Sudan: “In Jebel Marra, we face the indirect effects of this terrible escalation”

It was a tough decision to relocate and evacuate members of our team from the area. Before we arrived, most areas in Jebel Marra had been cut off from healthcare and other essential services for more than a decade, and in some in rebel-controlled areas for almost two decades.

We left behind a skeleton team of dedicated and experienced Sudanese colleagues, some of whom are from Rokero, and others who are from parts of Darfur. They continue to do an incredible job, working hard to maintain the hospital services in Rokero and primary healthcare activities in Umo, and working in remote villages through MSF trained community health workers.

As a project coordinator, it is difficult to deal with such an uncertain and fast-changing situation, as we don't know what is going to happen next and how best to plan ahead for our team in Rokero, for our patients and the communities we are there to assist. Thus, we had to evacuate our international colleagues, and the Sudanese colleagues who were from other parts of Sudan, while some Sudanese colleagues chose to stay and continue our work. And it is hard for patients and communities due to the fear of the unknown in an atmosphere of uncertainty.

Increasing numbers of people who are fleeing from urban areas like El Fasher, Zalingei, Khartoum, are arriving to Jebel Marra. They arrive on commercial trucks with nothing, having escaped extreme violence.

We are running the only specialist healthcare facility for people from both the Rokero and Umo localities, where more than 250,000 people are living. It was a very difficult decision for us and an emotional moment for the communities, who expressed how they did not want to lose our services.

People there still remember the pain they went through, when sick and wounded people had to be carried on donkeys for days to Tawila and El Fasher, and many died of preventable conditions due to the long distances they had to travel in search of healthcare. Rokero has experienced frequent flare ups of fighting. In November 2022, while fighting broke out in the town, we treated more than 50 trauma patients.

Women, men, community leaders and elders and former patients pleaded for us to stay. Some community leaders came to me directly to say that they would guarantee our safety. Jebel Marra has always been fragmented by different rebel or armed groups. But they all committed to overcoming their differences, acknowledging that not having access to healthcare would be more fatal to the community than any violence itself.

The number of deaths among pregnant women and new mothers is high in Darfur. Some women lose their babies in the first trimester of their pregnancy because they ride donkeys or have to work extremely hard, tending to both the fields and their children. Most people here are farmers, growing sorghum and millet, but years of conflict and the recent escalation have frequently disrupted farming activities, leaving families without their crops or with a poor harvest. Most people can barely afford two basic meals a day.

I remember in July 2022, there was a huge malnutrition crisis. We travelled into the villages in the mountains with mobile clinics to treat children who were in deplorable conditions. We brought the most severely sick children to our therapeutic feeding centre and treated many in the villages.

^{Doctors Without Borders supported facilities continue to provide life-saving medical care in El Fasher and Zamzam camp, North Darfur, in Kreinik, West Darfur, in Rokero and Umo, Central Darfur, in Khartoum, in Al-Jazeera, in Um Rakuba and Tinedba, El-Gedaref, and in Ad-Damazin, Blue Nile states. Doctors Without Borders first worked in Sudan in 1978, with an uninterrupted presence since 2003 to provide life-saving medical care to people who need it most.}