The World Health Organization (WHO) has warned on Thursday that health threats are surging as the war in Sudan escalates and millions of people, many sick and wounded, flee for safety within Sudan and across borders to neighboring countries where health services are fragile and hard to reach. The war, which erupted more than three months ago between the Sudanese Armed Forces (SAF) and paramilitary Rapid Support Forces (RSF), is not contained within the country but has profound regional implications.
The conflict has displaced more than 3.5 million people, including nearly 2.7 million inside Sudan. Over 823,000 people have been forced to flee as refugees to neighboring countries, with many people reportedly arriving in poor health, carrying infectious diseases and other afflictions.
More than 80 percent of hospitals in the country are now out of service, according to the WHO. And non-governmental organizations (NGOs) across the western region of Darfur have sounded the alarm that at least 60 operational NGO-supported health facilities are likely to run out of critical medical supplies in the next two weeks.
Attacks on health care continue to be reported across the country. WHO has verified 53 attacks on health facilities since the conflict began, resulting in 11 deaths and 38 injuries and cutting off access to urgently needed care. These are only incidents the World Health Organization has been able to verify. Attacks on health care include incidents involving hospitals, ambulances, laboratories, warehouses, health workers and patients.
Disease outbreaks - including malaria, measles, dengue and acute watery diarrhoea - that had been under control before the conflict are increasing due to the disruption of basic public health services. As the rainy season begins, outbreaks are likely to claim more lives unless urgent action is taken to control their spread.
Nima Abid, World Health Organization (WHO) representative in Sudan, said Thursday the scale of the health crisis triggered by the conflict in Sudan was enormous, noting that the fragile health system in Sudan was unable to cope with the multiple emergencies and unable to respond to the huge public health needs.
Abid said that "all the organizational activities have stalled; vector control activities have stalled. Currently, we have a large measles outbreak with more than 2,000 cases and 30 deaths.
"I mean, even before the war, the vaccination coverage was not high," added Abid, noting that the Blue Nile and White Nile states were the most heavily affected. "So, now we have outbreaks affecting almost 10 states."
Abid also said he was concerned that cases of malaria, dengue and rift valley fever will rise during the current rainy season, noting that "all these vector-borne diseases are endemic in Sudan" and control measures have stopped.
"We do have an outbreak of cholera in South Kordofan," he said, "with more than 300 cases and seven deaths. So, all this will have an impact on the health system and public health in Sudan."
Neighboring Chad is hosting a quarter million Sudanese refugees, and the UN expects an equal number will arrive in the country by the end of the year.
"This will significantly increase the health needs and exert huge pressure on the available health facilities," said Jean-Bosco Ndihokubwayo, WHO representative in Chad.
WHO reports around 2,500 people are arriving in Chad every day, many with serious gunshot wounds, while many others arrive sick with infectious diseases, malaria and cholera. Ndihokubwayo cited malnutrition as the most serious health problem facing people in refugee camps.
"For the time being, we have more than 4,000 children who are suffering from serious malnutrition. Two hundred and fifty children are being hospitalized, 65 dead … and when this is combined with a disease like measles in children who are poorly nourished, it has huge effects as it does with our other current diseases," he said.
The World Health Organization reports cases of malaria among children under age 5, as well as suspected cases of yellow fever also have been identified among some 17,000 Sudanese who have sought refuge in the Central African Republic (CAR). The UN agency added that a suspected cholera outbreak has been reported among many displaced people in northern Ethiopia.
Magdalene Armah, Incident Manager for the Sudan Crisis, WHO regional office for Africa, said the African region has received 65 percent of the Sudanese population that has fled the country. She said it was important to establish cross-border operations to ensure that all vulnerable populations are reached with health care.
"We want to increase access to health care services by expanding the set-up of emergency teams that are in the various border regions”, Armah said.
"We want to ensure that vaccination campaigns can happen to mitigate further outbreaks. We want to ensure that disease surveillance goes down to the communities," she said, adding that it was important that humanitarian agencies had the funding to enable it to carry out these vital health projects.
WHO and its partners are working to deliver emergency assistance and medical supplies to people in Chad, as well as in CAR, Egypt, Ethiopia and South Sudan, as swiftly as possible. But WHO says resources are overstretched, so providing aid to those in need is becoming increasingly difficult.
To adequately respond to the crisis, WHO in June issued an emergency appeal for US$145 million. To date, only some 10 percent of the funds have been received.
In a related development, the international humanitarian organization Médecins Sans Frontières (MSF, Doctors Without Borders) warned Thursday that hundreds of thousands of people face disease outbreaks in overcrowded camps in Sudan’s White Nile state.
More than 140,000 people, mostly South Sudanese women and children fleeing from Khartoum, have newly arrived in White Nile state since conflict broke out in Sudan on April 15. They are now facing huge unmet needs for food, shelter, healthcare, and water and sanitation in ten camps, which host around 387,000 people, according to local authorities.
MSF teams working in some of these camps are overwhelmed with dozens of daily cases of suspected measles and malnutrition among children. The NGO said, as more people arrive, there is an urgent need to scale up assistance, including nutritional support and provision of shelter, food, clean water, sanitation and measles vaccinations to curb an outbreak.
The crisis in Sudan not only severely affects South Sudanese refugees still in the country, but also has a profound impact on neighboring South Sudan and the people seeking refuge there.
On Wednesday, humanitarian organizations in South Sudan called for urgent funding to ensure continued support for onward transportation for people fleeing the Sudan conflict to South Sudan. Since the outbreak of hostilities in Sudan, over 193,000 people have crossed into South Sudan. In June 2023, the number of new arrivals surged significantly, with approximately 15,000 individuals arriving from Sudan every week.
Until now, South Sudanese authorities and aid workers have been able to provide transportation by river, air and road. Without $26.4 million to finance the operation through the end of this year, aid agencies say they will run out of money in two weeks’ time and be forced to suspend assistance.
Humanitarian organizations working in Sudan also urgently require additional resources to scale up responses across the country. The revised Sudan Humanitarian Response Plan (HRP) requires US$2.6 billion to provide life-saving assistance and protection services until the end of this year. So far only 23.5 percent is funded, with $603.8 million received as of July 29.
Some information for this report provided by VOA.
Further information
Full text: Health needs heighten as Sudan conflict displaces millions of people, WHO press release, published July 27, 2023
https://www.emro.who.int/media/news/health-needs-heighten-as-sudan-conflict-displaces-millions-of-people.html
Full text: Hundreds of thousands face disease in overcrowded camps in White Nile state, Médecins Sans Frontières (MSF), press release, published July 27, 2023
https://www.msf.org/sudan-hundreds-thousands-face-disease-overcrowded-camps-white-nile-state
Full text: Critical funding gap for onward transportation for people fleeing Sudan risks to create a humanitarian catastrophe in the border areas, OCHA press release, published July 26, 2023
https://reliefweb.int/report/south-sudan/critical-funding-gap-onward-transportation-people-fleeing-sudan-risks-create-humanitarian-catastrophe-border-areas