MSF nurse aide Barnaba performs the MUAC measurement test on a child during a screening in an MSF mobile clinic at the Riverside transit site in Renk town, Upper Nile State, South Sudan.

Medical supplies and mobile clinics

Elsewhere in the country, and especially in Khartoum, Darfur, North Kordofan and Gedaref states, MSF teams face serious challenges.

In Bashair Teaching hospital in Khartoum, an MSF surgical team has treated over 400 patients, performed 506 surgical procedures in 45 days. The hospital was barely functioning when volunteer medics and community members restarted it. It is now one of two functioning major hospitals in Khartoum, with MSF providing surgical capacity.

We also have surgical and medical teams working in the Turkish hospital in Khartoum and MSF teams working in collaboration with MoH staff in Umbada hospital. In addition, we are also supporting a diverse range of services provided by different groups and networks of medical volunteers in south Khartoum. These volunteer networks provide critical services such as trauma first aid, primary healthcare mobile clinics, and logistical support for the distribution of supplies.

An MSF team in Wad Madani, Sudan, is also providing lifesaving healthcare through mobile clinics for hundreds of displaced people fleeing violence in Khartoum. Since early May, the teams have conducted over 2,000 consultations. 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.

Despite the challenges, donations of medical supplies and fuel to hospitals and other health facilities in Khartoum, North and Central Darfur, Red Sea, and in Al-Jazeera states (where many displaced people have been seeking shelter), and other areas have been and are ongoing. We are in constant contact with hospitals and medical networks to supply more.

Committed to providing healthcare

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.

In the hospitals supported by MSF in Kreinik, West Darfur state, MSF teams continue to provide medical assistance.

We suspended mobile clinics and outreach activities for nomadic communities in West Darfur due to the security situation. The situation remains calm in Kreinik. The hospital is open and is the only functioning hospital in West Darfur. The biggest challenge is supplies that usually come El-Geneina where intense fighting and violence continues.

MSF teams have delivered multiple donations of medical supplies and drugs to several hospitals in Khartoum and El-Gedaref. On June 18, Umdawanban and Albanjedeed hospitals received 11 tons donations. On June 21, our teams delivered another batch of donations to the Ministry of Health in El-Gedaref State, to support Gedaref hospital.

In Zamzam camp in North Darfur state, MSF has reopened its health clinic in 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, with some requiring urgent medical attention.  

MSF remain committed to providing much needed healthcare to people in Sudan, especially during these challenging moments. But to do so, we need to be able to ensure safety and security for our staff and patients.

Healthcare across borders

It is estimated that over 75,000 people, including Sudanese refugees and Chadian returnees have fled to Chad’s eastern provinces according to UNHCR.

Three provinces in Chad were already hosting more than 400,000 Sudanese refugees settled 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.

MSF is currently working at the border with Sudan, in collaboration with health authorities, to run mobile clinics, vaccination, malnutrition screening, referrals in temporary refugee camps in Ouaddaï province.

Our teams continue to support Adre hospital and three health centres, where we’ve been working since 2021. MSF is also providing medical care through mobile clinics in Sila province only 500 meters from the border with Sudan.

Since April, over a hundred thousand people have fled the Sudan conflict to seek safety in South Sudan.

MSF has launched emergency responses in Upper Nile and Northern Bahr El Ghazal states, running three mobile clinics, offering primary healthcare services. In Aweil, our teams are doing around 100 consultations per day.

Many patients have respiratory infections and acute watery diarrhoea, and we are seeing increasing cases of malnutrition.

An urgent call

MSF has not left and does not plan to leave Sudan. We have scaled up an emergency response to respond to the already overwhelming medical needs in Sudan.

Without vital medical supplies, there will be further loss of life. MSF urges parties to the conflict to ensure the safe movement of medical supplies and equipment within the country to reach medical facilities and those in need.

We are worried about our Sudanese colleagues, patients and civilians who are trapped in this conflict. Our thoughts are with them, and we reiterate our calls to all parties to the conflict to avoid civilian areas and to spare civilian lives.

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

We additionally request that all parties to the conflict ensure that all health facilities – including hospitals, clinics, warehouses and ambulances – are protected.

As humanitarian health workers we are trying to ensure that the provision of basic healthcare continues and access to care for those directly affected by the conflict is available.
Dr Mohammed Mosuke, MSF Deputy Operations Manager, Sudan