MSF staff going through the Sudan conflict: "I feel saddened seeing months of our efforts reduced to ashes."

Saturday 15 April

I wake up to the news of fighting in Khartoum. It isn’t a complete surprise: after months of following the context, the challenges of the political transition, the movement of troops, and many other aspects of this complex environment, I’d had a hunch that conflict was coming. 

I would have much preferred to be wrong.

The three weeks I expected…

My name is Fleur Pialoux, I am the outgoing project coordinator for the MSF team supporting El Geneina Teaching Hospital in West Darfur, where MSF has supported the paediatric department since 2021.

The conflict broke out three weeks before the end of my assignment in El Geneina. I had imagined that I would spend those three weeks working on my handover report.

The measles outbreak was not receding, so I was planning to advocate hard for the authorities to set up vaccination campaigns. 

The team and I were going to finalise contingency plans so we’d be ready for the coming surge in malnutrition and malaria patients, conditions that are related to the changing seasons here.

We were also working on our strategy for supporting two new departments at the hospital: neonatology and maternity. 

And I was looking forward to throwing our big staff Eid celebration, with delicious food and catchy Sudanese tunes. It would double as my goodbye party, and while I was expecting to work until the last minute, my successor would already be in post to ensure everything would continue smoothly.

What actually happened.

On Saturday 15 April, I gathered the team who live in the MSF house here and briefed them on the conflict. We had a plan in place to reduce risks in case the situation escalated in El Geneina. 

The first step was to ensure that as much as possible, staff were not out on the street. We contacted our office colleagues and told them not to come in the next day. For the hospital, we ensured that essential care was covered by staff living close enough that they felt comfortable making the short journey.

We set up a phone tree, to ensure we could regularly check on all our colleagues ahead of these uncertain times.

In the MSF staff house, we worked quickly to ensure we had food, water and essential commodities.

After that, we didn’t leave the house for 14 days. 

The first week was relatively calm compared to the violence in Khartoum and cities in Darfur such as El Fasher and Nyala. International colleagues from other organisations evacuated, but initially we stayed, hoping that the calm would remain and that we would be able to keep providing healthcare in the hospital. 

Then on 20 April, the day of Eid-al-Fitr, all remaining patients and staff fled the hospital, fearing for their lives. The hospital was effectively closed, despite the best efforts of several staff in its administration. 

On 24 April the conflict hit El Geneina.

Armed groups started targeting key locations inside the city. In the following days, fighting broke out in most neighbourhoods. Looting of the market, hospital, pharmacies and cars became the daily norm. Rumours and hate speech hit social media. 

From our windows we saw the smoke as sites that had been hosting more than 100,000 displaced people were burnt to the ground.  Across the city, people were left without power and water for days. Mobile networks were down. Banks were closed and unable to process payments, leaving many people with no access to money for essentials like food, fuel or medicine. Hundreds of people were wounded or killed, but virtually no health facilities were able to function. 

We spent several nights on the floor, privileged to have access to a bunker, while the city faced crossfire and mortars. I spent those last weeks of assignment working 15 hours a day, crosschecking information, giving updates, assessing risks and preparing for an eventual evacuation into neighbouring Chad. 

The situation now

The moment the last member of our relocatable team crossed the border into Chad, met by MSF colleagues, I felt immense relief. 

A minute later came everything else. 

Days of fear, stress and uncertainty. The guilt at having been able to leave the country, while our Sudanese colleagues and patients were still in El Geneina. The acute awareness that patients had been left without care. 

The grief of seeing months of efforts poured into the El Geneina Teaching Hospital and our ambitions that even more people would be able to access life-saving care, reduced into ashes. 

The empathy for our few relocated Sudanese colleagues, scared for their families in places like Khartoum. 

Finally, even after years of working alongside displaced people and hearing their stories, came the first-hand, hard realization that safety and security is the bedrock of all human needs, and the search for it will make you endure everything else. 

Home

Now, safe at home, I take solace on the fact that MSF remains committed to providing healthcare in West Darfur. A specialist emergency team and medical cargo has already been organized to start meeting some of the immense medical needs in the region. 

The coming peaks in malaria and malnutrition will not wait for the conflict to be over. The deadly measles outbreak will not abate on its own. Mothers and children remain the most vulnerable. 

Whether in El Geneina or border areas in Chad, I hope to go back one day. I hope for peace for the people of Sudan, and to enjoy sweet tea and Sudanese hospitality, and everything else that made fall in love with this country.  

Soon, inshallah, as we say in Sudan.

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Fleur Pialoux is a French humanitarian worker who has been working with MSF for over 6 years in various positions across different contexts such as South Sudan, Ukraine, DRC, Iraq, Tanzania, and Guatemala. She is the outgoing Project Coordinator in Sudan, in El Geneina, the capital of West Darfur, where she ensured that necessary support has been provided to the community. She was also responsible for the safety and security of the team and patients.