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Sudan: Rapid scale up of response needed
In one of the world’s worst crises for decades, Sudan is facing a colossal, man-made catastrophe, one year after the start of the war between the government-led Sudanese Armed Forces (SAF) and the paramilitary Rapid Support Forces (RSF), says a statement by MSF international.
It is a matter of life or death for millions of people to urgently enable safe humanitarian access. As governments, officials, aid organisations, and donors meet on 15 April in Paris to discuss ways to improve the delivery of humanitarian aid, Médecins Sans Frontières (MSF) is making an urgent call for them to immediately scale up the humanitarian response.
Millions of people are at risk, yet the world is turning a blind eye as the warring parties intentionally block humanitarian access and the delivery of aid. The United Nations (UN) and member states must redouble their efforts towards negotiating safe and unhindered access, and to scale up the humanitarian response to prevent this already desperate situation from deteriorating any further.
“People in Sudan are suffering immensely as heavy fighting persists —including bombardments, shelling and ground operations in residential urban areas and in villages — and the health system and basic services have largely collapsed or been damaged by the warring parties,” says Jean Stowell, MSF head of mission in Sudan. “Only 20 to 30 per cent of health facilities remain functional in Sudan, meaning that there is extremely limited availability of healthcare for people across the country.”
Every day we see patients dying because of violence-related injuries, children perishing due to malnutrition… Despite all this, there is an extremely disturbing humanitarian void.
In areas close to hostilities, MSF teams have treated women, men and children injured by stray bullets and in the fighting, including shrapnel wounds, blast and gunshot injuries. Since April 2023, MSF-supported facilities have received more than 22,800 cases of trauma injuries and performed more than 4,600 surgeries, many of them related to the violence which occurred in Khartoum and Darfur. In Wad Madani, a town surrounded by three active frontlines, we currently see 200 patients per month with violence-related injuries.
According to the UN, more than eight million people have already been forced to flee their homes and been displaced multiple times, and 25 million – half of the country’s population – are estimated to need humanitarian assistance.
“Every day we see patients dying because of violence-related injuries, children perishing due to malnutrition and the lack of vaccines, women with complications after unsafe deliveries, patients who have experienced sexual violence, and people with chronic diseases who cannot access their medicines,” says Stowell. “Despite all this, there is an extremely disturbing humanitarian void.”
Although MSF works in good cooperation with the Ministry of Health, the Government of Sudan has persistently and deliberately obstructed access to humanitarian aid, especially to areas outside of their control. It has systematically denied travel permits for humanitarian staff and supplies to cross the front lines, restricted the use of border crossings, and established a highly restrictive process for obtaining humanitarian visas.
“Today, our biggest challenge is the scarcity of medical supplies,” says Ibrahim*, an MSF doctor working in Khartoum. “We’ve run out of surgical equipment, and we are on the brink of stopping all work unless supplies arrive.”
Khartoum is a city that has been under blockade for the past six months. A similar situation has been impacting the city of Wad Madani since January.
In RSF-controlled areas, where many different militias and armed groups also operate, health facilities and warehouses were frequently looted in the first months of the conflict. Incidents such as carjackings happen on a regular basis, and medical workers, particularly from the Ministry of Health, have been harassed and arrested.
In hard-to-reach areas like Darfur, Khartoum or Al-Jazirah, we often find ourselves the only, or one of the few, international humanitarian organisations present. The needs far exceed our capacity to respond. Even in more accessible areas such as White Nile, Blue Nile, Kassala and Gedaref states, the overall response is negligible: a drop in the ocean.
One example is the catastrophic malnutrition crisis in Zamzam camp in North Darfur, where there have been no food distributions from the World Food Programme since May 2023. Almost a quarter (23 per cent) of children we screened there in a rapid assessment in January were found to have acute malnutrition – seven per cent were severe cases. Forty per cent of pregnant and breastfeeding women were suffering from malnutrition, and there was a devastating mortality rate across the camp of 2.5 deaths per 10,000 people per day.
We’ve run out of surgical equipment, and we are on the brink of stopping all work unless supplies arrive.
“The situation in Sudan was already very fragile before the war and it has now become catastrophic,” says Ozan Agbas, MSF Emergency Operations Manager for Sudan. “In many of the areas where MSF has started emergency activities, we have not seen the return of the international humanitarian organisations that initially evacuated in April last year.”
Khadija Mohammad Abakkar, who had to flee her home in Zalingei, Central Darfur, in search of safety, recounts how difficult it was to survive without humanitarian assistance: “During the fighting, there was no access to healthcare or food in the camp. I sold my belongings to earn some money for food.”
While these are difficult conditions in which to operate, the response should have increased, not diminished, especially in the areas where access is possible. Increased efforts are urgently needed by all humanitarian organisations to find solutions to these problems and scale up activities across the country.
“The United Nations and their partners have persisted in self-imposed restrictions on accessing these regions,” says Agbas. “As a result, they have not even pre-positioned themselves to intervene or establish teams on the ground when opportunities arise.”
MSF calls on the warring parties to adhere to International Humanitarian Law and the humanitarian resolutions of the Jeddah declaration by putting in place mechanisms to protect civilians and to ensure safe humanitarian access to all areas of Sudan without exception – including stopping blockages. MSF also calls on the UN to show more boldness in the face of this enormous crisis and to focus on clear results related to increasing access so that they actively contribute towards enabling a rapid and massive scale-up of humanitarian assistance. MSF also urges donors to increase funding for the humanitarian response in Sudan.
*Name changed to protect identity.
MSF currently works in and supports more than 30 health facilities in 10 states in Sudan: Khartoum, Al Jazirah, White and Blue Nile, Al Gedaref, West Darfur, North, South and Central Darfur, and Red Sea. Our teams have also recently intervened in Kassala. We run activities in both SAF- and RSF-controlled areas. We provide trauma care, maternal care and treat malnutrition alongside other healthcare services.
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ICC confirmation of 17 charges against El-Hishri draws praise from rights groups
Human rights organisations and migrant rights advocates have welcomed the International Criminal Court’s (ICC) decision to confirm all 17 charges against Osama El-Hishri, describing it as a landmark step towards justice for victims of abuses committed at Libya’s notorious Mitiga Prison.
The ICC’s confirmation of the charges clears the way for El-Hishri to stand trial over allegations linked to murder, torture, sexual violence and other crimes allegedly committed against detainees at the prison in Tripoli.
Reacting to the decision, migrant distress network Alarm Phone described the ruling as “historic” for survivors of crimes committed at Mitiga Prison.
“The International Criminal Court confirmed all 17 charges against El-Hishri. This is a historic decision for survivors of crimes committed at Mitiga prison in Libya,” the organisation said in a statement posted on X.
Alarm Phone also echoed calls by refugee advocacy group Refugees in Libya, saying the prosecution should mark the beginning of broader efforts to hold perpetrators of abuses in Libya accountable.
Similarly, Sea-Watch International hailed the ICC’s decision, noting that the confirmation means the case will now proceed to trial.
The organisation alleged that El-Hishri was a senior member of Libya’s Special Deterrence Force (SDF/RADA) militia and headed parts of Mitiga Prison, where migrants and refugees were subjected to severe human rights violations.
“The ICC confirmed all 17 charges against El-Hishri today. The case is going to trial,” Sea-Watch International said.
It added that people on the move detained at Mitiga Prison had been subjected to murder, torture and sexual violence, describing the prosecution as an important step in addressing longstanding impunity for abuses against migrants in Libya.
Activist Yousef Ismail also welcomed the court’s decision, saying it represented the kind of justice victims had long demanded.
“This is the real number; this is the truth we seek. We always speak of justice and respect for human rights. The International Criminal Court has fairly proven 17 charges against the so-called ‘Hashri,’ the rapist and the gatekeeper of Mitiga,” he wrote on X.
The ICC’s decision has been widely viewed by rights advocates as a significant milestone in efforts to secure accountability for crimes allegedly committed against migrants and refugees held in Libya’s detention system.
Campaigners, however, stressed that the prosecution of El-Hishri should not be the end of international efforts, urging authorities to investigate other individuals allegedly responsible for serious human rights violations in Libya’s detention facilities.
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Expert raises questions over UNHCR’s strategic direction after new leadership appointments
A former Head of Policy Development and Evaluation at the UN Refugee Agency (UNHCR), Jeff Crisp, has suggested that the organization’s newly announced leadership appointments could signal a shift in its priorities away from refugee protection and asylum toward humanitarian assistance and development.
Reacting to the appointments in a post on X, Crisp said the selection of the agency’s new senior officials “suggest that the agency might be going to focus on humanitarian assistance & development issues rather than refugee protection & asylum.”
He added that his concerns were reinforced by UNHCR’s support for the European Union’s Pact on Migration and Asylum.
“A suspicion strengthened by UNHCR’s endorsement of the EU Pact on Migration & Asylum,” Crisp wrote.
His comments came shortly after United Nations Secretary-General António Guterres announced the appointments of Tressa Rae Finerty as Deputy High Commissioner for Refugees, Antón Leis García as Assistant High Commissioner for Operations, and Edem Wosornu as Assistant High Commissioner for Protection.
UN High Commissioner for Refugees Barham Salih welcomed the appointments, saying the three officials bring extensive experience in humanitarian affairs, international cooperation and refugee protection. They are expected to assume their duties in the coming weeks.
Crisp’s remarks reflect concerns held by some refugee rights advocates and migration experts who have argued that UNHCR faces increasing pressure to balance its traditional mandate of protecting refugees and defending the right to asylum with expanding responsibilities in humanitarian response, development cooperation and migration management.
The appointments come at a time when the agency is grappling with record levels of forced displacement worldwide, shrinking humanitarian funding and increasingly restrictive asylum policies in many parts of the world.
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Conflict, displacement fuel Ebola outbreak in Eastern DR Congo, NRC warns
The Norwegian Refugee Council (NRC) has warned that the ongoing Bundibugyo Ebola outbreak in the Democratic Republic of Congo (DRC) is spreading in communities already devastated by years of armed conflict, displacement and inadequate access to basic services, urging the international community to step up funding and political support for the response.
In a statement, NRC’s Country Director in DR Congo, Eric Batonon, said the outbreak was unfolding in Ituri province, the current epicentre of the epidemic, where thousands of displaced people have spent years living in overcrowded shelters with poor sanitation and limited healthcare.
According to Batonon, prolonged violence by armed groups competing for control of land and mineral resources has forced millions from their homes, while the humanitarian crisis has received insufficient attention from donors and the international community.
He said these conditions had created an environment in which Ebola has been able to spread rapidly, contributing to the rising number of infections.
Batonon stressed that infection prevention and control measures must remain central to the response, adding that affected communities should play a leading role in shaping response strategies.
He said building trust and engaging directly with local populations would be critical to containing the outbreak, arguing that Ebola can only be effectively controlled when community priorities guide public health policies.
The NRC said it has intensified its Ebola response in eastern DRC through community awareness campaigns and preventive health measures. The organisation is establishing handwashing stations, distributing hygiene supplies and supporting efforts to reduce the risk of infection in affected communities.
It also said its teams are working to minimise disruptions to children’s education by helping schools operate safely during the outbreak.
In addition, NRC staff are assessing the impact of the epidemic on internally displaced persons in Ituri as well as neighbouring North and South Kivu provinces, where many people continue to live in overcrowded camps with inadequate sanitation facilities.
The findings, Batonon said, will help shape humanitarian interventions for some of the country’s most vulnerable populations.
The NRC noted that DR Congo has appeared on its annual list of the world’s most neglected displacement crises every year over the past decade, reflecting what it described as persistent international neglect of the humanitarian situation in the country’s east.
Batonon called on donors to provide flexible and sustained funding while increasing political engagement to ensure the Ebola response can outpace the spread of the disease and address the underlying humanitarian conditions that have worsened the outbreak.
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