Sudan Humanitarian Crisis

• According to UN OCHA in Sudan’s 2023 Humanitarian Needs Overview, “the four most significant risks identified are conflict, disasters associated with natural hazards, disease outbreaks, and economic deterioration.”
• At least 15.8 million people – one-third of the country’s population – were in need of humanitarian assistance as of January 2023, which was an increase from 14.3 million in 2022. However, since April 15 the number of people in need dramatically increased. In the revised Humanitarian Response Plan, 24.7 million people were identified as being in need, and 18.1 million are targeted in the plan. IOM is predicting that this could grow to 26.5 million. From April to Aug. 15, 3.5 million people had been reached. In the prior plan, 57% of people in need were women, 55% were children and 15% had disabilities.
• Humanitarian workers have faced increasing violence. Dozens of warehouses and offices of humanitarian operations were looted. More than 200 vehicles have been stolen from humanitarian aid workers. Despite this, there are 117 organizations supporting the people of Sudan, including 53 national nongovernmental organizations (NGOs), 50 international NGOs, nine UN agencies, four government partners and the Sudanese Red Crescent.
• The annual flooding season affected thousands of people this year, despite starting a couple of months later than last year. Over 72,000 people have been affected, including more than 6,600 homes damaged and 5,823 homes destroyed. According to the 2023 Sudan Floods Dashboard, the Northern state had the most number of people affected (34,000).
• The cost of the war, as measured by economic loss, is estimated to be $80 million daily. The Sudanese economy has declined rapidly and the exchange on the market to U.S. dollars is unfavorable.
• On Sept. 9, Volker Perthes, the UN special envoy to Sudan, resigned. In his final speech to the UN Security Council he warned that the violence had “worsened dramatically” and the conflict “could be morphing into a full-scale civil war.”
• According to IOM, from April 15 to Sept. 17, 2023, the Displacement Tracking Matrix (DTM) “estimates that 4,232,840 Individuals (845,779 Households) have been recently internally displaced. The IDP caseload has been observed in 3,929 locations across all of Sudan’s 18 states … The majority (2,875,125 IDPs, 67.92%) have been reportedly displaced from Khartoum state, followed by South Darfur (15.11%). DTM Sudan also estimates that approximately 2.83% of the IDP caseload are non-Sudanese nationals. In addition to the internal displacement, the conflict in Sudan has caused the Mixed Cross-Border Movements of 1,180,626 individuals into neighbouring countries namely Egypt, Libya, Chad, Central African Republic, South Sudan and Ethiopia. 67% of arrivals tracked in those countries were Sudanese nationals and 33% estimated foreign nationals and returnees. The majority of arrivals were reported in Chad (40.7%), Egypt (27.4%), and South Sudan (23.2%).”

As of Sept. 8, there have been at least 7,500 fatalities, according to the Armed Conflict Location & Event Data Project (ACLED). These numbers include military deaths.

From Aug. 5 to Sept. 1, the ACLED recorded 2,280 reported fatalities. Of these, more than 1,400 fatalities and 300 political violence events were in Khartoum and there were 40 events in South Darfur with 380 fatalities.

Civilian deaths are much harder to track with different sources reporting a variety of numbers. While this presents a challenge, all numbers are significant and include attacks on aid workers and facilities. Dabanga Sudan, Sudan’s independent newspaper, reported that the Sultanate of Dar Masalit has claimed that more than 5,000 people were killed and 8,000 injured in 17 attacks in El Geneina between April 24 and June 12.

Survivors have claimed that the attacks on El Geneina and the surrounding areas were reminiscent of the Rwandan genocide. In July, CNN reported local sources that increased the number of fatalities in West Darfur to 10,000.

On Aug. 16, Radia Dabanaga reported: “The UN High Commissioner for Human Rights says that the initial toll indicates that 4,000 people have been killed since the war broke out in April, including hundreds of civilians, including 28 humanitarian and health workers and 435 children.”

The lack of medical facilities has hindered accurate tracking, as official sources generally use hospital death data.

On Sept. 3, BBC reported that the official total from the Health Ministry was only 1,100 but that the real number was likely higher.

September has been a particularly deadly month for civilians, with dozens of deaths not yet recorded by ACLED. On Sept. 13, at least 20 people, including two children, were killed in the Kalakla al-Qubba neighborhood of south-west Khartoum, by an army strike.

On Sept. 5, a similar attack killed 32 people in Ombada neighbourhood in western Omdurman according to an activist group Emergency Lawyers. At least 19 people were killed in the same neighborhood on Sept 3.

On Sept. 10, a drone attack on an open market in Khartoum’s May neighborhood killed 43 people and wounded 55 others according to the activist group, The Resistance Committees.

The health care system in Sudan was already weak, and the fighting has significantly reduced medical access as health facilities have been attacked, destroyed or had to close their services. The shortage of food, fuel and supplies is also concerning, as are power outages and dangers to staff and patients.

On Sept. 6, Dr. Tedros Ghebreyesus, the Director-General for the World Health Organization, said, “About 65% of the population has no access to health services and more than 70% of health facilities in conflict areas are not functioning. The implications are horrific. Every day, nine patients with renal dialysis die, and dialysis centres in four states have closed due to lack of supplies … Meanwhile, attacks on health have continued to increase. So far, WHO has verified 56 attacks on health care, leading to 11 deaths and 38 injuries. WHO condemns in the strongest terms the increasing attacks on health care in Sudan, and the occupation of health facilities … The health situation at Sudan’s borders is dire, with a combination of disease outbreaks, impact of extreme weather events, hunger and malnutrition.”

According to the WHO Surveillance System of Attacks on Healthcare, details further the attacks mentioned above. Since the start of the conflict, WHO has verified 56 attacks on health care resulting in 11 deaths and 38 injuries. Of these, 36 attacks impacted facilities, 23 impacted personnel, 16 impacted supplies, eight impacted transport, seven impacted patients and six impacted warehouses.

Types of attacks are broken down into several categories including individual weapons (30 attacks), psychological violence (27), assault (17) and heavy weapons (11).

These attacks have lessened as the conflict has continued with the highest number occurring in April (27) but only three in August. They are not solely related to the current conflicts as there were 23 in 2022 and 29 in 2021. There was one other attack before April 14, 2023.

According to UN OCHA, “The Health Cluster has reported that the number of suspected measles cases across Sudan has increased by more than 1,000 new cases, compared to the 3,311 cases reported last week and reached 4,334 cases since April. This includes 127 deaths (40 more than those reported last week), representing a case fatality rate of 2.9 per cent. White Nile State accounts for 98 deaths—77 per cent of measles-related deaths.”

Additionally, UN OCHA added, “Between 15 May and 12 September, 1,222 refugee children under five died in White Nile State, UNHCR reported in its latest Sudan Health and Nutrition Update.  Most of the deaths were linked to suspected measles and underlying malnutrition. This is a more than a 120-fold increase on a year-on-year basis. From April to September 2022, there were 10 deaths of refugee children under the age of five in 10 refugee camps/settlements in White Nile State, according to UNHCR. The UN Children’s Fund (UNICEF), Médecins Sans Frontières (MSF), Plan International, Save the Children and UNHCR have supported the State Ministry of Health in Whtie Nile to carry out a measles vaccination campaign. About 6,400 children were reached during the first round of the campaign in July, and about 45,500 children under five years (107 per cent of the target) were vaccinated during the second round in August that targeted refugee camps in the state.”

The ongoing conflict will have an outsized and enduring impact on children. They are losing out on education, they are being exposed to trauma and war, and even being used in the fighting as child soldiers. Some young girls are being married off, in a desire to prevent sexual exploitation, although that act itself can also be seen as exploitative.

Children are dying of preventable diseases because of the lack of medications, health care professionals and vaccines. They are also being killed in the fighting. Philanthropists funding in Sudan must be understand that the enduring effect of war on children will require long-term solutions, including building local capacity in the children’s care sector.

UNICEF reports that more than 13.6 million (1 in 2) children are in urgent need of humanitarian aid. At least 1.7 million children have been newly displaced, adding to the 1.9 million children who were displaced before this crisis.

On Sept. 19, UNICEF spokesperson James Elder said, “333,000 children will be born in Sudan between October and December. They and their mothers need skilled delivery care. However, in a country where millions are either trapped in warzones or displaced, and where there are grave shortages of medical supplies, such care is becoming less likely by the day … Nutrition services are equally devastated. Every month 55,000 children require treatment for the most lethal form of malnutrition. And yet in Khartoum less than one in 50 nutrition centres is functional, in West Darfur it’s one in 10.”

UNICEF, released a statement in July stating that at least 435 children have been killed since April 15 and more than 2,025 children have been injured. They also state that there is an average of at least one violation of children’s rights every hour (more than 2,500 total).

Ted Chaiban, UNICEF Deputy Executive Director for Humanitarian Action and Supply Operations stated, “Every day children are being killed, injured, abducted and seeing the schools, hospitals and the vital infrastructure and life-saving supplies they rely on damaged, destroyed or looted.”

James Elder of UNICEF said, “Sudan is already facing one of the largest learning crises in the world, with more than seven million children out of school, and 12 million waiting for the schools to re-open. For children education is about more than the right to learn. Schools can protect children from the physical dangers around them – including abuse, exploitation, and recruitment into armed groups. Should the conflict result in schools remaining closed, this will have devastating impacts for children’s development and psychosocial wellbeing.” Being out of school puts young people at increased risk of recruitment in one of the armed groups, sold in child marriage or forced into child labor.

There are 1.7 million children under the age of one who are at risk of missing one or more essential vaccinations.

At least 14.9 million people are in need in the WASH sector, according to the updated Sudan Humanitarian Needs Overview 2023, dated Aug. 15, 2023. The amount of funding needed has grown from $129 million to $230.9 million and only $41.2 million has been received.

UNICEF has found that, “Inadequate water, hygiene and sanitation practices poses major risks for communities especially children. Moreover, water and sanitation related diseases are one of the leading causes of death for children under five. In Sudan 17.3 million people lack access to basic level drinking water supply and are at risk of disease. About 24 million lack access to proper sanitation facilities. Sanitation coverage has stagnated with more than 10.5 million people practice open defecation. This poses a major hazard to children and communities and has a significant impact on food security, rising malnutrition, disease outbreaks, conflict, and ultimately child morbidity and mortality.”

Key infrastructure, including pipes, has been damaged by the fighting (although it was not well maintained prior). Residents are using the Nile River for all water needs, including drinking, bathing and cleaning.

Sudan, as an agricultural nation, uses 97% of its water to support that industry, but climate change – including water scarcity and desertification – is affecting that water supply as well.

One of the key goals of the WASH sector will be to create better gender-sensitive sanitation and basic water services for millions of women and girls.

Sudan’s economy remains in crisis, with high inflation, a shortage of foreign currency and a large national debt. The country is struggling to provide basic services to its citizens, and many people are experiencing food insecurity and poverty. Even prior to the latest civil war it had the highest poverty rate in Northern Africa.

The 2022 poverty rate was 15.3% when looking at the $2.15/day marker. But when increased to the lower middle-income poverty rate of $3.65/day, the rate jumped to 49.7%. The upper middle-income poverty rate of $6.85 shows a rate of 86.2%. While the GDP were expected to grow in 2023, the war has caused the economy to freeze. Food prices have increased dramatically and the banking system has essentially collapsed. The informal economy is behind much of the employment currently.

According to the World Bank, “The secession of South Sudan [in 2011] led to multiple economic shocks, including the loss of oil revenue that had accounted for more than half of the Sudan government’s revenue and 95% of its exports. This has reduced economic growth and resulted in double-digit consumer price inflation…”

Since 2011, inflation has increased to triple-digit numbers, although it decreased throughout 2022. As of January 2023, school fees had increased 400% and oil prices had grown by 300%.

There are ongoing concerns about human rights abuses in Sudan, including reports of extrajudicial killings, arbitrary detentions, and restrictions on freedom of expression and association. The government has taken some steps to address these issues, but progress has been slow. The protection issues have been amplified by the war, with fighting happening in urban areas leading to civilian deaths.

According to Amnesty International, there have been “extensive war crimes including mass killings of civilians, rape and sexual slavery of women in the ongoing conflict … Amnesty detailed waves of violence in West Darfur province —one of five constituting the Darfur region — including the killing of civilians, looting and destruction of homes and facilities such as the main hospital and markets.”

On July 13, the UN Security Council was informed about a mass grave of 87 bodies found outside the region’s capital El-Geneina. Most are Masalit, who are often targeted by the RSF and their allied militias, especially Arab militias. It is believed they were killed between June 13-21. This ethnic cleansing is reminiscent of the genocide in Darfur in 2003, which killed hundreds of thousands of people.

The Council on Foreign Relations reports that the group most at risk varies by location. They said, “With places like El-Obeid, Kadugli, and El-Geneina becoming arenas of conflict, many Sudanese civilians have been caught in the crossfire. The Washington, D.C.-based Search for Common Ground (SFCG) found that children were most impacted in Blue Nile and North Kordofan, elders were most affected in Khartoum, and women were disproportionately affected in Gadarif and Kassala.”

As of Sept. 19, more than 4.2 million people (and over 845,779 households) have been displaced internally. This is more than 1.2 million additional people since Aug. 1. People relocated to almost 4,000 locations across all 18 states. This is the highest number of internally displaced people in the world.

The majority of IDPs were displaced from Khartoum state (67.92%), while South Darfur has 15.11%, North Darfur had 8.45%%, Central Darfur had 3.76% and West Darfur had 3,70%. There were also less than 1% displacement from each of South Kordofan (0.59%), North Kordofan (0.46%) and Aj Jazirah (0.01%).

The majority (55.62%) came from urban areas, while 44.38% are from rural communities.

UNHCR said, “All the neighbouring countries impacted by this new emergency were already hosting large numbers of refugees and internally displaced people on insufficient and dwindling levels of humanitarian funding. At the same time, countries like Chad and South Sudan (the two least developed countries in the world) were battling hunger, insecurity, and the impacts of climate change. Now the conflict is disrupting trade and supply chains, pushing up the costs of food and fuel.”

It is important for funders to consider the needs of host countries as they receive refugees.

In Venezuela, another large refugee crisis CDP is monitoring, the needs of receiving communities are often overshadowed by the needs of the sending country, but they are equally important. The same is true for Sudan and its neighbors. The influx of refugees is adding to pre-existing problems in the countries.

The Council on Foreign Relations points out: “Five of the seven countries bordering Sudan have recently suffered internal conflict, and refugees who previously fled violence and famine in Ethiopia and South Sudan are now returning to their home countries alongside Sudanese nationals. Additionally, countries are concerned about spillover conflict and potential foreign interference; Egypt has close ties to the SAF, while Libyan warlord Khalifa Haftar, reportedly backed by Russian mercenaries, has sent military supplies to the RSF. The crisis could also threaten regional economic cooperation on Nile River water resources and several major oil pipelines that cross through Sudan. UN experts say Sudan’s neighbors need far more assistance. The Central African Republic has called for more aid, as its own internal conflict has rendered it ill-equipped to handle incoming refugee flows. Chad closed its land border with Sudan but continues to aid refugees that make it across. Meanwhile, Egypt’s border remains open, but reports say crossings are often delayed for days, and there are worries about the country’s ability to absorb refugees. Several countries in the Horn of Africa and Sahel regions—including Chad, Djibouti, Egypt, Eritrea, Kenya, and South Sudan—have participated in peace negotiations in hopes of stemming these issues at their source.”

Nearly 275,000 people have fled Sudan for South Sudan, which won independence from Sudan in 2011. South Sudan is facing a massive hunger crisis and has its own shaky power-sharing leadership agreement. However, the terms of the peace deal signed in 2018 after a five-year civil war that caused 400,000 deaths, have not been met.

The United Nations envoy to South Sudan says that the crisis in Sudan should “serve as a wake-up call for Juba” (the capital of South Sudan). He adds, “‘[The situation] reinforces the imperative to move swiftly in strengthening the foundations for peace, stability and inclusive governance. A conducive political and civic environment is required for all political parties, civil society groups, media and all South Sudanese.’ The United Nations has repeatedly criticised South Sudan’s leadership for its role in stoking violence, cracking down on political freedoms and plundering public coffers.”

Due to its own crises, South Sudan faces many challenges in welcoming and meeting the needs of the Sudanese refugees. The Acting Humanitarian Coordinator for South Sudan, Peter Van der Auweraert said, “When people arrive South Sudan today, they are more vulnerable than they used to be, they are more likely to be undernourished, they are more likely to be sick and they are more likely to need more assistance than before.”

Learn more about the South Sudan Humanitarian Crisis.

In Egypt, where nearly 325,000 people have fled, a coordination platform has been developed by 14 organizations operated by Sudanese refugees and migrants. More than two million Sudanese already live in Egypt. The New Humanitarian reports that they are operating under the belief that “The best experts to assist refugees are the refugees themselves … The organisations have been helping new arrivals find affordable apartments and free temporary shelter, and are offering a range of other services, from psychosocial support and enrolling children in local schools to helping people formally register as refugees.”

As of Sept. 2023, more than 20 million people are facing severe food insecurity. This is an increase of five million people since the fighting broke out, and it was 13 million in 2022.

According to the Famine Early Warning Systems Network, the majority of the country is in crisis phase (level 3), with a few areas of stressed (level 2) and several areas of emergency (level 4). The latter aligns with areas of the highest numbers of internally displaced people. August and September are typically the leanest months in Sudan, as they are during the growing season. While the harvesting season (October 2023 to February 2024) may reduce this to 15 million, the long-term outlook is not good.

According to the Integrated Food Security Classification (IPC), “Conflict and economic decline have driven about 20.3 million people across Sudan (over 42 percent of the country’s population) into high levels of acute food insecurity, classified in IPC Phase 3 or above (Crisis or worse) between July and September 2023. Of those, 14 million people (29 percent of the population) are … in IPC Phase 3, Crisis, and almost 6.3 million people (13 percent of the population) are experiencing worse conditions in IPC Phase 4, Emergency. The most highly food insecure populations are in locations and states with active conflict, including West Darfur (where 62 percent of the population is highly food insecure), Khartoum and South Kordofan (56 percent of the population in IPC Phase 3 or above in these states), the Central Darfur, the East and the South Darfur as well as West Kordofan (53 percent of the population is in IPC Phase 3 or above in these states).”

The IPC also said that food insecurity has increased because of the looting and attacks on markets, water facilities, banks and public buildings. “The price of food and essential commodities has soared, limiting access to the market for the population. According to reports from numerous states, including those unaffected by the ongoing fighting, the conflict between SAF and RSF in Sudan is endangering the production of staple crops this year.”

UNICEF says that 3.4 million children under the age of five suffer from acute malnutrition, up from three million before the fighting started. The number jumps to 4.6 million when including pregnant or nursing mothers. Of these, 690,000 are severely malnourished, up from 612,000 children. Much of this increase comes from families displaced by the crisis.

The World Food Programme (WFP) has been able to assist 2.7 million people since the fighting began. However, their distribution has been hampered by the violence, and they suspended services temporarily after three WFP aid workers were killed.

Food prices have more than doubled since April 15 when the fighting began.

WFP says that the price of a local food basket in August had reached $1.07 USD, a 23% increase from August 2022. In July 2023, food costs were $1 and before the fighting began, the food basket price was just  from $0.74. At the same time, the foreign exchange rate has increased, and the daily labor wage rate has decreased.

WFP reports that inflation is reducing people’s ability to meet basic needs, with 36% unable to afford the contents of a WFP food basket. About 85% of households spend 65% of their income just on food and overall, food prices are 228% higher than two years ago.

A Rapid Gender Analysis on Power and Participation conducted by CARE in Sudan’s Kassala State showed women are often not consulted in decision-making, and social norms are a key barrier towards greater inclusion. The report highlights opportunities to enhance women’s participation and leadership. Bringing women (and youth) into community organizing can reduce extremism.

Gender-Based Violence (GBV) is increasing. As many as 4.2 million women and girls face the risks of GBV.

There are several types of gender-based violence present in Sudan. CARE’s Rapid Gender Analysis was conducted in early 2023, ending just as the conflict was beginning. They are clear that the conflict will have only increased the risks for women and girls in the country and in surrounding countries.

In particular, the report calls attention to, “The types of GBV identified in Sudan include domestic / family violence (e.g., hard beating, psychological abuse), community social violence (e.g., exclusion, humiliation), harmful traditions and customs (e.g., early marriage, FGM/C [female genital mutilation/cutting]), and violence during war (e.g., rape, killing). Women experience several challenges related to GBV – beyond the act of violence itself – such as stigmatization of reporting and the normalization of domestic violence. GBV is so prevalent due to unequal laws the enable it, patriarchal gender norms, economic hardship, insecurity and conflict, and the absence of law enforcement. It is driven internally by the family by the deep need to protect family honor.”

Sudan is also subject to the impacts of climate change. Sudan is one of the ten countries in the world most vulnerable to climate change.

These vulnerabilities include seasonal rains becoming more unpredictable, increasingly frequent droughts and rise in temperature. Land degradation and forestation compound the impacts of climate hazards.

Climate change has also been a source of conflict due to competition for water resources, grazing land and pastures. Available evidence suggests that climate change has also heightened competition for access to water sources, pastures and traditional grazing lands.

According to UNEP research, “approximately 40% of internal conflicts over the past six decades can be attributed to the exploitation of natural resources, including competition over scarce resources, such as fertile land and water.”