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One year of war in Sudan

How a massive humanitarian crisis has unfolded over the past year in Sudan.

Displaced Sudanese woman with her children in Wad Madani, Sudan.

Sudan 2023 © Fais Abubakr

For a year, fighting between the Sudanese Armed Forces and paramilitary group the Rapid Support Forces has wrought devastation across Sudan, forcing millions of people from their homes and driving the country’s health care system to collapse.

One year on, more than 15,000 people have been killed and Sudan has become the largest internal displacement crisis in the world, with more than 6.6 million people displaced within its borders. Two million more have fled to neighboring countries like Chad and South Sudan

Doctors Without Borders/Médecins Sans Frontières (MSF) has been providing medical humanitarian aid in Sudan since 1979, and our teams continue to work across the country amidst the current conflict. Over the past year, they have borne witness to a massive crisis that is unfolding largely outside the world’s headlines while humanitarian aid is falling far short of meeting the spiraling needs.

A bullet hole shot through glass at an MSF facility in Khartoum, Sudan.

Sudan 2023 © MSF

Fighting breaks out in Khartoum

April 15


Violence erupts between the Sudanese Armed Forces and the Rapid Support Forces in Khartoum and other parts of Sudan. Over the next 48 hours, MSF receives 136 wounded patients at the hospital we support in El Fasher, North Darfur, 11 of whom die from their injuries.

Armed group raids MSF compound in Nyala

April 18

Looting of El Geneina Teaching Hospital

April 28


Parts of the MSF-supported El Geneina Teaching Hospital in West Darfur are looted during a violent intrusion. Widespread looting and destruction are reported across the city of El Geneina, including burning property and attacks at the central market, gathering sites, and camps where displaced people are sheltering.

Displaced children with malnutrition are transferred by car for treatment in South Sudan.
Displaced children with malnutrition are being referred the MSF Hospital to an inpatient therapeutic feeding center in Bentiu camp. South Sudan 2023 © Nasir Ghafoor/MSF

MSF returns to Zamzam camp after fighting disrupts medical care

May 7


The residents of Zamzam camp in North Darfur went several weeks without any access to health care due to intense fighting and insecurity in and around El Fasher, which prevented MSF's team from being able to return to the camp until May 7.

A car stripped of its tires during a looting in Khartoum, Sudan.

A car stripped of its tires during the looting in Khartoum. Sudan 2023 © MSF

MSF warehouse in Khartoum looted

May 16-20


“People are in a desperate situation, and the need for health care is critical. These attacks make it so much harder for health care workers to help. It’s senseless.”

MSF joins local health care workers to treat trauma patients in Khartoum

May 9


MSF medical and surgical teams at Bashair Teaching Hospital in Khartoum work closely with local Sudanese medical professionals and volunteers.

“When we arrived, the situation was chaotic,” said Dr. Hisham Eid, a member of the MSF team. “The hospital was not operational. A few doctors and volunteers were doing their best to attend to the big number of patients despite the shortage of all forms of supplies including electricity. It is getting better now and we are able to attend to many patients efficiently.”

Dr Shahzid Majeed and Dr Federica Iezzi are busy in the operating theatre discussing the upcoming cases list.
Dr. Shahzid Majeed and Dr. Federica Iezzi discuss upcoming cases in the operating theater of Bashair Teaching Hospital Sudan 2023 © Ala Kheir/MSF

Governor of West Darfur is killed

June 15


“On Wednesday night, the governor of West Darfur was killed,” said Nour, a 25-year-old from El Geneina who arrived at Adré hospital on June 15, 2023, after being shot in the face. “We knew that the situation would get even worse, and it was a collective decision of the people of El Geneina to leave. The only solution was to head west."

MSF teams in Zamzam camp, Sudan, carry out a rapid malnutrition assessment for displaced people.
Patients wait for care at MSF's clinic in Zamzam camp, near El Fasher. Sudan 2024 © Mohamed Zakaria

Over 1,000 ER patients received at Bashair Teaching Hospital

June 15


Of more than 1,150 ER patients MSF receives, 906 have violent trauma. "I cannot recall any time in recent years when MSF has treated anything like the number of trauma cases or done as many major surgeries as we have done in Khartoum," said Raphael Veicht, MSF emergency coordinator.

Refugees fleeing Sudan conflict wait to be treated by Doctors Without Borders teams in Adré hospital, Chad.
Over 600 refugees arrived in Chad within just two days in June, many war-wounded and in need of care. | Chad 2023 © Mohammad Ghannam/MSF

Adré hospital sees 600+ war-wounded refugees in just three days

June 16 – 19


A large number of the wounded are from the capital of West Darfur, El Geneina, and the surrounding area. Local sources report that at least 1,100 people have been killed in El Geneina since the conflict began. Approximately 430 of these refugees need surgical care for injuries like gunshot wounds. 

Jerry cans lined up outside in El Geneina, West Darfur, Sudan.
Jerrycans lined up at one of the few accessible water points in El Geneina, West Darfur, on June 11. Sudan 2023 © MSF

MSF urges armed groups in and around El Geneina to spare civilians and allow people to safely flee

June 19


After nearly two months of blockade and large-scale violence in El Geneina, thousands of people attempt a perilous escape to seek refuge in Chad.

MSF aid workers stand in front of an inflatable tent hospital for Sudanese refugees in Adre, Chad
Chad 2023 © Mohammad Ghannam/MSF

MSF teams turn an inflatable tent into an emergency field hospital

July 13


To handle the arrival of wounded patients in Adré, Chad, MSF teams set up an emergency field hospital using a modular kit made up of inflatable tents, with bed capacity for 170 patients, two operating theaters, and X-ray technology.

MSF staff threatened and beaten in Khartoum

July 21


A team of 18 people working for MSF are violently assaulted by a group of armed men while transporting medical supplies to the Turkish Hospital in southern Khartoum. After arguing about the reasons for MSF’s presence, the armed men assaulted the MSF team, beating and whipping them. They detained the driver of an MSF vehicle, threatened his life before releasing him, and stole the vehicle.

MSF calls for visas for surgeons, nurses, and other staff

August 18


If long-awaited visas are not granted to new staff, including surgeons, nurses, and other specialists, MSF may soon be forced to withdraw much-needed medical support.

A man in an MSF vest stands over a patient taking notes on his clipboard.
MSF doctors treat children in a measles isolation unit at Um Sangour refugee camp in White Nile state. | Sudan 2023 © Ahmad Mahmoud/MSF

Turkish Hospital receives casualties from Khartoum market strike

September 2


A strike on a market in south Khartoum kills 21 and severely injures six people arriving at the Turkish Hospital, where an MSF team is working.

Renewed fighting in Umbada, Omdurman

September 3


Medical teams in Omdurman treat more than 50 patients for violence-related injuries following renewed fighting in Umbada. Eight patients die due to injuries from bullets or explosions. 

MSF's Emergency Surgical Team at Bashair Hospital in Khartoum, Sudan in 2023.
Members of the emergency surgical team in the operating theater at Bashair Teaching Hospital in Khartoum, balancing operation time with generators that are running out of fuel. Sudan 2023 © Ala Kheir/MSF

MSF responds following explosion in Khartoum and Darfur fighting

September 9


The residential neighborhood of Al Haj Youssef is struck by a deadly explosion that damages houses and leaves people with severe shrapnel wounds. A nearby hospital supported by MSF staff, Alban Al-Jadeed, receives 45 people wounded in the blast, including six who were dead on arrival.

"Our teams heard a loud explosion, so they rushed to prepare for the emergency," said Christian Mas Bouilloud, MSF medical coordinator in Khartoum. "Soon after that, patients started arriving in groups. Most had shrapnel wounds, many of them critical. It's horrific that residential areas, such as homes and markets, are being hit."

IDPs in Twic, South Sudan.
A family in Majook-noon camp for displaced people in Twic, Warrap state. South Sudan 2023 © Sean Sutton/Panos pictures

Explosion in Khartoum market kills 43

September 10


An explosion in Khartoum's Gorro market kills 43 people and wounds more than 60 who were treated at Bashair Teaching Hospital in south Khartoum. "The horror of the day was overwhelming," said Marie Burton, MSF emergency coordinator in Khartoum. Horrific attacks in residential areas of Khartoum have resulted in some of the city’s highest death tolls since the conflict began.

MSF director of operations addresses United Nations General Assembly

September 21


In a statement delivered in writing for the high-level ministerial event on Sudan at the UNGA, MSF director of operations Ahmed Abd-elrahman calls for urgent action: “Excellencies, distinguished guests, a catastrophic health crisis is upon us in Sudan. Yet our collective ability to address it head-on is in question.”

An MSF staff member in Sudan looks at medical supplies on a shelf at Umdawanban hospital near Khartoum
Medical supplies are dwindling. Sudan 2023 © MSF

Sudanese authorities block lifesaving surgical supplies from hospitals in parts of Khartoum controlled by RSF

October 2


The ban contravenes the international laws of war—to which SAF and RSF reconfirmed their commitment in the Jeddah declaration in May. In addition, it goes against medical ethics to refuse lifesaving treatment for someone with war wounds—no matter whether they have been fighting or caught in the crossfire. MSF treats people based on their medical needs alone, without discrimination. The policy is intended to prevent wounded opposition soldiers from receiving treatment, and it also prevents women and children from receiving lifesaving surgeries, including cesarean sections. 

An MSF team member adjusts equipment for a mobile solar energy in Ourang refugee camp, eastern Chad
An MSF team member adjusts equipment for mobile solar energy in Ourang refugee camp, eastern Chad. Chad 2023 © Jan Bohm/MSF

Al Nao Hospital shelling leaves four dead

October 9


Around 7:20 a.m., shelling strikes the MSF-supported Al Nao Hospital, one of the last functioning hospitals in Omdurman. The shells hit its emergency department, killing two patient caretakers and injuring five people who were immediately referred to other facilities. The hospital was treating patients at the time it was hit.

MSF suspends surgery in Khartoum hospital as supplies are blocked

October 18


MSF continues to provide and support medical care at three other major hospitals in Khartoum and Omdurman, but some of these hospitals are running out of supplies as well. 

Green empty hallway with windows at Umdawanban hospital in Khartoum, Sudan
Empty hallways at Umdawanban Hospital. Sudan 2023 © MSF

7,000 people cross the border to Adré

November 1 – 3


From November 1 – 3, about 7,000 people crossed the border near the city of Adré, in eastern Chad, where MSF teams treated 36 wounded people on Nov. 4 and 5. “In the first three days of November, we have seen more new arrivals of Sudanese refugees than during the whole previous month,” said Stephanie Hoffmann, MSF outreach coordinator in Adré.

People collecting water at MSF distribution point in Metche camp, eastern Chad
Sudanese refugees in Metche camp in eastern Chad, collecting water at a distribution point. Chad 2024 © Linda Nyholm/MSF

MSF calls for an end to the ban on lifesaving surgical supplies

November 14


If MSF is not able to bring in more supplies, the operating theater in the Turkish Hospital will have to close its doors and there is no doubt that the death toll of the war will rise further, as women, children, and men in need of lifesaving surgery will be unable to receive treatment. The ban on surgical supplies is unconscionable, it violates the laws of war, and it must be immediately reversed.

Refugees in a transit center in South Sudan.
"I was in Darfur and had to flee in 2003. My journey took me to Nyala, and now, escaping from there, I've arrived here," said Ahmed, who lives at a UNHCR transit center for Sudanese refugees. | South Sudan 2023 © Sean Sutton/Panos pictures

RSF takes control in Wad Madani

December 15


The Rapid Support Forces take control of large swathes of the south and east of Sudan, including areas that had been spared from active fighting, such as Al Jazirah state and its capital of Wad Madani. Active frontlines remain in Al Fao and Sennar.

MSF compound attacked and looted 

December 19


Due to the security deterioration, MSF suspends all medical activities in Wad Madani and evacuates staff to safer areas of Sudan and neighboring countries. Following the escalation of violence and RSF takeover, about 300,000 people flee the city, according to the UN. Many of those who sought safety in Wad Madani undergo an arduous second displacement as a result of the continuing violence.

Two MSF team members work on water infrastructure with a yellow truck in the background in Chad.
MSF is one of the main providers of water in Metche camp. Chad 2023 © Linda Nyholm/MSF

Rapid nutrition and mortality assessment in Zamzam camp

January


MSF conducts rapid nutrition and mortality assessment of 400 households in Zamzam camp, where a catastrophic malnutrition and mortality crisis is unfolding due to the almost complete absence of humanitarian actors.

Also in January, MSF teams provide support to approximately 49 sites that shelter more than 5,000 displaced people in Port Sudan, predominantly on school premises. Our teams focus on providing emergency medical care and hygiene while advocating for adequate water supply and food distribution from other humanitarian partners.

Sudanese women and children wait for malnutrition care from MSF in Zamzam camp.
A rapid nutrition and mortality assessment carried out by MSF in Zamzam camp in January 2024 revealed a deadly situation that has unfolded over the previous nine months. | Sudan 2024 © Mohamed Zakaria

MSF report exposes spiraling ethnic violence against people in Darfur

January 9


A retrospective mortality survey carried out by MSF finds that deaths in the region increased dramatically among communities that were targeted by attacks since the eruption of war. Refugees who have fled West Darfur over the last six months describe looting, sexual violence, and massacres targeting the Masalit people.

MSF Team travel by camels to reach far communities
MSF Team in Torung Tonga

Teams travel to hard-to-reach communities who live in the mountains by camel, since roads are not accessible for cars (left); staff at the MSF Primary Health Care Cooperation in Torung Tonga, Jebel Marra (right).

MSF returns to Wad Madani

January 13


As a result of discussions with the government of Sudan and the Rapid Support Forces to assure staff access and the impartiality of our medical mission, an MSF team returns to Wad Madani to assess the needs and evaluate the feasibility of carrying out activities in the city.

MSF calls on Sudanese authorities not to reinstate travel restrictions on humanitarian workers 

January 18


MSF warns that health care is on the verge of collapse in Khartoum, calling on Sudanese authorities not to reinstate travel restrictions on humanitarian workers who are needed to sustain vital medical services.

A displaced woman and child stand in a room full of luggage in Sudan.
"The situation here is very chaotic," said Marry Monga, a displaced woman from Khartoum. Sudan 2023 © Fais Abubakr
February 5

Malnutrition assessment finds alarming rate of child deaths 

MSF’s rapid assessment finds that malnutrition is causing children to die at a catastrophic rate in Zamzam camp for people displaced by violence in the North Darfur region. MSF calls for an urgent international humanitarian response.

Border between Adré, Chad and El Geneina, capital of Sudan's West Darfur state.

MSF holds Mapathon to map El Geneina area

February 29


Mapping remote locations is key to responding effectively to humanitarian emergencies—that's why MSF and Missing Maps volunteers held a virtual Mapathon focusing on the area around El Geneina, capital of Sudan's West Darfur state, from which thousands have fled since the start of the war.

MSF concludes emergency response in Kassala

March 10


The MSF intervention in Kassala included the provision of primary health care services, sexual and reproductive health care, mental health care, and health promotion initiatives. Mobile clinics were also deployed to reach remote gathering sites, ensuring that people could access essential medical care.

MSF teams treated more than 2,100 patients for respiratory infections in the different gathering sites for displaced people in Kassala. Respiratory infections are common in cold temperatures but are made worse when people have no choice but to sleep in shelters that do not sufficiently protect them from the cold and wind.

MSF international president discussing with a refugee's community in the transit site in Adré, Eastern Chad.
Dr. Christos Christou, MSF international president, meets with a refugee community in a transit site in Adré hosting more than 120,000 people who fled extreme violence in Sudan. Chad 2024 © Laora Vigourt/MSF

Dr. Christou: Sudan among worst crises in decades

April 8


Dr. Christos Christou, international president of MSF, calls on UN member states to use their influence and initiate a rapid scale-up of the humanitarian response to the crisis in Sudan and to increase funding.

Sudan crisis response