People are arriving in Tawila from Zamzam in extreme need; famine was declared in the camp in August 2024, and many people have been seriously injured in the attack. Doctors Without Borders/Médecins Sans Frontières (MSF) is providing medical care in dedicated health posts in Tawila, as well as distributing water and donating dry food, but the needs of the arriving people are overwhelming emergency and nutritional services at the local hospital that MSF supports. People speak of fleeing horrific violence.
Why are people fleeing Zamzam and going to Tawila?
- On April 11, the Rapid Support Forces (RSF), one of the parties in the war in Sudan, launched a massive ground offensive on Zamzam camp, North Darfur, which is home to at least 500,000 displaced people. Hundreds of people are estimated to have been killed.
- MSF teams in Tawila, about 35 miles away, witnessed the arrival of thousands of displaced families, who told us that fighters were going door-to-door, shooting people hiding in their homes, and burning large parts of the camp.
- The two health posts MSF set up at the main arrival sites in Tawila have been overwhelmed for two weeks in a row, providing up to 850 medical consultations per day, with patients suffering advanced states of dehydration and exhaustion. People have also arrived with gunshots and shrapnel injuries. MSF has set up a mass casualty plan, and in three weeks, our teams treated 779 patients with gunshot and shrapnel wounds, including 138 children under 15. Of these, 187 were severe cases (including 24 children).
- Tens of thousands of people have now set up makeshift shelters in the surroundings of Tawila, and are trying to survive in extremely dire conditions.
The RSF came with their machine guns and drones,” says Mariam* who reached Tawila three days after the attack on Zamzam took place. “They attacked and killed [people]—including children. They burned our house with everything we had inside. They raped the women. They killed, they looted. Even before the attack, people had died of thirst and of starvation because of the siege that had been imposed on Zamzam for the past year. ... They entered the house of one of my sisters, dragged her out, and killed her. My uncle’s son, my aunt’s son, and many people were killed. They slaughtered us like animals."
Mariam arrived in Tawila with 20 family members, including her mother, her sisters and their own children. They now spend their days crammed into a makeshift shelter they built with branches and a piece of fabric, sharing the little shade it provides.
Newly displaced people are living in fields
Since April 12, when the people first began reaching Tawila from Zamzam, the areas surrounding the town have been completely transformed, with tens of thousands of people now estimated to be living in makeshift shelters in fields that were totally uninhabited just a few weeks ago.
"For four days now, we have been staying here as you see us, with nothing: no walls, no roof,” says Ibrahim, who fled Zamzam on foot with 11 of his family members. He carried one of his children on his shoulders and another on his back for five days. It’s the fourth time in 10 years he has been displaced in similar circumstances. He describes how soldiers entered people’s homes, forced them outside, and opened fire. Three of his brothers were killed in this manner. On his way to Tawila, he was robbed and witnessed people being beaten so harshly that they could no longer move.
“We don’t see any future anymore”
“I’ve been displaced four times over the past 10 years. We arrived in Tawila on April 16. We have been living here since then, under this tree, all 11 of us.
On Friday, April 11, it started with shelling directly on the camp. Shells were falling where people were gathering. Then they attacked on the ground. We heard gunfire everywhere. Many people got killed, including three of my brothers. Soldiers entered their houses, brought them outside, and opened fire.
When we managed to leave Zamzam, we left on foot. We had no vehicles, no donkey, no cart, nothing. I had one of my children on my shoulders, another one on my back. My older son and daughter were carrying their younger siblings the same way. Everyone around us was doing the same.
We were stopped at the exit of the camp by armed men. They searched everyone, even the smallest children. There were looking for anything that had value. Some of us were beaten so harshly, they were not able to move anymore.
The first night, we took shelter a few miles from there, in the valley of Golo. But there as well, they came for us, to steal from us. We had nothing left, but all those who did, got looted and beaten, once again.
For four days now, we have been staying here with nothing—no walls, no roof. Under this tree, it is so crowded. We’re lacking water, shelter, and there is nothing to eat. Everyone is hungry. We’re getting most of our food from community kitchens. Sometimes, we manage to get some rice when they distribute meals, but if we don’t, we must wait until the next day to eat something. For the water, we go to the well, which is a bit further away, with our jerrycans. But there are many people, and we have to wait hours to be able to drink.
We have nothing left—no money, nothing that could help us leave. We just stay here, hoping we will get enough food to survive on the next day. We don’t see any future anymore.”
-Ibrahim*
Needs far outweigh available assistance
A handful of organizations are present in Tawila, but the number of people in need of assistance far exceeds the capacity to respond. MSF teams have set up two health posts at the main arrival sites to provide newcomers with water and immediate nutritional and medical support, and are referring critical patients to the local hospital that MSF has been supporting since October 2024.
“Every single person they saw, they shot at”
“In my life, I have been displaced many times by the violence, from Sarafaya to Mouqrin in 2014, then to Shagra last year, and to Zamzam earlier this year, to finally arrive here, in Tawila. It was on Monday, April 14.
It was already a similar attack that made us flee from Shagra to Zamzam. In 2024, attackers came on camels and motorcycles and stole everything from us: our horses, our donkeys, our camels, even the tobacco we had just harvested.
When we got to Zamzam, the camp was already under siege. Everything was blocked, no supplies entering anymore. Everything became so expensive: food was not affordable anymore. Then the attack on Zamzam happened. It has started with a lot of shelling and then shooting. They came walking, directly inside the camp. Every single person they saw, they shot at them, not matter if it was a child, a woman, or an old person.
At the exit of the camp, they were waiting for us. They searched the women, they took anything they thought had value: our money, our cell phones, even our clothes. And on the road to Tawila, it happened again. What little we had left was looted on the way, including our blankets.
I arrived to Tawila with my children. I came walking, carrying my youngest children on our donkey. The little water we had was finished. I saw two bodies on the way, with my own eyes. Dead from thirst.
Living conditions here are terrible. My elder children go to the market, they buy big boxes of biscuits they then resell by unit. With that very little money, we manage to survive. For water, we can go to a water tank which is a bit further away, but sometimes it’s empty. We managed to buy two jerrycans on the market, but here as well, they were really expensive.
My children are coughing a lot. We have been to MSF’s health post; they gave us medications, but their condition is not improving. Nights are so cold; we are sleeping on the floor and only have two blankets for the 11 of us.
As long as we remain safe here, we will stay. And if not… well, we will leave. Once again.”
Tiphaine Salmon, MSF head nurse, was working in the hospital on the day the mass influx of severe cases began on April 12. “The emergency room was overwhelmed," she says. “Over the first few days, the number of patients in the hospital almost doubled. At one point, we had four patients in a bed because we did not have enough space. A lot of people had gunshot wounds and blast injuries—we've treated 779 people over the past three weeks, including 138 children. Of the 779 patients, 187 were severe cases. The youngest I saw was a 7-month-old baby with a bullet wound that went under his chin and into his shoulder. We also received patients as young as 1 day old suffering from dehydration. Many children arrived without their parents—and many parents were searching desperately for their children.”
At the same time, our teams in the hospital witnessed an explosion of admissions in our intensive therapeutical feeding center, which treats children under 5 years old suffering from severe acute malnutrition. In the week following the influx, admissions increased almost tenfold, from an average of 6 or 7 per week to more than 60. They were mostly children from Zamzam.
Disease and displacement make a deadly combination
A suspected measles outbreak began in Tawila in March, worsening an already catastrophic situation. MSF has treated more than 900 suspected measles cases since early February, with more than 300 patients in such severe condition that they required hospitalization. This situation led our teams to launch a large-scale vaccination campaign in the city in the first week of April, reaching 18,000 children under 5 years old.
Only one week after the massive influx of people from Zamzam began, our teams saw several suspected cases among children who had just arrived from the camp, meaning that measles had already begun to spread in displacement sites.
In such sites with a high population density and low hygiene conditions, malnutrition and measles can be an especially deadly combination, with disastrous consequences for young children.
“They just slaughtered us like animals”
“Our household is composed of 20 people, including my 12 children, my mother, my sisters and their own children. We arrived from Zamzam five days ago. We were living there since 2014.
The RSF came with their machine guns and drones. They attacked and killed, including children. They burned our house with everything we had inside. They raped the women. They killed, they looted. But even before that, people died of thirst and of starvation, because of the siege they imposed on Zamzam for the past year. Everything was so expensive and so unaffordable in the end.
I’ve seen a full group of children being killed during the attack by a shelling. I’ve seen it with my own eyes as we were fleeing.
Nobody will ever go there and bury them now.
They entered the house of one of my sisters, dragged her out, and killed her. My uncle’s son, my aunt’s son, and many people were killed. They slaughtered us like animals.
On our way to Shagra, at a checkpoint, I asked them why they were killing us like this. They didn’t answer. They raped several girls there. They beat the people, and loot them once again, whatever they had. We had a bit of water left, but they took the bottle and emptied it on the ground, in front of us. They also took our luggage, threw everything on the ground, and chose what they wanted to keep. I only had about 1,500 Sudanese pounds on me [about $2.25], even that they took from me.
On the way, there were six checkpoints like this one. At every single checkpoint, they emptied our luggage, searched, and kept what had value. Then they ordered us to pick up the rest and leave immediately.
Here, in Tawila, there is no food. Some people in Tawila shared a bit of millet flour with us, from which we make porridge. This is how we have survived so far: begging. We have one blanket for all of us.
We don’t have any other place to go, and even if we did, we wouldn’t have the money to do so. So, we’re just staying here, hoping to receive a bit of help. We need a better place to stay than this shelter we built with our hands."
Immediate scale-up of aid is imperative
MSF is continuing to scale up its intervention in Tawila. As well as carrying out hundreds of medical consultations per day, our organization has donated food to local community kitchens, enabling them to prepare and distribute more than 16,000 meals per day. We have also been providing 100,000 liters of clean water daily, and we have additional plans to construct 300 latrines.
But the needs of people in Tawila are immense and far outstrip our capacity to respond. Although other actors have also mobilized, and a first mass food distribution has taken place, the humanitarian response still needs to be urgently and rapidly scaled up. We urge UN agencies to substantially increase their presence on the ground so they can coordinate a response with the magnitude to meet the ever-growing needs.
*Names have been changed for privacy.
