Since 15 April, different states in Sudan have been impacted by the fighting, the scale of violence, and limited access to healthcare and essential resources. This has drastically affected the lives of millions of people, leading to displacement and an influx of refugees seeking safety in neighbouring countries.
According to UNHCR, Sudan hosts one of the largest refugee populations in Africa, with 61 per cent of the population living outside of camps and 39 per cent settled in camps. Many refugees live in out-of-camp settlements, host communities, and urban areas, while others reside in camps, particularly in East Sudan and White Nile State.
For Ethiopian refugees like Salim* and Qamar*, who had already experienced escaping violence in their homeland, their journey from Khartoum to east Sudan was fraught with risks. They recounted the strenuous details of their journey with their four children after arriving at their second resettlement in camp in East Sudan, where MSF is providing medical and emergency support
"Our entry point to Sudan in November 2020 was the refugee reception centre in Hamadayet, situated on the Sudanese-Ethiopian border. From there, we were transferred to Um Rakuba refugee camp. Although we tried to adapt to life in the camp, our circumstances became worse when our tent burned down, destroying all our food and our children's clothes. Consequently, we made the decision to leave the camp and travel to Khartoum. I took my children and accompanied my husband to begin his heart disease treatment journey." said Qamar.
Fleeing violence in Tigray, Ethiopia, was not the end of their exposure to life-threatening situations. Little did they anticipate being caught in another wave of violence when the current conflict in Sudan erupted in April.
Salim recalls the details of his escape from Khartoum: "On the morning of April 15, the sound of gunfire and clashes erupted. I was outside our house and hurriedly returned home. The intensity of the fighting between the Rapid Support Forces (RSF) and the Sudanese Armed Forces (SAF) was overwhelming. The battle took place on the street directly opposite our house, with bombs raining down on the surrounding homes. The air was filled with the deafening noise of warplanes and explosions. I sought refuge while my children hid under the bed. It was disheartening to think that I had fled my own country due to war, only to face the possibility of death in the country I sought refuge in,” said Salim.
“Fifteen days later, our food supplies were depleted, and we ran out of money. Almost all our neighbours left Khartoum. One of our neighbours, upon learning of our dire situation, helped us reach the bus station and even covered the cost of our tickets to Wad Madani. As we departed, I witnessed smoke rising and buildings engulfed in flames. That horrifying scene will forever haunt me. Along the road, we encountered armed men at a checkpoint who questioned whether we were armed. I reassured them that we were refugees and simply wished to live peacefully with our children. They let us pass, but we trembled with fear."
The family spent 11 days in Wad Madani, finding temporary accommodation in a school that lacked basic services. Without transportation tickets to reach Um Rakuba in Al-Gedaref state, they struggled to provide food for their four children. The assistance of other families provided them with the necessary tickets to travel to Um Rakuba camp.
In Al-Gedaref state, MSF is operating standalone secondary health care hospitals in Um Rakuba and Tanedba refugee camps. These hospitals also provide care to a significant number of patients from the host communities. Prior to the current conflict, in Um Rakuba hospital, the majority of admissions to the therapeutic feeding centre were from the host community.
In recent years in Um Rakuba camp, our teams have been providing access to comprehensive primary, secondary and emergency medical care; including paediatric outpatient and inpatient support in addition to the therapeutic feeding and blood transfusion centres. We also provide referrals to secondary and tertiary healthcare facilities as well as for mental health services.
“As soon as I arrived at Um Rakuba camp, I took my children to the Doctors Without Borders hospital for treatment of skin diseases and diarrhoea they contracted during our escape from Khartoum. I don't have shelter, food, or anything here. I rely on the assistance of my relatives among the refugees in the camp. We appeal to other organizations to help us. We have nothing. We came to Sudan not for work or money. We came to save our lives and protect our children,” said Salim.
The situation through the eyes of children like 11-year-old Mondi*provides a distinct perspective on the impact of the conflict: "I was getting ready to go to school when I saw my mother terrified, asking us to hide under the bed. I cried along with my siblings because the sound of bombs was very frightening. I don't like war because it made me very hungry. My father couldn't buy food for us. I don't want to go back there; they made my siblings cry."
These words highlight the profound fear and trauma experienced by children who witness and endure the consequences of conflict.
“In the face of the current crisis, one of the biggest challenges in Um Rakuba refugee camp in east Sudan is access to safe shelter as well as the poor condition of current shelter infrastructure especially in the rainy season. A few days ago, some shelters were destroyed by heavy wind and rainfall. With the arrival of approximately 850 new refugees from Khartoum, the situation became worse. Some refugees are living with relatives in the camp, but most are in common shelter with poor living conditions. They are traumatized and have very limited access to essential services like food, shelter, and sanitation.” Zahir Gul, MSF project Coordinator in Um Rakuba.
MSF has been actively working in the refugee camp since 2020, providing vital support to refugees and host communities. Even before the current crisis, we were advocating for increased support to address the lack of services, where the consequences of significant funding cuts were already visible. Despite the current conflict, the security situation in this part of Sudan remains calm and relatively accessible. However, we are not seeing humanitarian organisations returning to resume activities to a level which meets the needs of the people in East Sudan. MSF appeals to donors and humanitarian organisations to redouble their investment to ensure that the most basic services, including adequate shelter, health, nutrition and protection assistance can be assured.
From April to June 2023, our teams in Um Rakuba provided around 4000 outpatient consultations to the host community and refugees. MSF also donated medical supplies and drugs to the Ministry of Health in the state to support Al- Gedaraf Hospital as of June 21.
Since the escalation of the current crisis in Sudan, MSF has been actively working in 12 states: Khartoum, Kassala, Al-Jazeera, West Darfur, North Darfur, Central Darfur, South Darfur, Red Sea, El-Gedaref, Blue Nile, and White Nile States.
*Names changed to protect anonymity.