People wait outside an MSF clinic in Zamzam camp, around 15 kilometres from El Fasher, the capital of North Darfur state. Sudan, 2024. © Mohamed Zakaria
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Sudan: MSF forced to halt activities as violence engulfed Zamzam camp

The current escalation of attacks and fighting in and around Zamzam camp for displaced people ur is making it impossible for Doctors Without Borders/Médecins Sans Frontières (MSF) to continue providing medical assistance in such dangerous conditions. Despite widespread starvation and immense humanitarian needs, we have no choice but to take the decision to suspend all our activities in the camp near El Fasher in North Darfur, including the MSF hospital.

In the first three weeks of February, our teams in Zamzam received 139 wounded patients in the MSF hospital, mostly suffering from gunshots and shrapnel injuries. Designed to help tackle the massive malnutrition crisis unfolding in the camp, which was declared as undergoing famine conditions by the Integrated Food Security Phase Classification last year, the MSF facility cannot provide trauma surgery for people in critical conditions.

“Eleven patients died while in the MSF hospital, five of them children, because we could neither treat them properly nor refer them to Saudi hospital, the only facility with surgical capacity in nearby El Fasher. In December and January, two of our ambulances carrying patients from the camp to El Fasher were shot at. Now it’s even more dangerous and as a result, many people, including patients requiring trauma surgery or emergency cesarian section, are trapped in Zamzam,” says Yahya Kalilah, MSF country director in Sudan.

“The sheer proximity of the violence, great difficulties in sending supplies, the impossibility to send experienced staff for adequate support, and uncertainty regarding routes out of the camp for our colleagues and civilians leave us with little choice.”

Yahya Kalilah, MSF country director in Sudan

The area has seen heavy fighting between the Rapid Support Forces (RSF) and the Joint Forces, the latter a coalition of armed groups allied with Sudanese government armed forces. This violence has had dreadful consequences on civilians. Besieging and shelling the town of El Fasher for the last 10 months, the RSF have stepped up their offensive in recent weeks and launched attacks against Zamzam camp, in particular on Feb. 11 and 12. People who were already struggling to survive now find their access to water and food even more compromised, as the central market has been looted and burnt down.  

“Halting our project in the midst of a worsening disaster in Zamzam is a heartbreaking decision. During more than two years, our teams did their utmost to provide care against all odds, despite the siege, supply shortages, and multiple other challenges, calling and waiting for a scaled up humanitarian response which never materialised,” says Yahya Kalilah. “However, as the battle for El Fasher rages on and now directly reaches Zamzam camp, the most minimal security conditions are currently not met for us to stay. The sheer proximity of the violence, great difficulties in sending supplies, the impossibility to send experienced staff for adequate support, and uncertainty regarding routes out of the camp for our colleagues and civilians leave us with little choice.”  

Hosting about 500,000 people, Zamzam camp saw new arrivals fleeing from Abu Zerega, Shagra and Saluma who are now staying in schools, community buildings or under the trees in the open. They have told our teams of dwellings set on fire, looting, sexual violence, killings, beatings and other abuses in villages and roads of El Fasher locality. Some hundred families also reached Tawila, sometimes barefoot after leaving everything behind and escaping horrific violence on their way.  

MSF is deeply concerned about the safety of our staff and the hundreds of thousands of people in Zamzam camp and urges the RSF, the Joint Forces and all armed actors in the area to protect civilians and let those willing to flee able to do so unharmed.  

In North Darfur, we continue to run emergency activities in Tawila while looking for every possible way to help people in Zamzam and El Fasher without exposing our staff to unacceptable risk levels. In West, Central and South Darfur and in other parts of the country, our teams keep responding to the catastrophic malnutrition and health crisis driven by a relentless conflict, continued obstructions of the warring parties and exacerbated by a failing humanitarian response. MSF reiterates our call to drastically scale up the provision of assistance in the many places where it remains possible. Warring parties must grant unhindered access for aid delivery, and their allies and influential states must use their leverage to ease the obstacles that are causing deaths and starvation.