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MSF forced to suspend support in Madani Teaching Hospital, Sudan
Médecins Sans Frontières (MSF) has been forced to suspend work and withdraw staff from Madani Teaching Hospital, the only functional hospital for the hundreds of thousands of people in dire need of medical assistance in the capital of Al Jazirah state, Sudan.
This difficult decision comes after more than three months of relentless challenges trying to provide care at the hospital. Amidst the growing insecurity, we have been unable to bring new staff and medical supplies into the area due to the denial of travel permits, and faced repeated security incidents, such as looting and harassment, affecting our ability to provide medical care.
We call on the warring parties to stop violating health facilities and guarantee the safety of medical personnel, and to grant the necessary travel permits for our staff and supplies.
While the humanitarian and medical needs in Wad Madani and Al Jazirah are immense, we have no other option than to stop our work immediately and leave the area.
“The health system and basic services in Al Jazirah state have collapsed as a consequence of the fighting and the systematic blockade on supplies and personnel entering the area,” says Mari Carmen Viñoles, operations manager for MSF in Sudan.
“MSF was the only international NGO providing some support in Wad Madani. Our departure leaves a deep void for people struggling to access healthcare and living in a very insecure environment without transportation to move around.”
In mid-December, when fighting reached Wad Madani – the capital of Al Jazirah state located about 136 kilometres southeast of Khartoum – at least 630,000 people were forced to flee Al Jazirah towards other parts of Sudan according to the International Organization for Migration – many of whom had already been displaced.
At the end of that month, MSF evacuated all staff from Wad Madani following the offensive from the paramilitary group Rapid Support Forces (RSF) in the city, which until then had been controlled by the Government led-Sudanese Armed Forces (SAF).
By 13 January, we were able to send a team back to Wad Madani, where several hundred thousand people remained in which used to be one of the most populated cities of Sudan.
Since then, our teams have been supporting the emergency room, operation theatre, maternity, inpatient department – including paediatrics, the therapeutic feeding centre, and adult and surgical wards – and pharmacy at Madani Teaching Hospital.
We also provided mental health support and care for sexual violence. In addition, we are also provided training, salary incentives to 240 Ministry of Health (MoH) staff, and food for patients.
Between mid-January and the end of April, MSF provided nearly 10,000 outpatient consultations – malaria was the most common illness treated – 2,142 antenatal consultations, and care to 16 survivors of sexual violence. During this period, there was a constant influx of patients into the emergency room, totalling 2,981 admissions. A significant number of these admissions involved physical injuries sustained in the ongoing violence.
MSF has now suspended all support to the facility, and we have relocated our staff to safer areas of Sudan. Over the past three months, our team and the supported MoH staff have faced repeated security incidents that have been either carried out or tolerated by the RSF, including looting of the hospital, stolen vehicles, and staff being retained, among multiple other incidents.
The deliberate administrative blockages, the increasing insecurity, and the constant violations of the hospital as a neutral space made it impossible to continue providing services.
Since January, Sudanese authorities have persistently denied travel permits to bring new staff and medical and logistic supplies into the city.
“While the humanitarian and medical needs in Wad Madani and Al Jazirah are immense, we have no other option than to stop our work immediately and leave the area,” says Viñoles.
“The deliberate administrative blockages, the increasing insecurity, and the constant violations of the hospital as a neutral space made it impossible to continue providing services.”
MSF is willing to return to support the Madani Teaching Hospital to support people in Al Jazirah if the warring parties commit to respecting our medical work and ensure safe and uninterrupted access to the area.
We call on the RSF to stop violating medical facilities and guarantee the safety of MoH and MSF personnel. We also call on the Government of Sudan-led military and civilian authorities to grant the necessary travel permits for our staff and supplies.
MSF currently works in and supports more than 30 health facilities in nine states in Sudan: Khartoum, White and Blue Nile, Al Gedaref, West Darfur, North, South and Central Darfur, and Red Sea. We run programmes in both SAF- and RSF-controlled areas. Our teams provide trauma care, maternal and paediatric care, and treat malnutrition alongside other healthcare services. Our teams are also supporting Sudanese refugees and returnees in South Sudan and eastern Chad.
News
New rescue vessel Aurora 2: Sea-Watch’s response to political blockades of civilian sea rescue
Sea-Watch is putting a new rescue vessel into service: With the Aurora 2, the organization is responding to the repeated detentions of civilian rescue ships by the Italian authorities. Now, Sea-Watch will remain operational even when one of its ships is detained. While one ship is blocked in port, the other will be available to carry out rescue missions. The far-right government’s strategy of limiting rescue operations through arbitrary detentions has therefore failed.
Julia Winkler, spokesperson for the organization Sea-Watch:
“Italy is detaining rescue ships to stop people from being rescued. With the Aurora 2, we are making sure this strategy fails. If one of our vessels is detained, the other will be ready to save lives. By expanding our fleet, we are fighting back against the far-right Italian government’s efforts to obstruct civilian search and rescue at sea.”
In the Mediterranean, speed is a matter of life and death. Every distress case is a race against time. That is why Sea-Watch operates not only the large vessel Sea-Watch 5 but also a smaller, faster ship—the Aurora. The Aurora reaches top speeds of up to 25 knots, allowing it to quickly reach people in distress at sea. With the Aurora 2, the organization is now specifically expanding its operational capabilities.
The acquisition of the Aurora 2 is a direct response to the far-right Italian government’s policy of systematically detaining civilian rescue ships. Since 2023, the Meloni cabinet has detained civilian sea rescue ships in port more than forty times. As a result, the entire civilian fleet has lost more than 900 days of operational time. The Aurora has also been blocked five times already. Italian courts subsequently overturned the rulings on several occasions. However, by the time the respective court decisions were issued, the Aurora had lost a total of 113 days of operational time.
With the Aurora 2, Sea-Watch is specifically countering this strategy. If one of the ships is detained, the other can continue to set sail and rescue people in distress at sea. In this way, the organization ensures its independence from bureaucratic blockades and guarantees the continuation of its rescue operations.
The detentions of civil search and rescue vessels are politically motivated and cost lives. The Mediterranean is one of the deadliest borders in the world. More than 34,000 people have been reported dead or missing since 2014. The actual number is estimated to be significantly higher. With its new ship, the Aurora 2, Sea-Watch can continue to quickly rescue people from drowning — even if one of its ships is blocked by the far-right Italian government.
Sea-Watch is part of the Justice Fleet, an alliance whose members are committed to upholding human rights and international maritime law. Its members refuse to comply with instructions provided for in the so-called Piantedosi Decree that conflict with international law and human rights obligations and are primarily intended to hinder rescue operations. As a result, their vessels are regularly detained by the Italian authorities. In recent months, Italian courts have overturned detention orders imposed on several Justice Fleet vessels in summary proceedings. Rulings on the overall legality of the Decree are still pending.
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Sea-Watch strongly criticises EU response following attack on Sea-Watch 5

In response to the attack on the Sea-Watch 5 on Monday, 11 May 2026, the European Commission stated at its press conference on Wednesday, 12 May 2026, that EU cooperation with Libyan actors “prevented further violence.” Sea-Watch condemns this portrayal as a grotesque distortion of reality. Without the political, financial, and operational support of the EU, the so-called Libyan coast guard would neither possess boats nor the necessary infrastructure to operate at sea.
Julia Winkler, spokesperson for Sea-Watch:
“The EU has been working closely with actors in Libya for years, who are accused of committing the most serious crimes against people on the move, equipping them and enabling their operations at sea. Against this background, claiming that this very cooperation prevents violence is an absurd distortion of reality and is nothing short of cynical.”
A Commission spokesperson responded to questions regarding the violent attack on the Sea-Watch 5 on Monday, 11 May 2026, stating that it cannot be determined how many further attacks may have been prevented precisely due to consistent engagement (from 4:39). After the crew had rescued people in distress in international waters, Libyan militias opened fire and threatened to forcibly return the ship and those on board to Libya.
The attackers identified themselves as so-called Libyan Coast Guard. During the attack, the vessel involved was accompanied by the Murzuq 662 – a Bigliani-class ship handed over by Italy in June 2023 to Libyan actors as part of the EU–Libya cooperation framework SIBMMIL. Later the same day, the Sea-Watch 5 was also followed by the Ras Jadir 648, another vessel transferred by Italy to Libyan actors in May 2017.
Despite mayday calls being issued, neither Germany nor Italy, nor the EU naval mission EUNAVFOR MED IRINI provided assistance at sea on the day of the attack. On the contrary, on the same day the EU emphasised its intentions to expand cooperation and funding for Libyan actors in eastern Libya. These groups have been documented for years as responsible for torture, sexual violence, and kidnappings of people on the move. Without European support, such structures would not be operational in their current form.
For years, Sea-Watch and international organisations, including the United Nations, have documented serious human rights violations by Libyan militias and coast guard units with which they are closely linked. The political and legal responsibility of European actors is subject to ongoing international legal scrutiny. In 2022, the European Center for Constitutional and Human Rights filed a criminal complaint against senior representatives of the EU and its Member States for alleged crimes against humanity in connection with the EU–Libya cooperation.
News
Court annuls 20-day administrative detention imposed on Ocean Viking
SOS MEDITERRANEE has welcomed the recent decision of the Court of Chieti in Italy, which fully annuls the 20-day administrative detention imposed on the Ocean Viking in November 2023, together with the related fine and all associated sanctioning measures.
On 15 November 2023, Italian authorities detained the Ocean Viking in Ortona for 20 days and imposed a financial penalty under Decree Law No. 1/2023, known as the “Piantedosi Decree”. The case relates to a rescue operation conducted on 11 November 2023 in the Libyan Search and Rescue Region, during which our rescue ship rescued 34 people from a boat in distress after repeated unsuccessful attempts to obtain effective coordination from the Libyan maritime authorities.
In its first instance decision, the Court clearly confirmed that the Ocean Viking’s rescue operation was lawful, and that the captain “was faced with the necessity to intervene without delay” to protect human life. It also underscored the absence of effective coordination by the Libyan authorities, recognizing that the Ocean Viking was “the only vessel to intervene” to fulfill the duty to rescue at sea.
The judgment also reaffirmed that international maritime obligations under the UNCLOS, SOLAS and SAR Conventions prevail when human lives are at risk, and that sanctions cannot be imposed where state coordination is absent or inadequate. The decision recalls the Italian Constitutional Court’s ruling n°101/2025, which confirmed that national laws on sea rescue must comply with international law. In other words, no national law can be in contrast with the duty of saving lives at sea.
“This ruling confirms what we have consistently stated since November 2023: the Ocean Viking acted in full compliance with international maritime law and in the clear fulfilment of its maritime obligations,” said Soazic Dupuy, Director of Operations at SOS MEDITERRANEE. “Humanitarian rescue organisations must never be penalised for doing what authorities fail to do: ensuring timely and effective rescue for people in distress.” she concludes.
2026 is already among the deadliest years of the last decade. People continue to go missing at sea while the Italian government doubles down on efforts to prevent Search and Rescue NGOs from operating. This week, the Senate began discussing a new migration package that includes Provisions aimed at preventing Search and Rescue NGOs from entering Italian waters, yet another attempt to obstruct lifesaving operations.
On Saturday 16th, the captain of the Sea-Watch 5 was accused of facilitating irregular migration after completing a rescue operation following which the Libyan Coast Guard opened fire.
Despite repeated court rulings confirming the legality of civil rescue operations, Search and Rescue NGOs continue to face legal and administrative harassment for saving lives at sea. People in distress cannot wait for justice while lifesaving assistance is obstructed for political purposes.
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