Sudan’s two years of war
Millions living in world’s largest humanitarian crisis sink deeper into despair with no end in sight
As the war in Sudan between the Rapid Support Forces (RSF) and the Sudanese Armed Forces (SAF) enters its third year, people remain unseen, bombed, besieged, displaced and deprived of food, medical care and basic vital services. Sixty per cent of the country’s 50 million people need humanitarian assistance, according to the United Nations (UN), and people are facing simultaneous health crises and limited access to public healthcare.
Doctors Without Borders/Médecins Sans Frontières (MSF) calls on warring parties and their allies to ensure civilians, humanitarian personnel and medical teams are protected and that all restrictions are removed on the movements of humanitarian supplies and staff, especially as the rainy season approaches.
“The warring parties are not only failing to protect civilians – they are actively compounding their suffering,” says 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.”
“These compounding crises reflect not just the brutality of the conflict, but the dire consequences of the crumbling public healthcare system and a failing humanitarian response.”
Marta Cazorla, MSF emergency coordinator
As frontlines have shifted over the course of the war, especially in Khartoum and Darfur, civilians 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 neighbourhoods and occupation of medical facilities. Both sides have laid siege to towns, destroyed vital infrastructure and blocked humanitarian assistance.
Widespread starvation is taking hold, 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 and has since spread to 10 more areas. An additional 17 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 two in South Darfur. The over 17,000 children, in 11 of the 14 localities, who received vaccinations were also screened for malnutrition, showing seven per cent of those screened suffering from severe acute malnutrition and 30 per cent from global acute malnutrition. In December 2024, during a therapeutic food distribution in Tawila locality, North Darfur, MSF teams screened over 9,500 children under five years old. They found a staggering 35.5 per cent global acute malnutrition rate, with seven per cent of the children suffering from severe acute malnutrition.
Simultaneously, Sudan is facing multiple, overlapping health emergencies. 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, the capital of South Darfur, 26 per cent of the 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. 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 healthcare system and a failing humanitarian response,” says Marta Cazorla, MSF emergency coordinator.
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 320,000 people were admitted in our emergency wards.
“Buildings were destroyed, even beds were looted, and medicines were burned to the ground. From afar, it looked like a hospital, but when you entered it, it was a shelter for snakes and grass.”
Muhammad Yusuf Ishaq Abdullah, MSF health promotion officer in Tawila, North Darfur
More than 13 million people have been displaced by the conflict, according to the UN – many of them multiple times. Of these, 8.9 million remain displaced inside Sudan, while 3.9 million have crossed into neighbouring countries. Many live in overcrowded camps or makeshift shelters, without access to food, water, healthcare or a sense of future. People depend entirely on humanitarian organizations – but only where these organizations are responding.
Health facilities destroyed
According to the World Health Organization (WHO), more than 70 per cent 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 healthcare workers assaulted, threatened or killed.
“Buildings were destroyed, even beds were looted, and medicines were burned to the ground. From afar, it looked like a hospital, but when you entered it, it was a shelter for snakes and grass,” says 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.
These attacks must stop – medical personnel and facilities are not targets.
Upcoming rainy season
The rainy season, fast approaching, threatens to make an already catastrophic situation even worse – severing supply routes, flooding entire regions, and cutting off people 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.
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 the 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 two years too long, they cannot and should not wait any longer.
