Category: News & Stories

“We are experiencing a violation of humanitarian principles and the space for humanitarians to work is shrinking on a scale I’ve rarely seen before,” says Jean-Nicolas Armstrong Dangelser, MSF’s Emergency Coordinator in Sudan.  

“After the looting of one of our medical warehouses in Khartoum, fridges were unplugged and medicines removed,” says Armstrong Dangelser. “The entire cold chain was ruined so the medicines are spoiled and can’t be used to treat anyone.”

“We are shaken and appalled by these deplorable attacks,” Armstrong Dangelser continues. “People are in a desperate situation and the need for healthcare is critical, but these attacks make it so much harder for healthcare workers to help. It’s senseless.” 

There have been multiple incidents affecting MSF premises in Sudan since the conflict started, including:

• Between 16 and 20 May an MSF warehouse in Khartoum was looted and occupied with medical supplies, fuel and vehicles stolen. Medicines were spoiled.
• Between 17 and 23 May the MSF office in Zalingei, central Darfur, was looted, as was the Zalingei Teaching Hospital. A generator was destroyed and fuel that MSF had donated was stolen.  
• On 19 May, three MSF cars were taken after armed men entered an MSF office in Khartoum.
• On 18 May, an MSF guesthouse in Nyala, south Darfur, was looted. MSF had already been forced to suspend our medical activities in South Darfur after our compound and warehouse were violently looted in Nyala on 16 April, with two vehicles stolen. The MSF warehouse remains occupied by armed fighters.  
• On 11 May, an MSF office in Khartoum was looted with two vehicles stolen.
• On 4 May, an MSF office in El Geneina was looted.  
• On 26 April, the El Geneina Teaching Hospital, where MSF managed the paediatric and nutrition departments, was also looted, with parts of the hospital damaged or destroyed. The hospital remains closed following the attack.  

These attacks are not limited to MSF and are part of a wider trend of both warring parties disregarding civilian lives, infrastructure and healthcare facilities. As of 22 May, the World Health Organization has documented  38 attacks on healthcare since the conflict began. Hospitals and healthcare workers are protected under international humanitarian law, but there are reports of the occupation of hospitals by armed groups which can weaken their protection, putting patients, healthcare workers and facilities at risk. 

Some people are also suffering from water shortages, which could create a setting for epidemics. Malaria and dengue fever have existed here for a long time even before the war, and they will continue to be present. There is also a risk of environmental health. There are dead bodies outside, and there is no waste management. Rubbish is gathering along with flies and mosquitoes.

During our visit to the Turkish hospital – we saw that the staff have added surgical capacity to the facility, including 20 to 30 beds for the war-wounded patients. 

Three days before our visit, the hospital received a large number of casualties – around 60 patients and three dead people. The hospital is performing around five to eight surgeries per day depending on the intensity of the violence. 

Most of the doctors who are working in the hospitals are volunteers: surgeons, medical doctors, nurses, and some people from the community trying to assist. So far, they have been able to cope with the number of surgeries. However, there is insufficient medication needed to cope with the number of caesarean sections and patients in the delivery ward. Meanwhile, the neonatal ward has had to close due to the lack of capacity.”

“The current fighting has forced us to stop almost all of our activities in West Darfur. Our teams have not been able to reach the hospital, nor have they been able conduct mobile clinic activities in the nomadic communities of Galala, Mogshasha, Wadi Rati and Gelchek. We have been able to continue providing services in Kreinik hospital, but we have seen a reduction in the number of patients coming from outside the town.  

We are incredibly worried about the impact this violence is having on people who have already lived through waves of violence in the previous years. Violence prevents people from seeking the medical care they desperately need. The humanitarian and medical needs are immense.
  
Our teams in West Darfur are closely following the situation to ensure that we can safely continue to provide much-needed medical care and humanitarian assistance. We are ready to scale up our response to meet the growing needs. To do so, we need to be able to ensure the safety and security for all our staff and patients.   

We demand that all health facilities, including hospitals, clinics, warehouses, and ambulances, and their staff are respected and protected. We reiterate our calls to all parties to the conflict to avoid civilian areas and to spare civilian lives. 

We urge them to immediately cease attacks on medical facilities and ensure that patients can receive the medical care they desperately need.”

After more than a week sheltering from heavy fighting in Sudan, some of our teams have relocated to safer locations, while there are plans for others to leave the country. Some staff have also relocated with their families to safer areas, often joining other family. We continue to keep in close contact with all team members, as far as possible. The safety of our staff is a top priority, and we appreciate the support we have received to safely relocate our teams.
    
“We reiterate our call for all those participating in the violence to respect their obligations under international humanitarian law to ensure the safety of medical personnel and health facilities,” says Dr Abubakr Bashir Bakri, MSF operations manager for Sudan. “They must also allow safe passage of our teams, ambulances and civilians seeking healthcare, and to facilitate movement of those who are delivering humanitarian assistance.”  

I was thinking also of all my Sudanese colleagues and more generally people living in Khartoum who, unlike me, did not have the chance to be sleeping in a bunker, with emergency food stocks and water. It is now the sixth day of fighting in the streets of densely populated Khartoum, with its roughly 10 million inhabitants. People are running out of food, water, fuel, and are taking great risks to get supplies in shops that are already facing shortages.

Hearing all the destruction outside, reading about the loss of life, about the wounded and sick people who cannot get to a functioning hospital or clinic, even in the capital city of Khartoum, makes me incredibly sad for Sudan and for its people, stuck amid fighting between armed forces of their own country. People are struggling to get food, water, medication, healthcare… and these are just the first few days. The consequences and aftermath of this fighting on the already-high humanitarian needs will be dramatic.

For a year, I have been monitoring humanitarian needs in Sudan and documenting the impact of the lack of response to those needs on the health and nutrition of Sudanese people, especially children. We had just released a briefing note to raise the alarm on the dire needs of people living in West Darfur, calling on humanitarian groups and donors to scale up the response and support Sudan’s already collapsing health system.

Until last weekend, South Hospital had no surgical capacity. It was a maternity hospital that we began to support last year to help reduce the high rates of maternal mortality in the region. However, since the fighting began, we have had to repurpose the hospital to make it possible to treat the wounded.

All other hospitals in the city have had to close due to their proximity to the fighting, or the inability of staff to reach them due to the intensity of the conflict. Surgeons from those hospitals have now come to South Hospital and have been able to carry out a number of operations. However, they are rapidly running out of supplies. We were able to reach the hospital to restock it on Tuesday, when there was a lull in the fighting, but if we cannot get more supplies to Darfur – and if we continue to receive such high numbers of wounded – there are only enough medical supplies to last another three weeks.

Currently, within Sudan, nothing can move. The airports across the country have all been closed since the fighting began and there is fighting in the streets, so we cannot get more supplies to North Darfur – or into the country. Chad has closed its border. So, if the situation doesn’t change and humanitarian access is not granted, there will be even greater loss of life.

Saturday afternoon, a small team of surgeons from the hospitals that had to close began carrying out surgical interventions in the hospital. So far, they have carried out six major surgeries on people wounded by the violence.

Cyrus Pays said: “However, the hospital is rapidly running out of medical supplies to treat survivors. It is running out of medicines and blood. There has also been a power outage in the city since the beginning of the fighting, and fuel supplies for the hospital generator are also running low. We have received a list of surgical items that the surgical team urgently requires and we are seeking a safe corridor in order to transport these to the hospital using our two ambulances. Due to the conflict, the airport has been closed since Saturday, and it is vital that it is re-opened so that we can bring in additional medical supplies and possibly an MSF surgical team to support the surgeons who are currently at work. Without these vital supplies, there will be further loss of life.”

Elsewhere in the country, and especially in Khartoum, Darfur, North Kordofan and Gedaref states, MSF teams face serious challenges. MSF premises in Nyala, South Darfur, have been looted – including one of our warehouses. In Khartoum, most teams are trapped by the ongoing heavy fighting and are unable to access warehouses to deliver vital medical supplies to hospitals. Even ambulances are being turned back. They are not being permitted to pass in order to retrieve the bodies of the dead from the streets – or to transport those who have been injured to hospital. 

We have been in contact with Sudanese medical teams in Khartoum and other parts of the country where wounded patients are being received. Many have been on duty for many hours, providing lifesaving care in extremely difficult circumstances, and despite the impact of the situation on them and their own families.

We are ready to provide supplies and medical personnel to key functional health facilities that need support, but it is too dangerous for anyone to move within Khartoum and other cities. Many people also cannot reach any of the health facilities that are open due to the ongoing violence and fear that they will be risking their safety.  

MSF is making an urgent call for civilians to be protected from the ongoing indiscriminate and disproportionate attacks that are taking place. We urge all parties to the conflict to guarantee safety for medical staff and patients, so that they can access healthcare facilities without fearing for their lives. We additionally request that all parties to the conflict ensure that all health facilities – including hospitals, clinics, warehouses and ambulances – are protected. They should never be a target. MSF in Sudan provides life-saving and impartial medical care to all those who need it, based on medical need alone, but currently, we cannot move due to the intensity of the conflict. We reiterate our plea for all those participating in the violence to respect medical personnel, health facilities and ambulances and to spare the lives of civilians and humanitarian workers.   

Alongside the donations, an official MSF delegation of Dr Ahmed Abdel-Rahman, MSF director of operations and Michiel Hofman, a senior humanitarian specialist, arrived in Damascus to discuss MSF’s willingness to provide medical and humanitarian support to people living in areas that MSF is not currently present. They aim to have talks with the SARC officials to discuss with the SARC ways through which MSF can provide additional medical assistance to more people throughout Syria.