Doctors Without Borders/Médecins Sans Frontières (MSF) reiterates our call on the warring parties and their allies to ensure that civilians, humanitarian personnel, and medical teams are protected and that all restrictions impeding the movement of humanitarian supplies and staff are lifted, especially as the rainy season fast approaches.

“The warring parties are not only failing to protect civilians—they are actively compounding their suffering,” said Claire San Filippo, MSF emergency coordinator. “Wherever you look in Sudan, you will find needs—overwhelming, urgent, and unmet. Millions are receiving almost no humanitarian assistance, medical facilities and staff remain under attack, and the global humanitarian system is failing to deliver even a fraction of what’s required.”

As front lines have shifted over the course of the war, especially in Khartoum and Darfur, civilians have feared retaliatory attacks from both warring parties. For the past two years, both RSF and SAF have repeatedly and indiscriminately bombed densely populated areas. The RSF and allied militias have unleashed a campaign of brutality, including systematic sexual violence, abductions, mass killings, looting of aid, erasure of civilian neighborhoods, and occupation of medical facilities. Both sides have laid siege to towns, destroyed vital infrastructure, and blocked humanitarian aid. 

Sudan’s largest displacement camp is under attack

RSF and allied armed groups launched a large-scale ground offensive on April 11, attacking Zamzam camp and leaving its residents starved, shelled, and deprived of lifesaving assistance. Marion Ramstein, MSF emergency field coordinator in North Darfur, described the situation:

“There are reports of people fleeing and many casualties, although we can’t verify how many at the moment. 

“Back in February, we were forced to suspend all MSF activities in the camp because of escalating security issues. Repeated shelling, shooting at our ambulances, and a tightened siege that prevented us from resupplying facilities and sending staff made it impossible for MSF to continue working in Zamzam despite the immense needs. 

“The communication network with Zamzam has been shut down. We don’t have news of many of the people who worked with us and decided to remain with their relatives in the camp after the suspension of our field hospital. We’re horrified by what they have to endure, and extremely worried about them and the hundreds of thousands of people already on the brink of survival in the area. We were appalled to learn that nine staff from Relief International were killed. It was the only international humanitarian organization still operating in Zamzam.

“On April 12 and 13, our team in Tawila saw more than 10,000 people fleeing from Zamzam and nearby areas. They arrived in an advanced state of dehydration, exhaustion, and stress. They have nothing but the clothes they’re wearing, nothing to eat, nothing to drink. They sleep on the ground under the trees. Several people told us about family members left behind—lost during the escape, injured, or killed.”

MSF set up a health post at the entrance of Tawila city to receive the new arrivals and provide water and medical care. Our teams quickly distributed what we had on hand, such as blankets, mosquito nets, and buckets; and we are referring the most critical cases to the local hospital MSF has been supporting since last October. MSF teams are also screening newly arrived children for malnutrition so they can immediately receive therapeutic food and be enrolled in our nutritional program for adequate care.

Hunger and famine take hold

Widespread starvation is taking hold in areas across Sudan, according to the UN: Sudan is currently the only place in the world where famine has been officially declared in multiple locations. Famine was first declared in Zamzam camp for internally displaced people in August 2024, and has since spread to 10 more areas. Seventeen additional regions are now on the brink. Without immediate intervention, hundreds of thousands of lives are at risk.

In March, MSF supported multi-antigen catch up vaccination campaigns for children under 2 years old in South Darfur. The over 17,000 children who received vaccinations in 11 of the 14 localities were also screened for malnutrition, with 7 percent of those screened found to be suffering from severe acute malnutrition and with 30 percent with global acute malnutrition. In December 2024, during a therapeutic food distribution in Tawila locality, North Darfur, MSF teams screened over 9,500 children under 5 years old. They found a staggering 35.5 percent global acute malnutrition rate, with 7 percent of the children suffering from severe acute malnutrition.

Simultaneous emergencies compound crises

Sudan is facing multiple, overlapping health emergencies at the same time. MSF teams have treated over 12,000 patients—including women and children—for trauma injuries directly resulting from violent attacks. During the first week of February 2025, MSF teams in three areas of Sudan—Khartoum, North Darfur, and South Darfur states—treated mass influxes of war-wounded patients. Sudan is also experiencing one of the worst maternal and child health crises we are seeing anywhere in the world. In October 2024, in two MSF-supported facilities in Nyala, capital of South Darfur, 26 percent of pregnant and breastfeeding women seeking care were acutely malnourished. 

“Outbreaks of measles, cholera, and diphtheria are spreading, driven by poor living conditions and disrupted vaccination campaigns,” said Marta Cazorla, MSF emergency coordinator. “Mental health support and care for survivors of sexual violence remain painfully limited. These compounding crises reflect not just the brutality of the conflict, but the dire consequences of the crumbling public health care system and a failing humanitarian response.” 

Since April 2023, more than 1.7 million people have sought medical consultations at hospitals, health facilities and mobile clinics MSF supports or is working in, and more than 32,000 people were admitted to our emergency wards.

About 13 million people have been displaced by the conflict, according to the UN—many of them displaced multiple times. Of these, 8.9 million remain displaced inside Sudan, while 3.9 million have crossed into neighboring countries. Many live in overcrowded camps or makeshift shelters, without access to food, water, health care, or a sense of the future. People depend entirely on humanitarian organizations—but organizations are not responding everywhere. 

Health facilities destroyed 

According to the World Health Organization (WHO), more than 70 percent of health facilities in conflict-affected areas are barely operational or completely closed, leaving millions without access to critical care amid one of the worst humanitarian crises in recent history. Since the war began, MSF has recorded over 80 violent incidents targeting our staff, infrastructure, vehicles, and supplies. Clinics have been looted and destroyed, medicines stolen, and health care workers assaulted, threatened, or killed. 

“Buildings were destroyed, even beds were looted, and medicines ,” said Muhammad Yusuf Ishaq Abdullah, MSF health promotion officer in Tawila, North Darfur, about the state of Tawila’s hospital after being attacked and looted in June 2023. “From afar, it looked like a hospital, but when you entered it, it was a shelter for snakes and grass.”

These attacks must stop. Medical personnel and facilities are not targets. 

The threat of rainy season approaches

The fast-approaching rainy season threatens to make an already catastrophic situation even worse—severing supply routes, flooding entire regions, and cutting off communities just as the hunger gap peaks and malnutrition and malaria spike.

MSF calls for immediate preparedness measures ahead of the rainy season. More border crossings must be opened, and key roads and bridges must be repaired and kept accessible, especially in Darfur, where seasonal flooding isolates communities year after year. 

In addition, humanitarian restrictions must be lifted, and unhindered access must be guaranteed. MSF urges all actors—including donors, governments, and UN agencies—to enable and prioritize aid delivery, ensuring that assistance not only reaches the country but is transported swiftly and safely to the hardest-hit and most remote communities. Without a serious commitment to overcoming the political, financial, logistical, and security barriers that hinder last-mile delivery, countless lives will remain beyond the reach of help.

The people of Sudan have endured this horror for too long. They cannot and should not wait any longer to access essential needs.