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Sudan: After famine declaration, catastrophic malnutrition in Zamzam camp is only getting worse

The UN must consider all options, including airdrops, to bring food, medicine, and essential supplies to blockaded and starved communities in Zamzam camp, North Darfur.

A child eats ready-to-use therapeutic food to treat malnutrition in Sudan.

Muhab receives therapeutic food at the outpatient therapeutic feeding center in MSF's clinic in Zamzam camp. | Sudan 2024 © Mohammed Jamal

NEW YORK/PARIS, September 13, 2024 — The results of a nutrition screening carried out by the Sudanese health authorities and Doctors Without Borders/Médecins Sans Frontières (MSF) earlier this month in Zamzam camp, North Darfur, indicate a catastrophic nutritional situation that is only getting worse. MSF urges the UN and international stakeholders involved in negotiating broader humanitarian access to consider all options to quickly deliver food and essential supplies in the area, including by airdrops. 

“Not only do the results confirm the disaster that we and other stakeholders have been observing and alerting on for months, they also indicate that every day, things are getting worse and we’re running out of time,” said Michel Olivier Lacharité, head of emergency operations for MSF. “We are talking about thousands of children who will die over the next few weeks without access to adequate treatment and urgent solutions to allow humanitarian aid and essential goods to reach Zamzam.”

A child is screened for malnutrition in Zamzam camp, Sudan.
Three-year-old Latifa sits on her mother’s lap at the MSF clinic in Zamzam Camp, North Darfur, while a nurse performs a mid-upper arm circumference (MUAC) screening to check her nutritional health. | Sudan 2024 © Mohammed Jamal

Prevalent famine conditions in Zamzam camp

Despite an announcement that brought hope for positive developments—for instance, following Geneva peace talks—no significant amount of humanitarian relief has reached people in Zamzam camp and the nearby, war-stricken city of El Fasher since the Integrated Food Security Phase Classification (IPC) Famine Review Committee concluded that famine conditions were prevalent in the area on August 1 this year. Most supply roads are controlled by the Rapid Support Forces (RSF), who have made it all but impossible to bring therapeutic food, medicines, and essential supplies into the camp since the intensification of fighting around El Fasher last May.  

We are talking about thousands of children who will die over the next few weeks without access to adequate treatment and urgent solutions to allow humanitarian aid and essential goods to reach Zamzam.

Michel Olivier Lacharité, MSF head of emergency operations

There's no more time to waste if thousands of preventable deaths are to be avoided. Among the more than 29,000 children under five years old screened last week during a vaccination campaign in Zamzam camp, 10 percent suffer from severe acute malnutrition, a life-threatening condition, while 34.8 percent suffer from global acute malnutrition, which will evolve into a more severe form of malnutrition if not treated effectively and in a timely fashion.  

“The malnutrition rates found during the screening are massive and likely some of the worst in the world currently,” said Claudine Mayer, MSF emergency medical manager. “It’s even more terrifying as we know from experience that the results are often underestimated in the area when we use only the mid-upper arm circumference criteria like we did here, instead of combining it with measuring weight and height.”

An MSF mass screening carried out in March 2024 revealed an 8.2 percent rate of severe acute malnutrition and a 29.4 percent rate of global acute malnutrition, which was already twice as high as the 15 percent alert threshold set by the World Health Organization.  

A child is screened for malnutrition in Zamzam camp, Sudan.
A nurse attends to a patient in the ER department at the MSF clinic in Zamzam Camp, North Darfur. | Sudan 2024 © Mohammed Jamal

Supply blockages and soaring prices exacerbate threat

The only food available is from pre-existing stocks, which is not sufficient for people living in the area, and food prices are at least three times as high as in the rest of Darfur. Fuel prices are soaring as well, making it very difficult to pump water and run clinics that rely on generators for electricity. Our staff on site report that for many, it's impossible to obtain more than one meal per day.  

“In such a dire situation, we should be scaling up our response,” said Mayer. “Instead, running critically low on supplies, we are reaching breaking point and were recently forced to reduce our activity to focus solely on children in the most severe conditions. This means we had to suspend treatment for 2,700 children with less severe forms of malnutrition, and to put an end to consultations provided to adults and children over five years old, who represented thousands of consultations every month.”

When does hunger become famine?

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Zamzam camp is estimated to host between 300,000 and 500,000 people, many of them displaced many times over, who are trying to flee the war that has been devastating Sudan since last year. In El Fasher, where many of the displaced used to live, only one hospital remains partially functioning after the others were damaged or destroyed in the conflict.  

“Due to unconscionable blockages on supplies, we feel like we are leaving behind an increasing number of patients who already have very few options for getting lifesaving medical care,” said Lacharité. “If the roads are not an option for getting massive quantities of urgent supplies into the camp, the United Nations should look at every available option. Delaying these supplies means causing more deaths—thousands of them, among the most vulnerable.” 

Sudan crisis response