Sudan Humanitarian Crisis

• Since fighting broke out on April 15, 2023, more than 15,500 fatalities were recorded in the most recent report from the Armed Conflict Location & Event Data Project (ACLED).
• In addition to Sudan’s standing vulnerability to conflict, disasters associated with natural hazards, disease outbreaks and economic deterioration, the Sudan Humanitarian Needs and Response Plan (HRP) 2024 found extensive damage to critical infrastructure. An estimated 70% of health facilities in conflict-affected states are non-operational.
• It is expected that 25 million people in Sudan, more than half the population, will need humanitarian assistance in 2024. Of those, 26% are women and 48% are children. IOM predicts this could grow to 26.5 million – a significant increase from previous years: 15.8 million people in January 2023 and 14.3 million in 2022.
• According to the Famine Early Warning Systems Network (FEWS NET), famine warnings are in place from March to September 2024 in Khartoum, West Darfur and hard-to-access areas of Darfur region with high concentrations of displaced people.
• The International Organization on Migration’s (IOM) Displacement Tracking Matrix found an estimated 6.6 million internally displaced people (IDP) since April 15, 2023.
• Women and girls are disproportionately impacted by conflict, where sexual violence is used as a weapon of war. According to CARE International, “Even before the most recent conflict, a staggering 3 million women and girls lived in fear of sexual or gender-based violence.”
• 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, 163 organizations support the people of Sudan, including 87 national nongovernmental organizations (NGOs), 58 international NGOs, 11 UN agencies, six government partners and the Sudanese Red Crescent.
• The conflict has taken a toll on the economy, resulting in Sudan’s real gross domestic product (GDP) likely decreasing by 18.3% in 2024. The conflict has halted production and destroyed human capital and the country’s industrial, financial and technology base.

Since the start of the current civil war, civilians, including humanitarian personnel, have been killed in both deliberate and indiscriminate attacks by both the RSF and SAF.

As of April 5, 2024, there have been more than 15,550 deaths, including military and civilian casualties, according to ACLED.

The latest situation update also found that between Feb. 10 and March 8, 2024, 140 battles and almost 120 events of violence against civilians were recorded. During this period, the number of incidents of violence against civilians was 89% higher than in the previous four weeks.

Researchers have mentioned that these numbers are “a conservative estimate due to methodological limitations of real-time reporting in a conflict of this nature.”

The Guardian has also emphasized this point, saying, “But that figure is a significant underestimate, because much of the country is too dangerous for observers to enter.

The violence and insecurity have resulted in movement restrictions for Sudanese populations and humanitarian actors, preventing many from receiving aid. In December 2023, ACAPS released its annual Humanitarian Access snapshot and rated the constraints on humanitarian access in Sudan as extreme (5 out of 5).

Previous concerns about human rights abuses were amplified by the current civil war after a new UN report detailed horrific violations and abuses by the RSF and SAF. The report details the use of arbitrary detention, torture, sexual violence on women and girls, recruitment of child soldiers and extreme violence, such as beheading against civilians.

As the war spirals and atrocities mount, the U.S. determined the two warring parties have committed war crimes, including crimes against humanity and ethnic cleansing in Darfur.

Since the start of the conflict, more than 8.7 million people have been displaced within and across borders, making it the largest internal displacement crisis in the world.

Before the outbreak on April 15, 2023, Sudan was already hosting approximately 3.8 million IDPs, many of whom were displaced during the 2003 crisis in Darfur. The number of IDPs grew exponentially over the last year, representing over five times the number of individuals displaced in 2022. Women make up almost 70% of IDPs.

Khartoum remained the top state of origin, with approximately 54% of IDPs displaced since April 2023, followed by South Darfur and Aj Jazirah. On December 15, 2023, new clashes in Wad Medani between SAF and RSF led to the widespread displacement of almost 625,000 IDPs. This also resulted in a suspension of all humanitarian aid operations.

Meanwhile, over 1.8 million people, primarily women and children, have fled Sudan and sought refuge in neighboring countries, Central African Republic (CAR), Chad, Egypt, Ethiopia and South Sudan. Many of the countries were already hosting large numbers of refugees and IDPs on insufficient funding, limited supplies and poor infrastructure. There is significant fear and potential for the crisis in Sudan to develop into a regional one due to spillover of conflict, political tensions, and trade and economic disruptions.

Even after one year of war, thousands are crossing borders. In South Sudan, on average, 1,800 people arrive daily, exacerbating ongoing humanitarian needs. As of April 2024, nearly 640,000 Sudanese refugees have entered South Sudan.

Similarly, the UN Refugee Agency (UNHCR) in Egypt has seen a five-fold increase in refugees in the last year, with the daily average between 2,000 to 3,000 asylum-seekers from Sudan.

Humanitarian organizations supporting the influx of refugees are seeing dwindling supplies and resources. Most recently, in Chad, hundreds of Sudanese refugees in camps are unable to access vital medical care for injuries sustained during battles in Sudan. According to Nour-eldieen Mohamed, “there are not enough doctors here.”

One year since the conflict in April 2023, Sudan’s health system has been stretched to near collapse despite the rise in disease outbreaks, malnutrition and non-communicable diseases. Approximately two-thirds of the Sudanese population does not have access to healthcare, and between 70-80% of health facilities are no longer functioning.

To make matters worse, systematic blocking of aid and attacks on humanitarian actors have prompted aid organizations like Médecins Sans Frontières to warn of suspension of operations and to close hospitals temporarily.

According to the World Health Organization (WHO) Surveillance System of Attacks on Healthcare, since the start of the conflict until April 17, 2024, WHO has verified 62 attacks on health care, resulting in 38 deaths and 45 injuries. Of these, 40 attacks impacted facilities, 25 impacted personnel, 17 impacted supplies, eight impacted transport, eight impacted patients and seven impacted warehouses.

Insecurity and staff shortages, as well as shortages in medical supply, electricity and water, hamper ongoing health care support and access. The scale of deaths due to lack of access isn’t precise. However, it is important to note that even before the most recent conflict, the health care system suffered severely. Almost 80% of health services were based in the capital, Khartoum, meaning that when the conflict erupted in Khartoum, the entire health care system was debilitated.

As of April 3, 2024, a Public Health Situation Analysis by WHO and the Health Cluster found over 11,000 suspected cases of cholera and 305 deaths were reported across the country. In addition to ongoing disease outbreaks, including 5,000 cases of measles and 1.3 million clinical cases of malaria, mental health and non-communicable diseases are considered high health risks. Given access impediments, data is only representative of areas humanitarians have been able to reach, and numbers may likely be higher than reported.

Negative health implications, such as malnutrition, remain a substantial problem and of exceptionally high risk among vulnerable populations, including IDPs, refugees and individuals in camp settings.

Almost 5 million people are on the brink of starvation due to intense conflict and humanitarian access constraints, coupled with continued economic decline. Save the Children reported nearly 230,000 children and new mothers are likely to die in the coming months due to hunger and malnutrition.

The Integrated Food Security Phase Classification (IPC) results showed a dire picture of increasing food insecurity and malnutrition across Sudan. Over 17 million people, 37% of the population, are in high levels of acute food insecurity, classified in Phase 3 or above (Crisis or worse) between October 2023 and February 2024.

On March 29, the IPC released an alert for Sudan due to a dramatic increase in food insecurity and risk of famine (IPC Phase 5) in Khartoum, West Darfur and hard-to-reach areas of Darfur. The alert shared that ongoing fighting in Sudan has endangered the production of staple crops and contributed to soaring food prices and market inaccessibility. In addition, a joint update in February 2024 by the Food and Agriculture Organization and WFP indicated the prices of grains could increase by 50 to 100%. In 2023, food prices were 228% higher than between 2021-2022, and the average cost of a local food basket was 88% higher than before the conflict.

Hunger and starvation are causing already vulnerable populations to take up harmful coping mechanisms. With aid groups unable to reach areas in Darfur, specifically IDP camps, Coordination for Displaced Persons and Refugees in Darfur reported that eight out of every 10 families in camps eat only one meal a day. Similarly, Save the Children nutrition experts see pregnant women skip meals to allow their children to eat.

Humanitarian partners warn of mass deaths from hunger without immediate critical action.

Even prior to the outbreak of conflict in April 2023, Sudan’s economy suffered from rampant inflation, shortages of basic goods and high poverty rates.

While the GDP was expected to grow in 2023, the war has caused the economy to decline rapidly. Food prices have increased dramatically, and the banking system has essentially collapsed. The informal economy is currently behind much of the employment.

In 2023, the economy in Sudan shrunk by 40% due to the fighting and is predicted to shrink by an additional 28% in 2024, according to the Finance Minister, Gibril Ibrahim. This number is higher than the 18.3% projected by the International Monetary Fund for 2024.

The conflict has greatly damaged critical infrastructures like public facilities, roads and foreign trade and exports. Due to heavy battles and damages in Khartoum, an alternative capital may soon be established.

The economic crisis has decimated livelihoods and led to the collapse of economic activity, particularly commerce, finance and technology. Nearly half of Sudan’s population is unemployed. Internet and communication blackouts for months and the collapse of the banking sector have left millions struggling to access essentials, use mobile money services and seek safety.

The economic crisis continues to exacerbate widespread poverty and humanitarian needs.

Sudan is one of the ten countries 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. Among the most impacted and vulnerable to extreme weather events are farmers, whose livelihood and survival depend on their agricultural production and nomadic tribes, who use ancient migratory routes seasonally along with grazing animals.

In May 2023, Practical Action released a report highlighting the linkage between conflict, displacement, climate change and environmental damage. It found that climate change can bring additional pressures, such as diseases and pests, making farmers vulnerable to extreme climate patterns. Meanwhile, for nomads, migratory routes and pastureland turned into farmland, drought, and floods can reignite conflict and cause competition over limited resources.

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.”

The conflict has an outsized impact on women and girls, particularly new mothers. The lack of available health care, high food insecurity and displacement have caused many to forego meals and health care services.

The conflict in Sudan has led to an increase in the risks of gender-based violence (GBV), with women bearing the brunt of displacement, food insecurity, and unmet sexual and reproductive health needs. According to CARE International’s recent advocacy brief, since April 2023, a nearly 60% increase in the number of women and girls in need of GBV services was reported. The conflict has also reversed gains made during the transitional period and effectively created a “war on women.”

Of the more than eight million people displaced in Sudan, it is estimated that at least four million of these are children, making it the largest child displacement in the world. Due to the ongoing conflict, children are losing out on education, and an entire generation of Sudan’s children are exposed to the impact of war and trauma, some as child soldiers. As a result of the conflict, harmful coping mechanisms such as child marriage and reduced food intake are being reported.

In addition to children, women and displaced people, farmers and nomad communities have long been at the crossroads of conflict. Tension has led to strife across the country, commonly due to competition over resources, crop and land damage by livestock, and limited water supply. Drought and floods, among other extreme weather shocks, further exacerbate these tensions.