MSF staff and services under duress amid escalating conflict in Sudan

SUDAN— Médecins Sans Frontières (MSF) has released a statement condemning the harassment of their staff as well as the looting and occupation of their medical facilities and associated field services in Sudan’s escalating civil armed conflict.

As one of the humanitarian aid agencies in the country trying to provide health care services in the deteriorating civil unrest that has ensued in Sudan, MSF is raising the alarm on how the rapidly catastrophic events in Sudan are hampering their efforts.

MSF, which runs medical projects in 10 states in Sudan, has been attempting to scale up its medical activities since intense fighting broke out between the Sudanese military and the Rapid Support Forces in April.

MSF runs medical projects in Al-Jazirah, El-Gedaref, Kassala, Khartoum, Red Sea, North, West, South, and Central Darfur, and Blue Nile states in Sudan.

This includes treating war-wounded people in Khartoum and North Darfur, providing healthcare and water and sanitation services for refugees and displaced people in Al-Gedaref and Al Jazirah states and providing donations of medical and other supplies to health facilities.

As a neutral, independent, and impartial medical organization, MSF provides healthcare to people based on their medical needs alone, treating those who are most in need, regardless of whether they are on one side of the conflict or the other.

MSF details challenging Sudan conflict

Staff and patients are repeatedly facing the trauma of armed groups entering and looting MSF premises, with medicines, supplies, and vehicles being stolen.

MSF’s emergency coordinator in Sudan, Jean-Nicolas Armstrong Dangelser listed all incidences that are hampering their efforts in the country.

Beginning in Khartoum, where the country’s MSF offices and warehouses were looted and occupied with medical supplies, fuel, and vehicles stolen.

In Zalingei, central Darfur their facility was looted, where a generator was destroyed and fuel that MSF had donated was stolen.  

Another unfortunate incident in South Darfur has forced MSF to suspend all medical activities after their compound and warehouse were violently looted in Nyala with two vehicles stolen.

Their offices in El Geneina were also looted with the El Geneina Hospital where MSF runs their pediatric and nutrition units looted and the hospital damaged forcing it to close.

Their scale-up efforts have been continually hampered by violence, aggressive armed incursions, looting, or armed occupation of their premises, as well as continued administrative and logistical challenges.  

This shocking disregard for humanitarian principles and international humanitarian law has impeded MSF ability to provide healthcare to people at a time when it is desperately needed.

Jean-Nicolas Armstrong Dangelser, MSF’s emergency coordinator in Sudan also said, “We are experiencing a violation of humanitarian principles and the space for humanitarians to work is shrinking on a scale I’ve rarely seen before.”

Jean-Nicolas urged the Sudanese military and the Rapid Support Forces to ensure the safety of medical personnel and health facilities and to allow safe passage of ambulances and people seeking healthcare.

He also requested the warring factions to facilitate access and rapid and unimpeded movement for humanitarian workers, organizations, and supplies.

Although a nationwide ceasefire was announced between the warring parties on 20 May, local ceasefires have not always been respected in the past. 

Attacks on other Aid Agencies

These attacks extend beyond MSF and reflect a broader trend of warring factions disregarding civilian lives, infrastructure, and healthcare facilities.

The World Health Organization (WHO) has documented 38 instances of healthcare being targeted since the start of the conflict.

During the recent 76th World Health Assembly, the WHO emphasized that hospitals and healthcare workers should be protected under international humanitarian law.

However, there are reports of armed groups occupying hospitals, which weakens their protection and puts patients and the healthcare system at risk.

In the western region of Darfur, three employees of the World Food Programme (WFP) lost their lives, leading to the suspension of WFP operations in the country.

Additionally, Wim Fransen, the head of the EU’s humanitarian agency in Sudan, was shot and seriously injured.

These incidents occur amidst a worsening situation in Sudan, where the conflict has severe consequences for the population.

People in Khartoum, Darfur, and other heavily affected areas continue to endure immense suffering.

Gunshot wounds, stabbings, explosions, and sexual violence leave individuals injured and traumatized.

The proximity of fighting, airstrikes, and other acts of violence to healthcare facilities has created a climate of fear, preventing both patients and staff from accessing essential services.

Throughout the country, there are shortages of food and clean water, pushing people to migrate in search of their basic needs.

Access to humanitarian aid and healthcare is crucial, but the Sudanese healthcare system is already grappling with a lack of essential supplies. Transporting supplies from one part of Sudan to another is extremely challenging.

Despite efforts by MSF to deploy emergency teams to Sudan during the initial weeks of the conflict, obtaining permissions for travel to project locations or securing visas for additional staff has become increasingly difficult.

Long-term effects of armed conflict on healthcare services

A study commissioned by BMC on conflict and health reveals the long-term consequences of armed conflict on healthcare services.

Each year, approximately 133,750 individuals lose their lives due to armed conflicts, although this estimation does not include the indirect mortality that can be attributed to these conflicts.

Furthermore, parties engaged in warfare may intentionally target and disrupt civilian healthcare services, or they may inadvertently cause damage as a result of their military strategies.

Such actions violate the laws of war. However, beyond the immediate deaths and destruction resulting from attacks on health services, the comprehensive impact of these actions is challenging to quantify.

During armed conflicts and complex emergencies, the overall health of the population deteriorates.

However, women and children are particularly vulnerable and experience even worse health outcomes due to a combination of biological and sociocultural factors.

Disturbingly, a Lancet Global Health study highlights that in 2017 alone, approximately 630 million women and children, accounting for 10% of women and 16% of children worldwide, either became displaced as a result of conflict or lived in dangerously close proximity to armed conflicts.

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