For the past two consecutive years, Sudan has held onto the position of the country most likely to experience a new or worsening humanitarian crisis of the Emergency Watchlist; the country’s recent cholera outbreak will do nothing but exacerbate the plight of the Sudanese population in the midst of a raging civil war. Furthermore, Médecins Sans Frontières (MSF) announced on January 10 that they would withdraw from the Bashair Teaching Hospital in Khartoum after consecutive attacks on medical staff and patients.
On April 15 2023, war erupted between the Sudanese Armed Forces (SAF) and the Rapid Support Forces (RSF). The International Rescue Committee estimates that out of a population of 45 million, 25 million Sudanese require immediate humanitarian support and 11 million have been displaced since April 2023. The United States Secretary of State, Anthony J. Blinken, denounced the acts of genocide perpetrated by the RSF and its allies; his statement supports the Human Rights Watch’s claims of ethnic cleansing of the Massalit people. Both the RSF and the SAF have participated in acts of sexual and gender-based violence (SGBV), targeting civilians and public infrastructure, as well as recruiting child soldiers in the process, all while pushing their healthcare system to the brink of collapse and plunging the country into an unprecedented famine.
The state of the Sudanese healthcare system and its partners, such as the MSF, is critical as more and more people, especially children, require humanitarian aid. Namely, the United Nations (UN) has already recorded over 28,000 cases of cholera and 836 deaths between July and October 2024. The World Health Organization (WHO) describes cholera as an acute diarrheal infection which is transmitted through contaminated food and water. The quick spread and high mortality rate in Sudan represent a large health disparity in the region; indeed, the WHO emphasizes the importance of access to clean water and basic hygiene to deter the spread of cholera. Moreover, if not treated, the cholera disease can quickly become fatal.
Researchers posited in November 2024 that the cause of the recent outbreak of cholera is two-fold: climate change and wartime impacts on Sudanese healthcare. From June to September 2024, Sudan experienced a heavy rainy season. The consequential flooding and extensive damage to homes and infrastructures affected 600,000 Sudanese and displaced another 172,500. These displaced individuals are subsequently deprived of proper sanitation and clean water. Moreover, these conditions must be understood in a landscape ravaged by civil war, where many healthcare infrastructures have already collapsed, worsening the lack of clean water resources or secure environments. Women and children are at higher risk of exposure to contaminated food and water when they leave secure areas to escape SGBV, child soldier recruitment, or other crimes against humanity. Displaced individuals in camps also struggle to access appropriate food and water; indeed, the UN testifies that the conflicting pirates have interrupted the distribution of food and medicines to camps such as in Zamzam, increasing the likelihood of people coming in contact with infected food and water.
Since April 2023, MSF has been involved in Sudan with its primary focuses on malnutrition and vaccination, both of which are of the utmost importance in the face of epidemic diseases like cholera. In fact, on September 9, 2024, UNICEF launched a vaccination campaign through the distribution of 404,000 oral doses in Kassala and subsequent provinces in the following days with the goal of immunizing around 1.4 million people. MSF itself has also taken part in vaccination and malnutrition campaigns. Such examples highlight how humanitarian aid can alleviate pain and suffering during conflict. However, supply delivery issues and the attacks on healthcare remain an obstacle to the relief efforts.
Unfortunately, MSF recently withdrew from the Bashair Hospital in Khartoum, the capital of Sudan, one of the rare hospitals still providing free medical care. The catalyst was an attack on December 18 2024 when an individual fired his weapon inside the emergency room. This came after multiple attacks over the past 20 months where fighters from both sides routinely threatened medical staff and wounded patients, and forced the staff to treat their soldiers before the patients of the hospital. A specific incident stands out on November 11 2024, where a patient was shot and killed. In fact, since April 2023, the WHO Surveillance System for Attacks on Healthcare has reported 140 attacks, 239 deaths, and 216 injuries. Claire San Fillipo, the MSF Emergency Coordinator emphasized how medical teams and volunteers could not properly operate if the hospital itself became part of the warzone. While MSF continues to work in 11 out of 18 Sudanese states, the suspension of activities in Bashair Hospital is devastating to the people of Khartoum and its surrounding areas.
Hospitals, medical staff, volunteers, and easy access to supplies are necessary to help the people of Sudan escape a humanitarian crisis. Cholera is only the most recent blow: other epidemic diseases, such as malaria or dengue fever, can also thrive in wartime and outbreaks will continue to spread if not contained. Indeed, UNICEF stresses how 3.4 million children are already at risk of epidemic diseases, and a partial decline in vaccination rates due to a lack of MSF operations in the region will only increase those risks. As a result, it is vital to highlight the importance of health disparities in a landscape of violence for all those who wish to provide humanitarian aid.
Edited by Isaac Yong
This is an article written by a Staff Writer. Catalyst is a student-led platform that fosters engagement with global issues from a learning perspective. The opinions expressed above do not necessarily reflect the views of the publication.
Amélie Garneau-Daigneault is currently in her second year at McGill University. She is completing her bachelor’s in international development studies, along with minors in gender studies and history. Amélie is especially interested in researching health disparities and the global transmission of diseases. Moreover, she examines the cultural and social consequences of global health. Amélie aspires to attend law school after her B.A. and to apply her learnings to engage in international law.