As starving people continue to flee atrocities committed by the Rapid Support Forces (RSF) in El Fasher, capital of Sudan’s North Darfur state, Doctors Without Borders/Médecins Sans Frontières (MSF) teams are providing urgent care to those who have reached the town of Tawila. There, MSF staff are witnessing extreme levels of acute malnutrition—the most severe situation amid the malnutrition crisis that has gripped Sudan since the start of the war.
For months, MSF teams in Tawila have been treating patients with malnutrition who fled El Fasher, but malnutrition rates are now staggering. Among children under the age of 5 who reached Tawila between October 27—when RSF seized control of El Fasher—and November 3, over 70 percent were acutely malnourished, with 35 percent suffering from severe acute malnutrition. At the same time, 60 percent of the 1,130 adults MSF screened were acutely malnourished, 37 percent of whom with severe acute malnutrition. Malnutrition rates are even higher among pregnant and breastfeeding women.
Desperation for food in El Fasher
MSF’s findings corroborate fears that famine has devastated people in El Fasher, which was besieged for more than 500 days. These findings also correspond with a recent Integrated Food Security Phase Classification (IPC) report that found famine present in El Fasher and in Kadugli, South Kordofan.
Life has become unbearable in El Fasher, survivors tell our teams. People report having had no access to food, with community kitchens shut down, humanitarian aid blocked, and markets shelled and depleted. In September, 15 lbs. of millet cost 500,000 Sudanese pounds ($208) and 2 lbs. of sugar 130,000 Sudanese pounds ($54). Out of desperation, people have been forced to eat animal feed.
“We were so hungry we began eating ambaz [animal feed],” a displaced woman told MSF in North Darfur. “At first it was free, then we had to buy it for 20,000 Sudanese pounds [$8] per 1.5 kg. [3.3 lbs.], rising to 50,000 [$20] in June.”
Further, the RSF has shot people trying to bring food into El Fasher. Dozens of those who survived managed to make it to Tawila, where they were treated by MSF. “My cousin disappeared in June while trying to bring food, and since then we have had no news,” said a woman who fled El Fasher in October. “At the exit of El Fasher, they faced RSF fighters on motorcycles who shot at them.”
We fear that many people in and around El Fasher remain stranded, held for ransom, and unable to escape. The RSF and its allies must halt mass atrocities and provide safe passage for the survivors to flee.
Hardships continue for survivors reaching Tawila
People who reach Tawila face continued struggles. Since the start of the year, half of the 6,500 pregnant women MSF has seen for prenatal care were acutely malnourished, including 15 percent with severe malnutrition and 35 percent with moderate malnutrition. This puts their children at serious risk of being born underweight or malnourished, too.
At a glance: Malnutrition crisis in Sudan
- Over 70 percent of children under age 5 arriving in Tawila between October 27 and November 3 were acutely malnourished, along with 60 percent of the more than 1,000 adults screened.
- Half of the 6,500 pregnant women who have received prenatal care from MSF this year were acutely malnourished, including 15 percent with severe cases.
- Of 1,950 children MSF treated at Damazin Teaching Hospital between July and September, 100 died—many from co-occurring acute malnutrition and cholera.
- The crisis is being fueled by overlapping factors, including inadequate food, disease, insecurity, lack of livelihoods, and unsafe living conditions.
Beyond El Fasher, MSF teams across Sudan have seen a widespread deterioration in children’s nutritional status in recent months. The crisis is being fueled by overlapping factors, including inadequate food, disease, insecurity, lack of livelihoods, and unsafe living conditions.
"Across Sudan, there is more that can be done to reduce the suffering caused by malnutrition,” said Myriam Laaroussi, MSF emergency coordinator. “We call on all warring parties to allow humanitarian organizations safe and unimpeded access to increase services and help reduce this crisis.”
Displacement exacerbates malnutrition risk
Displacement plays a significant role in driving malnutrition for both those internally displaced and those who have fled across Sudan’s borders. In Blue Nile state, in the east of the country, the arrival of Sudanese returnees from South Sudan since June has pushed fragile resources to their limits. Thousands of families live in makeshift camps with little access to clean water, food, or hygiene services, leading to an ongoing cholera outbreak and a surge in preventable deaths among children. Between July and September, MSF treated 1,950 severely malnourished children at Damazin Teaching Hospital; 100 of these children died, many from combined cholera and acute malnutrition.
Even when people can return home after being displaced, they often face significant challenges in finding or affording food or accessing services such as medical care. In Khartoum state, malnutrition has worsened since June, as more than 700,000 returnees have moved back into war-torn neighborhoods with limited access to water and health care. Al Buluk Hospital in Omdurman, Khartoum state, admitted 351 malnourished patients in September, while Al Banjadeed Hospital in Khartoum city found 46 percent of children screened during consultations to be malnourished.
The humanitarian response in Khartoum still falls far short of the needs, with few organizations present and major gaps in both emergency aid and longer-term recovery efforts.
What’s more, the true scale of the crisis is likely much worse than reported. Without warring parties granting safe and unimpeded access to people at risk—combined with increased funding and humanitarian support from international organizations—more children will be vulnerable to Sudan’s protracted malnutrition crisis.
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