Sudan Starves as War, Floods and Disease Take Their Toll
A WHO official providing nutrition support to internally displaced children in Gedaref state, Sudan.

Over half of Sudan’s citizens face acute hunger and three-quarters of a million are in danger of starving to death – the official definition of famine – yet international assistance has been slow and inadequate.

Conflict has killed approximately 30,000 people and forced over a fifth of the population of 50 million to leave their homes, most in the past 15 months since fighting began between the Sudanese Armed Forces (SAF) and the paramilitary Rapid Support Forces (RSF).

The warring factions, previously allies in a successful coup in 2021, have used heavy artillery on each other, destroying  infrastructure, including health facilities and homes.

The RSF, which evolved from the Arab Janjaweed militia, has also been accused of “ethnic cleansing” of non-Arab groups, particularly the Massalit in West Darfur.

“Targeting the Massalit people and other non-Arab communities by committing serious violations against them with the apparent objective of at least having them permanently leave the region constitutes ethnic cleansing,” Human Rights Watch noted back in May, reporting widespread killing and raping of civilians.

Others including the United Nations Special Adviser on the Prevention of Genocide, Alice Wairimu Nderitu, have warned that RSF may be involved in genocide.

“The global inaction in the face of atrocities of this magnitude is inexcusable,” said HRW executive director Tirana Hassan.

Famine in Darfur 

A malnourished child in one of the few remaining functional health facilities in Sudan.

The UN Office for the Coordination of Humanitarian Affairs (OCHA) reported last week that nutrition surveys carried out in all 18 states indicate “an alarming deterioration of the nutrition situation”.

The surveys recorded global acute malnutrition (GAM) of 30% and over – the famine threshold – in Al Lait, At Tawisha and Um Kadadah in North Darfur.

Over 80% of the surveys recorded a GAM prevalence of 15% and above, which is higher than the World Health Organization (WHO) emergency threshold. 

However, Sudanese military leaders have denied that there is a famine, which could trigger a UN Security Council resolution empowering agencies to deliver relief across borders, according to the BBC.

Meanwhile, Medecins sans Frontieres (MSF) warned that thousands of children could die of malnutrition in ZamZam camp for displaced people in North Darfur last month, and the independent Famine Review Committee confirmed that famine was “plausible” in the camp back in July.

Most supply roads to the camp are controlled by the RSF who have made it “all but impossible to bring therapeutic food, medicines, and essential supplies” into the El Fasher area since May, according to MSF.

“The malnutrition rates found during the screening are massive and likely some of the worst in the world currently,” says MSF’s Claudine Mayer. “It’s even more terrifying as we know from experience the results are often underestimated in the area when we use only the mid-upper arm circumference criteria, like we did here, instead of combining it with measuring [children’s] weight and height.”

Residents of the camp, which shelters about 500,000 people, held a protest on 30 September demanding that the RSF allow aid to reach the camp, reporting dire shortages of food, water and medicine, according to the Sudan Tribune.

OCHA warned that the nutrition situation is “expected to deteriorate further in 2025 due to ongoing conflict, food insecurity, compromised health, water, sanitation and hygiene (WASH) services, displacement, access constraints and disease outbreaks”.

Floods, cholera and malaria

In September, calamitous floods damaged more infrastructure and homes, exacerbating cholera, malaria and dengue fever and displacing even more people.

“Since the current [cholera] outbreak began in July 2024, over 18,000 cases of cholera and approximately 550 deaths have been reported in 10 states across the country,” according to UNICEF, which delivered 1.4 million doses of oral cholera vaccines to Sudan last week.

Vaccinations will be offered to people living in the hardest-hit states of Gedaref, Kassala and River Nile.

A UN humanitarian relief worker walks through the remains of a house destroyed by recent floods.

Save the Children’s interim country director, Mohamed Abdiladif, said that most of the child cholera deaths “are from other complications due to weakened immune systems due to malnutrition”.

“For children, the collapsing healthcare system is not only depriving them of emergency medical care, but also disrupting their access to essential routine services, including lifesaving vaccinations for children under five and maternity care for pregnant mothers. Cases of cholera, measles and dengue fever have risen exponentially in recent months, and now hundreds of people are losing their lives to entirely preventable causes,” he added.

Earlier in the week, UNICEF also delivered some 190,000 doses of malaria vaccines to help protect children from malaria.

“Ongoing disease outbreaks are pushing Sudan’s already fragile healthcare system to a breaking point and exacerbating weaknesses in the sanitation and hygiene infrastructure,” according to UNICEF.

“Limited access to safe water and adequate sanitation, especially in overcrowded displacement sites and camps increases the risk of transmission. Children who have never been vaccinated and those suffering from malnutrition are particularly at risk.”

WHO estimates that 70-80% of health facilities are either closed or barely operational in areas worst affected by conflict, such as Al Jazirah, Kordofan, Darfur and Khartoum, while about 45% of health facilities in other parts of the country are similarly affected.

Muted international support

US-backed peace talks held in Geneva in August were boycotted by SAF leader Abdel Fattah al-Burhan.

However, a group of mediators calling itself the “Aligned for Advancing Lifesaving and Peace in Sudan (ALPS) Group”, representing Saudi Arabia, Egypt and the United Arab Emirates (UAE), is negotiating for humanitarian aid.

But a Ministerial meeting convened by Germany, France and the US last month on the sidelines of the United Nations General Assembly in New York, failed to come up with any tangible aid plan for Sudan. 

“Participants expressed deep concern about the catastrophic and still rapidly deteriorating situation in Sudan,” according to a joint statement of participants issued after the meeting 

The meeting was attended by representatives of the UN, Germany, France, US, EU, African Union, the Intergovernmental Authority on Development (IGAD) in Eastern Africa, the League of Arab States, UK, Ethiopia, Uganda, Egypt, Saudi Arabia, UAE, Norway, Switzerland and Türkiye. 

Participants called on the warring parties to “immediately re-engage in negotiations, cease hostilities and finally end the war”. 

They also called on them to commit, as a first step, to “localised humanitarian pauses and ensure immediate humanitarian access to El Fasher, Sennar and Khartoum so that civilians are protected and humanitarian operations can reach those in most dire need of lifesaving assistance”.

They also appealed to “all foreign actors” to refrain from “providing military support to the warring parties and to focus their efforts towards building the conditions for a negotiated resolution of the conflict”. SAF has accused the UAE of arming the RSF (denied by UAE), while it may be getting arms from Iran.

While the statement also noted that the international community “should be prepared to explore options to support the implementation and durability of any future local or nationwide cessation of hostilities”, it did not propose any concrete actions.

Meanwhile, UN agencies report being woefully under-resourced to support the Sudanese people. Humanitarian organisations have requested $2.7 billion in aid, yet received less than half this, according to WHO Director General Dr Tedros Adhanom Ghebreyesus.

Tedros visited Sudan in mid-September ande descried seeing children “wasted to skin and bone” while their mothers pleaded for food.

Image Credits: @UNHCR, WHO, BBC, UN Office for the Coordination of Humanitarian Affairs (OCHA).

Combat the infodemic in health information and support health policy reporting from the global South. Our growing network of journalists in Africa, Asia, Geneva and New York connect the dots between regional realities and the big global debates, with evidence-based, open access news and analysis. To make a personal or organisational contribution click here on PayPal.