People fleeing violence in North Darfur need shelter, water, and food

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.

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.

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.

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.