Sudan: 500 days of war, failing aid, and rising medical needs

The situation is also challenging in east and central Sudan. “In south Khartoum, Doctors Without Borders has been blocked from bringing medical supplies and international staff to hospitals for many months. It is becoming increasingly difficult to provide the medical care our patients need, including maternity and emergency care,” said Claire San Filippo, Doctors Without Borders Emergency Coordinator for Sudan. 

On top of man-made impediments imposed or tolerated by the warring parties, including lawlessness, insecurity, bureaucratic obstacles, and delayed or denied permissions to reach affected populations that have significantly slowed down the humanitarian response, now natural impediments are also hampering movements of humanitarian personnel and supplies.

The rainy season, an annual occurrence that exacerbates needs and complicates movements, is at its peak. Heavy rains have flooded crossing points and washed off critical roads and bridges. With the collapse of Mornei bridge in West Darfur, the only lifeline route connecting Central and South Darfur with Chad, from where supplies arrive, millions of people will not be able to receive assistance coming by road. 

We already see an uptick in malaria cases and water-borne diseases with cholera outbreaks now declared in at least three states. The threat of vaccine preventable diseases among children, such as measles, is looming with the war putting immunization campaigns on hold. 

Meanwhile, the conflict has put nearly 80% of the health facilities out of service, according to the World Health Organization, crippling an already struggling health system. In El Fasher alone, Doctors Without Borders-supported facilities were attacked 12 times and only one public hospital remains partially functional with the ability to perform surgery since fighting escalated in the city in May. 

Most recently, on 22 August at around 4:40 am, shelling struck the house accommodating part of the Doctors Without Borders team working in El Fasher and Zamzam. Fortunately, the damage was only material and no one in the house was injured. This constitutes the 84th violent incident against Doctors Without Borders staff, vehicles and premises in Sudan since the start of this conflict, which has been characterised by a glaring disregard for the protection of civilians, as well as health personnel and facilities.

The situation is not much better in neighbouring countries, where about two million have sought refuge, often separating from their dear ones. 

Warring parties, and member states with influence over them, must ensure the protection of civilians, health personnel and medical facilities. Responsible authorities on both sides of the conflict must simplify the processes granting permissions for humanitarian movements and personnel through all available routes across borders, states, and frontlines, and provide prompt responses. And the United Nations, relevant agencies and anyone who has the power to help must employ all measures to ensure that available access routes are utilized to their fullest extent.

“Doctors Without Borders tries to fill some of the gaps. In many places we work we are the only international organisation operating, but we cannot tackle this huge crisis alone. We are also struggling to get supplies and staff to our projects. In tandem with access, securing sustained funding to UN agencies, as well as local organisations and responders, who are carrying the brunt of this response, is also essential,” says Esperanza Santos, Doctors Without Borders Emergency Coordinator in Port Sudan. 

Doctors Without Borders is one of the few international organizations working on both sides of the conflict in Sudan. It currently runs and supports medical projects, including over 20 primary healthcare clinics and hospitals across 8 of Sudan’s 18 states. Doctors Without Borders employs 926 Sudanese staff and 118 international staff, and it provides incentives to 1,092 Ministry of Health staff.