In photos: The world’s largest displacement crisis

The majority of those displaced still remain in the country, seeking shelter anywhere they can find it, from camps to abandoned schools and firehouses. At times, even places of shelter have come under attack. The country's largest displacement camp, Zamzam in North Darfur, has been attacked repeatedly by RSF since December last year, and an escalation in February forced Doctors Without Borders/Médecins Sans Frontières (MSF) to halt operations there. This has further cut off access to care for a population facing serious health crises, including alarming rates of malnutrition and sexual violence as well as the threat of of diseases like cholera and measles. This series of photos illustrates the human impact of war and displacement in Sudan and countries receiving large numbers of Sudanese refugees.  

The war has caused more than 7.7 million people to be internally displaced within Sudan, often moving from camp to camp due to escalations of violence. Medical supplies and other critical needs are often inaccessible due to blockades by warring parties, even in places experiencing dire shortages such as Zamzam camp, where the entry of food, medicines, and other essential supplies has been blocked for months amid a famine. The camp, which is the largest displacement site in the country, has come under repeated attack in recent months, forcing people to flee yet again. Tens of thousands have arrived in the town of Tawila, where MSF is providing medical care at dedicated health posts, distributing water, and donating food. The needs of newly arriving people are overwhelming emergency and nutritional services at the local hospital that MSF supports. 

Arrival in Tawila

Displaced people arrive in the Tawila locality in June 2024. They mainly come from El Fasher and surrounding camps like Zamzam and Abu Shok, citing the extreme violence, shelling, and skyrocketing prices amid food shortages as their main reasons for leaving. Many remain behind because of increased protection concerns on the road and a lack of financial means to pay for transportation and fees.  

Adil

Twelve-year-old Adil sits beside his mother Nawal and little brother Musa at Tawila Hospital, where he is receiving care after being shot while fleeing Zamzam camp. In April, over 138 of MSF’s patients with gunshot wounds were children. 

Mass casualty response in Tawila

In April 2025, MSF teams in Tawila witnessed the arrival of thousands of displaced families fleeing Zamzam camp, who told out teams that fighters were going door to door, shooting people hiding in their homes and burning large parts of the camp. Here, Dr. Abdel Mafid examines an elderly woman at a health post in Tawila Umda who arrived severely dehydrated and exhausted.

Seeking shelter in Zalingei

The University of Zalingei—once a center for students of medicine, agriculture, and technology—has been transformed into a makeshift shelter, with more than a thousand people are living in its classrooms and offices, mostly displaced from Hasahisa camp. Bales of hay for donkeys are stored in the auditorium, while campus buildings are connected by laundry clotheslines. The community relies on each other because of the absence of humanitarian assistance.

“I think of Sudan and my heart aches”

“When the war started, we became wanderers, fleeing all night in search of safety," says Hanan. "Families were forced out into the streets. Mosques, roads, every space was filled with displaced people. We used to live together as neighbors and relatives. Now, people are scattered, lost in different countries. I sit and wonder when this will end. When will we go home? I think of Sudan and my heart aches.” 

"I was born in this camp"

“I was born in this camp, and now I have given birth to my first child, yet we still live the life of the displaced,” says Rehab, a patient at MSF’s health center in Kalma camp in Sudan's Darfur region. “I gave birth under extremely difficult circumstances, and those days were some of the hardest times in my life. I thank God that Ayman is now healthy and well thanks to the care we received here.”

Health effects of conflict

When a projectile reportedly shot by the Rapid Support Forces hit Rabak power plant on February 16, water pumps went out of service, forcing people to rely on unsafe sources of water which triggered a cholera outbreak in Sudan's White Nile state. More than 2,700 patients received care at the Ministry of Health's cholera treatment center at the MSF-supported Kosti Teaching Hospital.

Raising health awareness

An MSF health promotion team talks to patients in the waiting area of Murnei Hospital in West Darfur in January.

An estimated 869,000 refugees have fled across Sudan’s border into Chad since the start of the war. Most live in desert camps in the east of the country, where water is scarce, living conditions are poor, and people lack sufficient access to basic needs. Many of the Sudanese refugees MSF treats in Chad arrive malnourished, particularly children, and many have experienced extreme violence in the neighboring Darfur region, including sexual violence. MSF teams work at key transit points and refugee camps, providing primary health care, nutritional screenings, vaccinations, mental and maternal health care, and support for survivors of sexual violence, but the needs far exceed our capacity to respond. 

Fleeing to Chad

Refugees from Sudan arrive at the Adré border crossing point in April 2024. A year into the conflict, more than 600,000 people had already fled across this border due to the fighting. Today, there are over 770,000.

Basic needs in short supply

Parcels containing food and other essential items are prepared for distribution at Adré camp, where Sudanese refugees have faced severe cuts to food rations over the past year.

"Returning to Sudan is out of the question"

"I lost my arm because I couldn’t get treatment in time," says Adam, pictured with his family above. "We were careful to stay out of sight as we walked and kept hoping to reach the Chadian border. It was horrendous. My arm had to be amputated and I spent three months in the hospital ... This time, returning to Sudan is out of the question.”

Cuts to food rations exacerbate poor conditions

A refugee builds her own shelter in Aboutengue camp, which has experienced food shortages due to severe cuts in food rations affecting tens of thousands of Sudanese refugees, the majority women and children. The camp is located in a remote area with very few livelihood opportunities and its geographic isolation makes refugees even more dependent on this inadequate food assistance.

Survivors of the war

Many of the new arrivals MSF teams treat in Adré, along the Chad-Sudan border, share horrifying stories of brutal violence and rape endured both in Sudan and on their journeys to Chad. The true scale of this crisis remains difficult to quantify because services for survivors are limited, and the extent of the suffering is beyond comprehension.

Delivering hope

A pregnant Sudanese woman attends a prenatal consultation in a spontaneous site for refugees in Adré. "The women who come to the maternity unit trust us deeply, confiding their anxieties about the future," says Solange Ahidjo, an MSF midwife in nearby Aboutengue camp. "We do everything we can to reassure them and support them in any way possible."

Referral for maternal care

A nurse at MSF’s clinic in Adré escorts a maternity patient, Zamzam, to an ambulance that will transport her to a hospital for an ultrasound after her emergency consultation with MSF. Zamzam is 6 months pregnant and suffered a traumatic blow to her abdomen when she fell off a horse.

Physiotherapy for children with malnutrition

Mental health activity manager Saidi Nabiha and her colleague Zamzam, a Sudanese counselor, provide physiotherapeutic care to patients in the malnutrition ward to counteract developmental delays arising from malnutrition. Teams also organize interactive games and exercises to help improve physical growth and support the further development of motor skills. 

Everyday life as a refugee

A family does morning chores in their shelter in a spontaneous site for refugees in Adré.

"We took nothing with us"

“We fled El Geneina in June," says Iqbal, a Sudanese refugee in Aboutengue camp. "We took nothing with us. We hid as best we could to avoid the gunfire. My sister was shot in the stomach and her husband was wounded in the head. My husband disappeared, but I managed to find him. He’d been wounded too and MSF was treating him in Chad. Four months later I decided to go back to Sudan to look for my sister’s son—the sister who was shot in the stomach—and I was told he’d been murdered ... Fighter planes were flying overhead and everyone was running for cover. My car was hit and I was taken by cart to the MSF hospital in Adré. I’ve had nine rounds of surgery."

Care on the border

New arrivals at the Adré border crossing speak with MSF staff, who run a health post there to vaccinate children, screen for malnutrition, and organize medical referrals for sick and injured people.

People are also fleeing the war in Sudan across its southern border with South Sudan—more than 777,000 since April 2023. South Sudan is also experiencing insecurity and is at high risk of devastating floods during its annual rainy season, which raises the risk of waterborne diseases like cholera. MSF teams work in key transit points like Renk and informal settlements receiving refugees and returnees. MSF is the only organization currently providing medical and humanitarian services in some of the major informal settlements, and also works in key transit points like Renk, where a cholera outbreak is affecting those who fled Sudan in addition to host communities. MSF set up cholera treatment units including at Renk Civil Hospital and our hospital in Malakal. 

Fleeing war, seeking hope

An MSF staff member provides medication to a Sudanese refugee in Atam, just 15 miles from the Sudanese border. Many of the refugees here come from conflict-stricken areas like Sennar and Blue Nile, and many are South Sudanese returnees from White Nile state. MSF is the only organization currently providing medical and humanitarian services in some of the major informal settlements, and we urgently call for humanitarian organizations and South Sudanese authorities to ramp up their efforts.

Border crossings

Returnees and refugees board a bus at the Joda border point that will take them to the transit center in Renk.

Risks of lack of clean water

A stagnant pool of water is the only easily accessible water source in the Jerbana informal settlement, which saw a massive influx of more than 82,000 of people fleeing Sudan in December 2024 due to intensified violence in Sudan’s White Nile, Blue Nile, and Sennar states. The poor water and sanitation conditions are heightening the risk of disease outbreaks at a time when Renk is already experiencing an ongoing cholera outbreak.

Emergency care in Atam

Women wait to be seen at MSF’s emergency clinic in Atam, which is the only place people can access medical care in the area. “With health care and basic services limited, overcrowding is causing diseases to spread quickly, and outbreaks are a real threat," says Zakaria Mwatia, MSF head of mission in South Sudan

Fear of outbreaks

An MSF staff member tests a child for malaria at the emergency clinic in Jerbana. The risk of this infectious disease rises significantly during the annual rainy season, which brings severe floods to parts of South Sudan.