War in Sudan
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Thomas Kauffmann
General Director
MSF Luxembourg
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Last update: February 20, 2025
The world's worst humanitarian crisis
Since war broke out between the Sudanese Armed Forces (SAF) and the Rapid Support Forces (RSF) on 15 April 2023, millions of people have experienced intense fighting. In large parts of Sudan, particularly Darfur, the population has been the victim of ongoing violence, including intense urban warfare, shootings, bombings and air strikes. Our teams are treating patients injured by explosions, bullets and stab wounds. Health staff and facilities have been attacked and looted.
The conflict in Sudan has triggered the world's largest displacement crisis, with over 12 million people—more than one in five Sudanese—forced to flee their homes since the war began.
Sudan's health system has collapsed, according to WHO 70-80% of facilities non-operational due to insecurity, critical shortages of staff and supplies, soaring costs, and widespread looting—forcing patients to seek help late, often at the risk of their lives. Millions of Sudanese are without access to essential care amid alarming malnutrition rates, high maternal and child mortality, and widespread outbreaks of cholera, measles, and dengue—amplified by insecurity, critical shortages, and widespread obstruction of medical supplies.
The war in Sudan is a war on people. People in Sudan are continuing to be subject to horrific violence as warring parties continue to attack each other with little respect for civilian life.
Our call for Sudan
All armed groups and those with influence over them MUST ENSURE that humanitarian aid can move freely to all areas of the country. Parties to the conflict continue to impose deliberate blockages to stop medical and humanitarian supplies reaching places where they are desperately needed, and this prevents people from receiving the medical care they desperately need.
Civilians, humanitarian workers and health structures must be spared in the fighting. Bombing health facilities, deliberate harassment and attacks on healthcare workers MUST STOP.
The humanitarian response MUST IMMEDIATELY SCALE UP to meet the massive needs of the population and end this suffering.
Claire San Filippo, coordinatrice d'urgence de MSF, s'est récemment rendue au Tchad et au Darfour, au Soudan. Elle nous fait part de son témoignage.
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The human cost of conflict and violence
The report, ‘A war on people – The human cost of conflict and violence in Sudan’ describes how both the Sudanese Armed Forces (SAF) and the Rapid Support Forces (RSF) and their supporters are inflicting horrendous violence on people across the country. The war has wrought a catastrophic toll since fighting began in April 2023 with hospitals attacked, markets bombed, and houses razed to the ground.
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Driven to oblivion
Driven to oblivion: the toll of conflict and neglect on the health of mothers and children in South Darfur reveals the number of maternal deaths in just two MSF-supported hospitals in South Darfur between January and August to be more than seven per cent of the total number of maternal deaths in all MSF facilities worldwide in 2023. A screening of children for malnutrition also found rates well beyond emergency thresholds.
MSF's response in Sudan
In Sudan, MSF is present in 10 of the country's 18 states.
Our 1597 Sudanese and 222 international staff are currently working and/or supporting 22 hospitals and 42 basic healthcare centres or mobile clinics.
Despite the difficulties, MSF's presence and the medical care we have been able to provide demonstrate that it is possible to carry out humanitarian work in Sudan. However, very often MSF teams are the only humanitarian actors in the areas where we work.
Au Soudan, les équipes de MSF fournissent :
• Soins d'urgence et chirurgie, y compris soins de traumatologie pour les blessés de guerre et les blessures non liées à la guerre
• Soins de santé maternelle et pédiatrique, y compris les césariennes
• Dépistage de la malnutrition et traitement à l'hôpital et à domicile pour les enfants et les femmes enceintes souffrant de malnutrition aiguë
• Soins ambulatoires et cliniques mobiles, y compris dans les sites accueillant des personnes déplacées et des réfugiés
• Campagnes de vaccination de routine et de rattrapage
• Réponses aux épidémies de maladies - choléra, rougeole, etc.
• Dons de médicaments et de fournitures médicales aux établissements de santé
• Incitations, formation et soutien logistique au personnel du ministère de la Santé
• Activités liées à l'eau et à l'assainissement (WATSAN), y compris la mise en place et la restauration/nettoyage de latrines et de points d'eau.
MSF emergency response in 2024
Surgical consultations
ER consultations
Cases of malnutrition treated
War wounded patients treated
Assisted deliveries
MSF's response in border countries
Chad
Prior to the current war, the country was already hosting several hundreds of thousands of Sudanese refugees.
As per the data by UNHCR in January 2025, 734,413 displaced refugees and returnees have crossed the border to eastern Chad, and hundreds more keep arriving. MSF teams work in 3 border regions which have been hosting most of the new arrivals: Ouaddaï, Wadi Fira and Sila, supporting refugees, returnees and host communities.
In 2024, MSF provided a wide range of medical services: primary healthcare, malnutrition screening and treatment, vaccination, sexual and reproductive healthcare; through a wide range of modalities: supporting existing local health structures, setting-up hospitals, clinics and Integrated Community Case Management (ICCM) and referral systems, in addition of mobile clinics allowing to reach the most vulnerable communities. We have also played a key-part in large-scale public health initiatives such as responses vaccination campaign, or SCP (seasonal chemoprophylaxis) on the benefits refugee communities.
As populations often struggle to acquire water in enough quantity and quality – what increase the risks of water-borne diseases outbreaks and spreading – MSF is constantly working at improving the access to water and sanitation. Over the past year, our organisation has been digging boreholes, building and connecting waterpoints in the camps, brought its technical support to other actors, set-up hundreds of latrines, rehabilitated water-pump in host-communities, distributed hundreds of thousands of soap bars. An intervention, that among other, contribute to decrease the number of cases of hepatitis E, which is currently an epidemic in the east of the country.
Finally, where other competent organisations don’t have the capacity to do so, MSF keeps providing refugee communities with non-food items, such as plastic sheeting, mosquito nets or soap bars which, during the rainy season, are crucial to prevent additional heath troubles and to regain a minimum of dignity.
Despite these efforts, the humanitarian response in eastern Chad has been struggling due to insufficient funding for humanitarian organisations on the ground, leaving critical gaps in the provision of food, shelter, water, and sanitation.
South Sudan
The ongoing conflict in Sudan has significantly affected South Sudan, particularly in the border county of Renk, which has seen a surge of approximately 120,000 new arrivals since December 2024. Since April 2023, more than 1 million people have fled to South Sudan due to the violence, with most entering through five informal entry points.
MSF is providing medical services to these refugees and returnees and host communities in several regions, including Renk in Upper Nile State, the Abyei Special Administrative Area, and the capital, Juba. In Renk, MSF supports the 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 paediatric services, and operates a cholera treatment unit.
MSF had to set up 17 additional tents to accommodate the influx of patients.
MSF also conducts outreach activities at the Gossfami informal settlement and has expanded to Girbanat and Atam informal settlements, which host over 60,000 individuals facing a severe lack of healthcare services. MSF initially supplied non-food items like blankets and water containers and continues to conduct outpatient consultations, predominantly treating malaria and diarrhoea cases. Our teams also run an ambulance service referring patients needing further medical care to Renk Civil Hospital, provide up to 23,000 litres of water daily through trucks, and are currently setting up sanitation infrastructure, including latrines and water points.
On 28 October 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, and Juba, in the Gorom refugee camp, where currently over 12,000 Sudanese refugees are living.
Despite the increasing number of refugees and returnees, significant gaps remain in humanitarian response, putting additional pressure on vulnerable populations. Water supply and sanitation (WASH) 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, and lacking essential non-food items.
MSF is committed to supporting all affected individuals, including refugees, returnees, and local communities facing dire circumstances.
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