A displaced woman holds her child as she takes refuge in Alsafat Camp in Al Jazirah state. “I'm worried about the future of my children. I'm thinking about returning to Abyei so that I could provide an education for my children. But if the war comes to an end I'll return to Khartoum and my house as soon as possible, and my husband will be able to work,” she says. Sudan, December 2023. © Fais Abubakr
On December 15, the Rapid Support Forces (RSF) launched an attack on Wad Madani, Sudan, and took control of several other cities and areas in Al Jazirah state within days. Since then, more than half a million people have fled the fighting and ensuing insecurity, including about 234,000 1 internally displaced people who had previously sought refuge in Wad Madani as violence in Khartoum intensified.
The chaos following the evolving conflict dynamics and the severe insecurity and widespread violence created an environment in which Doctors Without Borders / Médecins Sans Frontières (MSF) could no longer operate in Wad Madani. Doctors Without Borders had to suspend all activities and evacuate its staff from Wad Madani on December 19, leaving behind a population with even less access to basic medical services. We also had to evacuate staff from Damazine, Um Rakuba in Gedaref state, and Doka. In Damazine, we reduced activities.
Doctors Without Borders had been present in Wad Madani since May 2023. Conditions were already dire for the half a million internally displaced people living there, which made up 8 per cent of all internally displaced people in Sudan—already the world’s largest internal displacement crisis, with more than 6 million forced from their homes within the country in addition to more than 1.4 2 million who have fled across borders. Between May and November, Doctors Without Borders teams performed 18,390 medical consultations (40 per cent of them for children under 15 years old) in several of the hundreds of locations hosting displaced people across the state, some in schools or old public buildings.
Through its mobile clinics, Doctors Without Borders diagnosed and referred 66 children suffering from severe acute malnutrition with serious complications in the past six months—cases that could be fatal if not treated in a hospital urgently. But health facilities were overwhelmed. As the population of the city had increased by 30 per cent, there were more and more patients, but considerable supply and staffing challenges. And as prices soared for all goods, access to lifesaving services was an obstacle for both displaced people and regular residents. Nowadays, with the departure of most international organisations—and despite efforts of local volunteer health workers—we can only assume it has worsened.Slaymen Ammar, Medical Coordinator
During the last month, Doctors Without Borders teams in Gedaref and Kassala states—where Doctors Without Borders has been operational since 2021 in response to the Ethiopian Tigray crisis—witnessed the arrival of thousands of people from Wad Madani 3, are currently assessing and responding to the escalating health and humanitarian needs. In Tanideba (Gedaref), Doctors Without Borders has started a short-term emergency intervention for newly displaced Ethiopian refugees and newly displaced Sudanese citizens covering basic health care, water and sanitation, and food rations. This included one-off distributions and donations. However, it is important to note that activities in Tanideba were temporarily reduced for a short while due to the escalation of conflict in Wad Madani.
The conflict in Sudan has caused immeasurable suffering, displaced millions, killed thousands, and injured countless others. For many displaced people, Gedaref and Kassala are just the latest stops in a long journey to seek safety, during which they have suffered violence and have endured a lack of essential needs such as food, clean water, sanitation, and access to medical care.
Al Bakri Al Taher Malik, a displaced man from Khartoum, has been injured twice by the fighting in Sudan. “I'm waiting for the day when the war is declared over; even if I have nothing to return home, I'll go, even if I had to walk on foot.” Sudan, December 2023. © Fais Abubakr
“We are originally from Darfur, but because of the violent clashes and the crisis over there, we went to Khartoum. But the war followed us to Khartoum, so we went to Wad Madani. And then, the story continues,” says Salem4 displaced man who arrived with his family in a gathering site in the Al Mufaza locality, Gedaref, two weeks ago from Wad Madani. Salem’s family fled Khartoum eight months ago, after a shelling hit their house and severely injured one of their children.
“We were six people in the house, and at that time my wife was pregnant. Our house was destroyed. I was hit on my arm, but my child got a much worse injury on his head. We managed to take him to the hospital, because he needed urgent lifesaving surgery. But as soon as he was discharged, we had to flee the city because of insecurity. We arrived in the internally displaced camp in Wad Madani, and she delivered there,”
In mid-December, and her family fled once again to Gedaref: “Clashes started, and we started hearing sounds of fires and those armed men fighting again. Immediately, we decided to leave. I started thinking where we should go now. Nowhere was safe at that time.”
Souad Abdullah, a displaced woman from south Khartoum, holding her baby in Al Zahra Camp, Al Jazirah State where she takes refuge. She came to Wad Madani in journey of three days. "When we arrived here, we were suffering; there were no bathrooms, water, food, or drinking water. Doctors Without Borders intervened and took care of us from the beginning, as the children suffered from sunstroke. The organization was present throughout the week. They also help me delivering my baby girl and did their best." Sudan, December 2023. © Fais Abubakr
In a region where healthcare and essential medicine were already extremely limited, displaced populations are now suffering from growing health demands, stemming from direct and indirect effects of violence. Basic needs are now further escalating and need an urgent response.
At the gathering sites in Kassala city, displaced people told our teams they haven’t received any assistance since their arrival in mid to late December,” explains Pauline Lenglart, Doctors Without Borders emergency project coordinator in Sudan.
Families are sleeping on the ground, access to healthcare is still severely restricted, there are few working medical facilities, and medicines aren't provided for free. Many people have told us that they are unable to afford items like food and medicine, forcing them to choose between these necessities. The Doctors Without Borders team is constantly evaluating the needs at new sites that are opening to house recently displaced people.4 In all these places, we see that the amount of humanitarian assistance provided is still woefully inadequate to meet people's basic needs and ensure them dignified living conditions.Pauline Lenglart,Emergency Project Coord
[1] International Organizaton for Migration (IOM) Displacement Tracking Matrix (DTM) Focused Flash Alert. Jan 8, 2024 ↩
[2] According to the International Organization for Migration Displacement Tracking Matrix (IOM DTM), and UN refugee agency (UNHCR). Jan 15, 2024 ↩
[3] 64,000 IDPs arrived in Gedaref and 30,000 in Kassala since December 15th, according to the UN. ↩
[4] Name changed to protect identity. ↩
