“A catastrophic failure of humanity”: MSF denounces six months of shameful neglect in Sudan.

• Six months since conflict broke out, Sudan´s brutal war continues to inflict immeasurable suffering: endangering lives, displacing millions from their homes, and causing deaths even in areas far from frontlines. 
   
• To prevent a larger tragedy, MSF calls for a substantial increase in humanitarian efforts, the safeguarding of medical staff, humanitarian workers and civilians, for the removal of administrative blockages on medical and humanitarian staff and supplies, and for people to be allowed unhindered access to humanitarian aid. 

Six months into the war in Sudan, people´s lives are still in danger from bombings, shelling and the shootings - both directly and indirectly. Sudanese health staff and volunteers are struggling to respond to people´s medical needs and the country’s health system is on the edge of collapse, says MSF, whose teams note a shameful absence of humanitarian organisations working in the country. In those areas where assistance is being provided, the response is insufficient for people´s immense needs, says MSF which is calling for an immediate increase in humanitarian efforts.

“Sudan’s crisis epitomises a catastrophic failure of humanity, marked by the warring parties’ failing to protect civilians or facilitate essential humanitarian access, and by the dire neglect and shortcomings of international organisations in delivering an adequate response. Without an immediate, substantial escalation of the humanitarian response, what we are witnessing now will be the beginning of an even larger tragedy yet to unfold – meaning more people will continue to needlessly die.” --- Dr Christos Christou, International President of MSF

Health system is on the edge of collapse

Across Sudan, the fragile health system is struggling emergency rooms are congested, and many hospitals have closed completely. In the capital, Khartoum, MSF medical teams are witnessing one of the most intense urban conflicts currently taking place worldwide. Large numbers of injured people are arriving at the hospitals with life-threatening wounds, often leaving medical staff with no choice but to amputate.

“In both Khartoum and Darfur, many patients are critically injured to the extent that they need to have multiple rounds of surgery,” says MSF surgeon Shazeer Majeed. “On more than seven occasions in September alone, the hospitals where MSF operates received significant influxes of injured people following shelling, airstrikes, and explosions.”

Even for people who are not directly affected by the violence, are suffering the indirect effects of the war. There is a chronic shortage of medications across Sudan. Pharmacies have either run out of supplies or have hiked their prices, making many medicines unaffordable for those who need them. As a result, patients with chronic illnesses are suffering serious complications and sometimes dying.

“We are seeing critical cases arrive at the hospital, due to the lack of medicine, especially patients with illnesses like diabetes,” says MSF head of mission Frauke Ossig. “By the time they reach us, there´s often very little we can do."

Even in places easier to access, millions of displaced people are living in overwhelmed camps and makeshift sites like schools, after being displaced from their homes by the violence. People, including children, in these sites are dying of preventable diseases, such as malaria and measles, as there is a shameful lack of humanitarian response. In Khartoum, as well as in many camps the water systems have been destroyed or are inadequate, for people´s needs, raising risk of cholera outbreaks and more difficult to address suspected cholera outbreaks amid war. MSF teams are supporting the Ministry of Health in many locations to make sure that health staff are ready to respond to possible cholera outbreaks.

Humanitarian response is being hindered by Sudanese authorities

MSF´s own humanitarian response is being hindered by considerable bureaucratic and administrative hurdles imposed by Sudanese authorities. These include restrictions on movements of staff, travel permit rejections, delays in releasing medical supplies and bans on specific supplies, such supplies for surgery. In south Khartoum one of the hospitals supported by MSF has less than one week´s worth of essential supplies left to provide emergency trauma care to injured patients. Once these supplies run out, MSF teams will no longer be able to provide this care. 

“Any supplies that do reach health care facilities are quickly exhausted, leading to dire health consequences and even fatalities,” says MSF deputy head of emergencies, Claire Nicolet. “We desperately need surgical and medical equipment not just for trauma care, but also for obstetric surgeries, as we see many pregnant women in life-threatening conditions.”

With no end to the war in sight, MSF is calling for a substantial increase in efforts to provide humanitarian aid, for the safeguarding of medical, humanitarian workers, and civilians, for the removal of administrative blockages on medical and humanitarian staff and supplies, and for people to be allowed unhindered access to aid.

“Sudan´s healthcare system is on the brink of collapse, and without urgent action, the most vulnerable people will continue to bear the brunt of the violence, resulting in more avoidable deaths”, says MSF head of mission Frauke Ossig.

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MSF response in Sudan
·    MSF has been working in Sudan since 1979; today MSF teams work in 10 states: Khartoum, Al-Jazeera, White Nile, Blue Nile, River Nile, Al Gedaref, West Darfur, North Darfur, Central Darfur and South Darfur state. MSF teams are also providing assistance to refugees and returnees across Sudan´s borders in South Sudan, Central African Republic and Chad. 

·    MSF teams in Sudan are providing emergency treatment, carrying out surgery, running mobile clinics for displaced people, treating communicable and non-communicable diseases, providing maternal and pediatric healthcare, including safe deliveries, providing water and sanitation services, and donating medicines and medical supplies to healthcare facilities, and providing incentive pay, training and logistical support to Ministry of Health staff. MSF is also continuing some of its medical activities that were in place before the start of the conflict.  

·    Since the start of the war MSF teams in Bashair hospital, Khartoum, have carried out more than 1,500 surgical interventions, 93% for patients with violence-related injuries. MSF staff in Bashair hospital have also provided more than 300 maternity consultations. 

·    Since starting work in the Turkish hospital in Khartoum in June, MSF teams have received more than 8,600 people in the emergency room (including almost 1,500 children and over 1,900 adult patients – including maternity cases), performed 122 general/orthopaedic surgeries, and carried out 166 emergency caesareans/obstetric surgeries. Since August, MSF midwives have delivered almost 300 babies. 

·    In the past six months, MSF teams have been supporting the Ministry of Health in Omdurman, Khartoum state, who has received more than 10,000 emergency admissions. In Darfur, MSF has received more than 8,500 emergency admissions. MSF teams have conducted more than 16,000 consultations in Zamzam camp, in North Darfur state, and received more than 1,000 maternity and paediatric admissions in Um Duwwan Ban, Khartoum state. In Alban Jadeed hospital, in Khartoum, MSF teams have provided more than 5,000 consultations, almost a fifth of them being emergency cases. In White Nile state, MSF teams have provided more than 50,000 consultations. In Al-Jazeera state, MSF teams have provided more than 25,000 consultations. In the past six months, MSF teams across Sudan, teams have provided over 10,000 mental health consultations.

·    MSF´s response in Sudan has a budget of €76 million for 2023. MSF has 1,145 Sudanese staff and 57 international staff currently working in Sudan. MSF is also paying incentives to 1358 Ministry of Health staff.