Sudan crisis response

For nearly 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.

What to know about the war in Sudan

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

The war in Sudan has forced more than 12 million people—over 1 in 5 Sudanese—to flee their homes in the nearly two years since it started, including over 3 million who have crossed its borders into neighboring countries like Chad and South Sudan, where MSF is providing assistance for refugees and returnees. Many displaced people 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.

Sudan's health system has collapsed. 

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 brought Sudan’s health system to the brink of collapse. Millions of Sudanese lack access to essential medical care despite alarming needs.

The war in Sudan is a war on people. 

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 Sudan’s Darfur region, which was devastated by another war in the early 2000s. Refugees who have fled from West Darfur to 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. The UN and other humanitarian organizations are barely visible on the ground beyond the main entry points in the east (Port Sudan) and west (El Geneina). This is partly due to the mounting violence, lawlessness, and access challenges imposed by both parties to the conflict.

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 2024, multiple screenings carried out by MSF and Sudanese health authorities in the camp indicated alarming and worsening rates of malnutrition. On August 1, 2024, the Integrated Food Security Phase Classification (IPC) Famine Review Committee concluded that famine conditions were prevalent in the area.

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 brought Sudan’s health system to the brink of collapse. 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 

Before the current war, Sudan had a high prevalence of non-communicable diseases and faced both seasonal and non-seasonal outbreaks of diseases like measles and cholera. Now, as the ongoing conflict has disrupted essential services such as water supply and the availability of medicine, the health situation has become even more dire.

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, especially newborns and toddlers, have an increased likelihood of contracting diseases and are more vulnerable to complications from malnutrition, malaria, measles, or acute watery diarrhea.

Obstruction of humanitarian access 

Throughout the war, there has been a 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 war and violence continue 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, including sexual violence; and the deterioration of their own health or the health of loved ones.

MSF works in 10 out of 18 states in Sudan with a team of more than 1,500 Sudanese staff and over 200 international staff. Our teams work in or support 22 hospitals; 42 primary health care facilities and mobile clinic sites; and 15 integrated community case management sites. We also pay incentives to 3,356 Ministry of Health staff.

MSF’s main medical activities in Sudan include:

• Emergency care and surgery, including trauma care for the war-wounded and  those with non-war related injuries
• Maternal and pediatric health care, including cesarean sections
• Malnutrition screening and treatment for acutely malnourished children and pregnant mothers
• Outpatient care and mobile clinics, including in sites where displaced people and refugees have sought shelter
• Routine- and catch-up vaccination campaigns
• Responses to outbreaks of diseases including cholera and measles
• Donations of medicines and medical supplies to health care facilities
• Incentives, training, and logistical support for Ministry of Health staff
• Water and sanitation activities, including setting up and restoring and cleaning latrines and water points.

MSF is providing assistance for refugees and returnees who have fled to Chad and South Sudan.

Chad

Since the war started, more than 700,000 refugees and returnees have crossed the border from Sudan to eastern Chad, according to the UN Refugee Agency. MSF teams work in three border regions that have been hosting most new arrivals: Ouaddaï, Wadi Fira, and Sila, supporting refugees, returnees, and host communities.

In 2024, MSF provided a wide range of medical services in Chad: primary health care, malnutrition screening and treatment, vaccination, and sexual and reproductive health care. Given the struggle to acquire sufficient, quality water—which increases the risk of waterborne diseases—MSF is constantly working to improve access to water and sanitation. Our teams dig boreholes, build and connect water points in camps, provide technical support to other actors, set up latrines, and rehabilitate water pumps in host-communities. MSF is also intervening in response to an increase in cases of hepatitis E, which is currently an epidemic in the east of the country.

In addition to medical 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. 

South Sudan

Since the war in Sudan started, more than 1 million 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. MSF is providing medical services to refugees and returnees and host communities in several regions, including Renk, the Abyei Special Administrative Area, and the capital, Juba.

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.

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

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 to at least seven of the nation's 10 states. MSF has responded in five states, treating cholera patients and administering vaccinations in areas such as Renk, Malakal, Rubkona, Juba, and Gorom refugee camp, where currently over 12,000 Sudanese refugees are living.

Despite the increasing number of refugees and returnees, 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.

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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