Sudan: Inside the world’s worst humanitarian crisis

The devastating war that has raged for more than a year and a half between the government-backed Sudanese Armed Forces (SAF) and the paramilitary Rapid Support Forces, as well as allied armed groups on both sides, has led to the world’s worst humanitarian crisis. The tragedy continues to worsen, sinking deeper into an abyss with no end in sight, despite the desperate efforts of local civil society and a few international organizations attempting to stop the cataclysm.

Since September, with the end of the country’s rainy season, the war has once again intensified, fueled by increasingly evident foreign interference. The army has started to retake territories previously lost amid a chaotic storm of abuse, destruction, and death. The war is now concentrated on three fronts: the area surrounding the capital, Khartoum; Gezira State in the center; and the capital of North Darfur State, El Fasher, in the west.

The humanitarian situation in Sudan is catastrophic due to the sheer scale and complexity of the crisis. The war has caused hundreds of thousands of casualties, including deaths and injuries, while widespread abuses such as sexual violence and torture continue. Conditions incompatible with life — extreme malnutrition, a failing health system, and the blockade of aid — are pushing mortality rates higher from preventable causes.

Despite these challenges, some humanitarian organizations have attempted to seize on the end of the rains to expand their operations in Sudan, according to sources and data consulted by EL PAÍS. However, this improvement is still meagre compared to the overwhelming needs. “Any increase in aid to Sudan is welcome, but it must be much more than just another drop in the ocean,” says Christopher Lockyear, secretary general of Médecins Sans Frontières (MSF).

Multitude of crises

Sudan is now home to the world’s largest displacement crisis. Since the war began, more than 8.7 million people have fled their homes in search of safer places, with over 3 million crossing into neighboring countries such as Egypt, Chad, South Sudan, and Libya. Before the current conflict, more than 3.8 million people were already displaced within Sudan, largely due to previous conflicts in peripheral regions such as Darfur and Kordofan.

In recent months, one of the main factors driving the increase in displacement has been the rise in violence in the states of Gezira and North Darfur. In these regions, the war has been accompanied by terror inflicted by paramilitaries and indiscriminate bombings by both sides in civilian areas.

Amid this crisis, more than 24 million people — half of Sudan’s population — are facing high levels of food insecurity. The latest report from the leading international committee of experts on food security, published on December 24, identified famine in at least five areas in the west and south, with predictions that five more regions will experience famine in the coming months. Famine is not only a result of food scarcity, but also the collapse of health systems, livelihoods, local economies, and the social structures of entire communities.

Speaking by phone from Sudan’s largest displaced persons camp in North Darfur, Zamzam, where famine broke out in August, Saddam Abkar Safi, a member of a local volunteer group, describes how conditions had worsened in recent months. “It is becoming very difficult, especially in Zamzam and [the neighboring regional capital] El Fasher, due to the siege imposed on us. In Zamzam, many displaced people cannot afford to buy enough to survive for a day,” he says.

The multiplicity of crises is being compounded by an overwhelmed national health system. In the areas most affected by the fighting, the World Health Organization (WHO) estimates that between 70% and 80% of health facilities are either closed or only partially functioning, while in other regions of the country, the figure is around 50%. Since the war began, the WHO has documented more than 120 attacks on medical facilities, services, and personnel, although the actual number is believed to be much higher.

This collapse of the national health system, coupled with severe damage to other essential services such as drinking water and electricity, has created a breeding ground for health crises that would normally be preventable. Since the summer, Sudan has been grappling with a concerning outbreak of cholera, triggered by a particularly intense rainy season and widespread flooding. The floods have primarily impacted regions with high population densities and large numbers of displaced people, which were previously little affected by the fighting, such as areas in the east of the country.

Limited response

Despite the scale of the crisis, humanitarian organizations have faced numerous setbacks and obstacles since the outbreak of the war. These include widespread insecurity and efforts by warring parties to exploit aid. Humanitarian agencies also face constant bureaucratic and logistical challenges, particularly from military authorities, who have been particularly inflexible when they have found themselves on the defensive on the front lines.

The arrival of the dry season has facilitated road transport, which is the primary means of moving supplies. This has allowed humanitarian agencies to increase the number of shipments to various parts of the country since October, utilizing cross-border routes and, to a lesser extent, routes crossing territories controlled by different factions of the conflict, according to data from the U.N. Office for the Coordination of Humanitarian Affairs (OCHA).

Much of this increase has been made possible by the World Food Programme (WFP), which announced in late November that it had received permission from the military government to send more than 700 trucks to areas suffering from or at risk of famine. Leni Kinzli, WFP’s communications officer, stated that this was part of a “broader plan” to access isolated areas and continue increasing the regular flow of monthly aid.

Kinzli says that the end of the rainy season has allowed more supplies to move by road. Additionally, he says, there have been more authorizations from Sudanese authorities to deliver aid, which coincides with a shift in the dynamics of the conflict since September and the army’s first significant advances. “This increase [in aid shipments] will allow us to reach more people, especially those at risk of famine who have been difficult to reach, [including] in Darfur, Khartoum, and Gezira,” he explains.

In the four months between August and November, the number of trucks delivering aid across borders and frontlines in Sudan was fewer than 1,000. By comparison, in October alone, during the period when the least aid entered Gaza, 1,166 humanitarian trucks arrived, according to U.N. data.

Cross-border convoys to Sudan are made through two main crossings between Chad and Darfur: Adré, the primary crossing, and Tine. However, their future remains uncertain. The U.N. has only authorized shipments from Chad with the approval of the military government, citing the need to respect the country’s sovereignty. Yet, military authorities are reluctant to send aid to areas outside their control, such as much of Darfur, and continue to deny the existence and risk of famine, despite the overwhelming evidence.

“In Sudan, we have found ourselves in a situation where the survival of the population has been sacrificed under the pretext of sovereignty,” says Lockyear from Médecins Sans Frontières (MSF), one of the most active organizations in Sudan and one of the few still operating in besieged areas. “Much more could have been done, much more can be done, and much more should be done from now on to challenge these restrictions, both practically and politically,” he adds.

In an implicit acknowledgment of the crisis’ severity, the military government’s Humanitarian Aid Commission (HAC) announced on December 24 that it would distribute hundreds of tons of humanitarian aid throughout the country — likely influenced by concerns over international pressure. However, these supplies will a priori be directed to areas controlled by the army. The HAC has not responded to requests for comment from EL PAÍS.

Despite the current increase in deliveries, many of the most affected areas are still receiving only the bare minimum of supplies necessary to prevent starvation, and even that is not always enough. According to the WFP, the 700 trucks announced in November could feed about 1.5 million people for one month. However, in Zamzam alone, MSF estimates that around 100 trucks would be needed each month to supply a month’s worth of emergency rations of approximately 500 calories per day.

The challenges faced by humanitarian actors have highlighted the growing significance of local mutual aid initiatives, which are primarily supported by the Sudanese diaspora and have proven highly effective in areas isolated by the ongoing conflict. “As I speak to you, I have a WFP delivery that I expect to leave the warehouse tomorrow. We try to distribute aid, even if it is interrupted, not continuous, and not abundant,” says Abdallah, part of the emergency response unit in the southern belt of Khartoum, who also assists in a free medical center.

However, these grassroots groups are among the most vulnerable to violence, often targeted in attacks, and their continued operations remain uncertain. “We are facing great challenges due to indiscriminate bombings that are happing now and the difficulty in providing assistance,” says Safi, a member of the emergency response unit in Zamzam. “We are calling for humanitarian aid to be provided in all possible circumstances,” he adds.

For many, what is desperately needed is a far greater political commitment. “We are witnessing a global humanitarian failure in terms of collective response,” says Lockyear. “The presence of the U.N. and international NGOs is very weak, even in areas with relatively easy access,” he laments.

Lockyear further emphasizes that “the supply of humanitarian aid must be increased by all available means,” but also stresses that “humanitarian response is more than just counting trucks and planes.” “We need humanitarian personnel on the ground; I was surprised by the lack of humanitarian presence in the places I traveled to in Darfur,” he adds.

WFP’s Kinzli agrees. “We continue to search for different ways to get aid or assistance to people, even if we can’t get trucks [to certain parts of the country],” she says. “The needs in Sudan are so immense that one in two people is facing acute levels of hunger,” she stresses. “This means that basically everyone needs some kind of help.”

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