Category: News & Stories

I remember people from Khartoum in an overcrowded student dormitory in Port Sudan in May 2023. The infrastructure was not adapted for dozens of families to be sheltered there, and they were telling us that they had nothing but the clothes on their back as they suddenly left the capital city when the fighting erupted.

I remember the refugees who fled the mass killings of June and November 2023 in El Geneina whom I met when the Rapid Support Forces (RSF) started the siege on El Fasher in May 2024. They recounted their own horrific stories of what they directly witnessed the previous year, when thousands of their community members were slaughtered. They were already fearing that the siege of El Fasher would spiral into similar exactions.

I remember the villagers who told us the violence they faced across Jazirah State when their villages were brutally attacked by the RSF and had to flee en masse at the end of October 2024. We responded for a second time in a few months to a massive wave of cholera as the consequences of overcrowded shelters lacking clean water and proper sanitation.

I remember the emergency room of Al Nao hospital in Omdurman on 1 February 2025, when the RSF shelled a marketplace at peak hour a few kilometres from the hospital. The emergency room was overwhelmed with patients alive and dead, and in the middle Ministry of Health staff were doing all they could to save lives and clean the blood from all over the floor.

I remember the shock and the sadness on the faces of the people returning to Khartoum after Ramadan. They were coming back to entire neighbourhoods completely destroyed after months of relentless street fighting and campaigns of indiscriminate heavy artillery shelling and airstrikes. The desolation was a stark indication of the armed factions aim to destroy the enemy and maintain the power over people without any regards for the preservation of human lives and dignity.

I remember the mothers in the neonatology ward of El Geneina Teaching Hospital, counting how many newborns died during the past week alone because of the immense gaps in the healthcare service delivery in West Darfur.

The scale of the devastation in Sudan is soul crushing.

The climate emergency is a major health threat to millions of people worldwide, and vulnerable communities hit the hardest. In 2024 alone, MSF teams responded to devastating floods in West Africa and South Sudan, repeated cyclones in Madagascar, and severe heatwaves and drought in the Horn of Africa. Across the Sahel, the deadly combination of malaria and malnutrition overwhelmed pediatric services. In Chad, MSF is now providing year-round treatment and prevention for malnutrition.

“The climate crisis is first and foremost a health crisis. Vulnerable communities are paying with their health and their lives for a problem they did not create,” said Dr. Didier-Mukeba Tshialala, MSF Medical Coordinator for West and Central Africa. “

Last year was the hottest ever recorded, the tenth consecutive year of record-breaking heat. According to the Intergovernmental Panel on Climate Change (IPCC), nearly 70% of global deaths are linked to climate-related diseases.[i] Yet climate action remains far too limited.

[i] https://www.ipcc.ch/report/ar6/wg2/chapter/chapter-7/  

Restrictive policies made SAR almost impossible

MSF was forced to halt rescue activities of the Geo Barents in December 2024, after more than two years of operating under restrictive Italian laws and policies, particularly the Piantedosi Decree and the distant port practice. These restrictive rules made operating the Geo Barents unfeasible; despite its capacity of up to 700 people, it was routinely directed to distant ports while carrying only around 50 survivors.

“MSF’s decision to deploy a smaller, faster vessel is a strategic response to the restrictive and obstructive laws and practice imposed by the Italian government, which specifically targets humanitarian rescue vessels” adds Gil.

How the War Changed Everything

When war broke out in Sudan, Tanzeel’s life was turned upside down. She tried to stay in safer areas, but the conflict kept spreading. Eventually, she was forced to leave Sudan and move to Egypt. Even before the war, the children’s home pharmacy in Khartoum struggled with limited supplies. But once the fighting began, the situation became desperate — she was the only pharmacist left, witnessing severe and ongoing medicine shortages.

Moments She’ll Never Forget

One of the hardest moments she faced was in September, when a young boy was brought in after a dog bite. His mother had delayed taking him to the clinic, and although the vaccine was available, it was too late to save him. “Ignorance can cost lives,” Tanzeel says sadly. “The problem wasn’t the lack of medicine, but the delay in getting treatment. Awareness is just as important as having a medical team in place.” She believes public health education is crucial. Without it, even the best medical teams can’t save lives in time.

Lessons Learned

Although her time working directly with MSF before her mission was short, Tanzeel felt at home in South Sudan. Being Sudanese herself, she understood the challenges deeply. She knows future missions in other countries may be more difficult, but she’s ready for them.

She also stresses the critical role of pharmacists in crises: “The most important thing is to make sure life-saving medicines are available when needed. Without medicine, even the best medical team can’t function.”

Water scarcity

In northeast Syria, widespread water scarcity, driven by climate change, the weaponization of water resources, prolonged droughts, and excessive groundwater extraction have been made worse by frequent damage to water infrastructure, including Allouk and Tishreen water stations.

Since 2019, repeated interruptions to Alouk station, the main source of safe water for nearly one million people, have forced families to rely on unsafe and unregulated water sources. Survey results indicated only 37 per cent of households can consistently access sufficient water to meet basic hygiene and domestic needs.

“We bathe once every five days now. We have to choose between being clean and being hydrated”, says *Khalid, a 26-year-old man who has been displaced to Al-Hasakah during the years of the conflict.

The assessment highlights water insecurity disproportionately affects women, who are primarily responsible for securing household water, often walk long distances, facing physical exhaustion, harassment, and exploitation.

“I was collecting our household’s water allocation from the communal water tank. The man managing the distribution insisted I step inside so he could “help me”. As he leaned in, he touched me inappropriately. I was so shaken that I left without taking the water, since then, I’ve never gone back alone”, says *Fatima, a 27-year-old woman from Al-Hasakah.

Women reported some private vendors have offered water in exchange for sex, which is unacceptable and highlights the intersection of vulnerability, gender, and survival.

MSF teams have recently rehabilitated 12 boreholes in Al-Hasakah and supported the rehabilitation of two water stations (Al Aziziah and Al Hamma) in readiness for any potential startup of Alouk and ensure access to safe water for local communities.

Economic vulnerability, food insecurity

Economic vulnerability is widespread, with median household incomes reported at $150 US per month, ranging from as low as $15 US to $200 US. Food has become increasingly out of reach for lower-income families, with 77 per cent of households surveyed reporting food shortages multiple times per month.  

In a context where basic healthcare is often out of reach, comprehensive and specialised care for Somali women remains a distant reality. Until recently, specialist fistula repair services were only available in the capital, Mogadishu.

About 250 kilometres (155 miles) northwest of Mogadishu, Médecins Sans Frontières (MSF), in collaboration with the Ministry of Health, opened a 20-bed obstetric fistula unit at Bay Regional hospital in Baidoa, in August 2025. The team now provides a sustained, comprehensive fistula service that focuses on prevention, timely repair—including management of severe perineal tears—pre- and post-operative care, and long-term reintegration through counselling, social support, and nutritional assistance.

 By the end of October, 20 women had undergone surgery, with many more registered for upcoming rounds. The unit will continue to expand, with physiotherapy services planned for early 2026 to support full recovery.

Underfunding and Violence Fuel South Sudan Cholera Crisis

At the heart of this crisis is the fragile nature of South Sudan’s public healthcare system, which depends almost entirely on external support. With the government allocating less than two per cent of its budget to health in recent years, the system is incapable of catering to the routine needs of its own population, let alone a robust emergency response. Moreover, existing programs are on a precarious footing as a result of long-standing challenges, including insufficient domestic and international funding and critical implementation failures. The withdrawal of support from major donors—including USAID—has forced the closure of some health facilities, eliminating crucial lifelines. In Bentiu, for instance, we witnessed how the reduction in funding to organisations that run water and sanitation and primary healthcare have left major gaps in the response, leaving people at risk while desperately searching for care.

Added to this is the influx of people who have fled to South Sudan from Sudan, increasing the burden on limited services at a time the country was facing reduced services due to funding cuts. Since April 2023 when the civil war in Sudan broke out, more than 1 million people found refuge in South Sudan, equivalent to 10 per cent of the country’s population. These vulnerable, mobile populations are often cut off from essential services, including vaccination programs, increasing their risk of both contracting and spreading the disease. The situation in transit camps in Renk—where the camps now host more than three times their capacity—illustrates the crisis perfectly.

This overcrowding, combined with poor water and sanitation and limited access to clean water, creates the perfect environment for disease to spread. It’s no surprise that this has driven the rise in other new waterborne diseases such as hepatitis E – a severe threat, especially to pregnant women.

Attacks on Healthcare Deepen South Sudan Cholera Outbreak

Perhaps the cruellest obstacle is the pervasive violence, insecurity and attacks on healthcare.

A heart-breaking example occurred in March 2025, when fighting in Ulang forced tens of patients to flee from the MSF hospital, including more than 30 patients admitted for cholera treatment. These patients fled into the community, not only facing the risk of death themselves, but also fuelling the spread of the disease. The hospital would later be closed permanently because of looting. Since the start of the 2025, MSF has been directly targeted in more than eight attacks, closing another hospital in Old Fangak in Jonglei state, and reducing or suspending activities in others. The result is hundreds of thousands of people cut off from healthcare.