For over two years, large parts of Sudan have been experiencing ongoing violence, including intense urban warfare, gunfire, shelling, and airstrikes. The health system, already fragile before the conflict started, is struggling to cope with existing and emerging medical needs while facing overwhelming pressure from the destruction and looting of health facilities, acute shortages of utilities and medical supplies, and under-resourced, unpaid, and overworked personnel. As a result, people face significant challenges accessing medical care throughout the country. 

It’s led to the world’s largest displacement crisis.  

The war in Sudan has forced nearly 12 million people—about 1 in 5 Sudanese—to flee their homes since it started in April 2023. The majority are internally displaced within Sudan, but more than 4 million have fled the country to neighboring countries like Chad and South Sudan. Many of those displaced are sheltering in crowded camps established in the aftermath of the 2003 Darfur crisis, with no roof over their heads to protect them from the rain and scorching summer heat. Others live in abandoned buildings or makeshift camps where conditions are dire.

Sudan's health system has collapsed.  

Sudan’s health system was already fragile before this conflict. Since 2023, it has been utterly devastated. Medical facilities are subjected to artillery and drone attacks, lootings, occupation by armed forces, power outages, and shortages of medical supplies and personnel. The facilities that remain functional are overwhelmed with the needs, while many Sudanese lack access to essential care.

Ethnic violence has broken out in Darfur.  

People in Sudan continue to be subjected to horrific violence as warring parties attack each other with little respect for civilian life. The violence has also taken on an ethnic dimension in the Darfur region. Refugees our teams see in Chad describe an unbearable spiral of violence, with looting, homes burned, beatings, sexual violence, and massacres, particularly targeting the Masalit ethnic minority.

Civilians, residential areas, infrastructure, health workers, and health facilities must be protected.

The humanitarian response remains critically underfunded.  

It’s also hindered by restricted access to conflict zones. An urgent-scale-up of humanitarian response is needed to meet the needs of people in Sudan. MSF is one of the few international organizations working in parts of Sudan that are most heavily impacted by the violence. This is partly due to the mounting violence, lawlessness, and access challenges imposed by both parties to the conflict. 

MSF works across Sudan with a team of more than 1,400 Sudanese and international staff. Our teams provide a range of services including surgical care, wound management, physiotherapy, maternal care, pediatric care, malnutrition treatment, primary health care, vaccinations, and mental health support. We also support water and sanitation in displacement camps through the construction of borehole wells and latrines, as well as water distribution.  

With a collapsed health system, the medical needs in Sudan are dire, urgent, and exacerbated by the conflict.

Food insecurity and malnutrition

Food insecurity and malnutrition have reached catastrophic levels in parts of Sudan, particularly in Zamzam camp, North Darfur, which is the largest displacement site in the country. In early 2024, multiple surveys and assessments carried out by MSF and Sudanese health authorities in the camp indicated alarming and worsening rates of malnutrition; by July, the Integrated Food Security Phase Classification (IPC) Famine Review Committee concluded that famine conditions were prevalent in the area. In April and May 2025, as thousands fled Zamzam due to RSF attacks, admissions to MSF’s intensive therapeutic feeding center in Tawila increased dramatically. 

Access to health care  

Sudan’s health system was already fragile before this conflict. Today, artillery attacks, the occupation of hospitals by armed forces, power outages, and shortages of medical supplies and personnel have devastated Sudan’s health system. Active fighting and lack of transportation hinder patients’ ability to reach the health facilities that are functioning. By the time many arrive at a hospital, they are in critical condition; pregnant women often have to give birth at home.

Disease outbreaks  

As people flee to overcrowded camps, the risk of disease outbreaks has risen, especially among children. The lack of availability and access to vaccinations has left many children unvaccinated, heightening the risk of deadly but vaccine-preventable diseases such as measles. In addition, people with chronic diseases like diabetes, asthma, and heart disease are facing serious complications due to the lack of medicines and access to functional health facilities. 

Surgery and emergency care  

The war has put intense pressure on hospitals with surgery and emergency departments. MSF teams are seeing war-wounded patients with catastrophic injuries caused by explosions, bullets, and stabbings, and are responding to mass casualty incidents. People injured in road traffic accidents and women in need of emergency cesarean sections also face difficulty accessing care.

Maternal and pediatric care  

Pregnant women and children residing in camps, particularly in the western, southern, and eastern regions of the country, are especially vulnerable to health risks due to harsh living conditions and the insufficient humanitarian response. Women often give birth in unsanitary tents or at home, increasing the risk of complications and infections, while access to maternal health care remains insufficient.

At the same time, the need for postnatal and pediatric care is immense. Children under 5 years old, particularly newborns and toddlers, have an increased likelihood of contracting diseases and are more vulnerable to complications from malnutrition, malaria, measles, and acute watery diarrhea.

Humanitarian access  

Throughout the war, there has been systematic obstruction of aid, humanitarian access, and supplies. It has been difficult to get visas for humanitarian staff to enter the country and travel permits to move around Sudan. Permits to cross front lines have repeatedly been denied. Attempts have also been made to prevent aid from entering the country, including from Chad and South Sudan.

Mental health  

The violence continues to have serious mental health implications for people fleeing or stuck in the midst of the fighting. People continue to experience extreme trauma as they lose family members and loved ones, witness and experience violence, and the see the deterioration of their own health or the health of loved ones.

MSF has been present in Sudan since 1979, witnessing historic changes and escalating needs in response to the rapid shifts in the country’s political and social dynamics, which in turn impact health needs. 

Our intervention began shortly before the Second Sudanese Civil War (1983-2005), which was fought primarily between the north and south of Sudan and was one of Africa's longest civil wars. MSF was actively involved in providing medical care to war-affected communities dealing with massive displacement, famine, and the outbreak of diseases. With the independence of South Sudan in 2011, MSF continued operations in both countries, adapting to the shifting dynamics of conflict and the division of resources. 

When the war broke out in April 2023, many activities were either stopped or shifted to respond to the emerging needs and emergencies across the country. Some activities continued—in Darfur, for example—thanks to the efforts of our locally hired MSF staff, who continued to work despite the extremely difficult personal and environmental circumstances. 

MSF provides medical care to anyone who needs it, regardless of race, religion, or political affiliation. We are calling on all parties to the conflict to ensure the safety of civilians, medical facilities, and personnel. Hospitals must remain a sanctuary for people seeking care.  

To facilitate our humanitarian and medical work, we speak to all parties to the conflict to request safe, rapid, and unimpeded access to civilians who require medical care and to ensure the safety and security of our staff. This is why our independence and impartiality are essential to our work in all the places we operate across the globe. 

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Since the war in Sudan started, more than 880,000 refugees and returnees have crossed the border into Chad, according to the UN Refugee Agency. MSF teams support refugees, returnees, and host communities in Ouaddaï, Wadi Fira, and Sila, three border regions hosting the majority of new arrivals.

Medical care

Our teams in Chad provide medical services including primary health care, malnutrition screening and treatment, vaccination, mental health support, and sexual and reproductive health care. 

Water and sanitation

Improving access to water and sanitation is also an important part of our work, as the lack of sufficient, quality water increases the risk of waterborne diseases. MSF teams are working to improve access to water and sanitation by digging boreholes, building and connecting water points in camps, setting up latrines, and rehabilitating water pumps in host communities. 

Other humanitarian support

MSF provides refugee communities with non-food items such as plastic sheeting, mosquito nets, and soap, which is crucial during the rainy season to prevent additional heath risks.

Despite these efforts, the humanitarian response in eastern Chad has been struggling due to insufficient funding for humanitarian organizations on the ground, leaving critical gaps in the provision of food, shelter, water, and sanitation. 

Since the war in Sudan started, more than 800,000 people have fled to South Sudan. The border county of Renk, which has seen a surge of approximately 120,000 new arrivals since December 2024, has been significantly impacted. 

Medical care

MSF is providing medical services to refugees and returnees and host communities in Renk and other regions including the capital, Juba, and Abyei Special Administrative Area.In Renk, MSF supports Renk County Hospital, offering pre- and post-operative care for war-related injuries in partnership with the International Committee of the Red Cross (ICRC), which provides surgical care, runs pediatric services, and operates a cholera treatment unit. MSF has set up 17 additional tents to accommodate the influx of patients. 

We also conduct outreach activities at the Gossfami, Girbanat, and Atam informal settlements, which host over 60,000 people facing a severe lack of health care services. 

Cholera response

On October 28, 2024, the South Sudan Ministry of Health declared a cholera outbreak in Renk County, exacerbated by inadequate sanitation and overcrowded living conditions. The disease spread unusually fast, reaching at least seven of the nation's 10 states. MSF responded by treating cholera patients and administering vaccinations in Renk, Malakal, Rubkona, Juba, and Gorom refugee camp, where over 12,000 Sudanese refugees are currently living.

Other humanitarian support

MSF initially supplied non-food items like blankets and water containers and continues to conduct outpatient consultations, predominantly treating malaria and diarrhea cases. Our teams also run an ambulance service referring patients to Renk Civil Hospital, provide up to 23,000 liters [over 6,000 gallons] of water daily, and are currently setting up sanitation infrastructure, including latrines and water points.

Significant gaps remain in the humanitarian response. Water supply and sanitation facilities pose urgent concerns; many communities depend on dwindling rainwater sources, which raises the risk of communal conflict. Moreover, food and shelter shortages persist, with many living in inadequate conditions, such as makeshift tents or under trees, while lacking essential needs. MSF is committed to supporting all affected people in South Sudan, including refugees, returnees, and local communities facing dire circumstances.