Sudan Humanitarian Crisis

• 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 2024 says, “The fighting has also caused extensive damage to critical infrastructure, including water and healthcare, the collapse of banking and financial services, frequent interruptions to electricity supply and telecommunication services and widespread looting. An estimated 70 per cent of health facilities in states affected by conflict are not working, and the remaining ones are overwhelmed by the influx of people seeking assistance.”
• The Intergovernmental Authority on Development (IGAD) in Eastern Africa Heads of State Summit met on Jan. 18, 2024, in Uganda. The Sudanese government did not take part in the summit and requested that IGAD stay out of its affairs. On Jan. 20, 2024, Sudan suspended its membership in IGAD stating that “it is not bound by or concerned with any IGAD pronouncements regarding Sudanese matters.”
• As of January 2024, more than 20 million people are facing acute food insecurity. 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 is predicting that this could grow to 26.5 million. This is a significant increase from previous years: 15.8 million people in January 2023 and 14.3 million in 2022.
• 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, there are 163 organizations supporting 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 war is costing the Sudanese economy roughly $80 million each day. The Sudanese economy has declined rapidly and the exchange on the market to U.S. dollars is unfavorable.
• According to IOM, from April 15, 2023 to Feb. 20, 2024, the Displacement Tracking Matrix (DTM) estimates that 6.27 million individuals (1.25 million households) have been displaced since April 15, 2023. “The internally displaced persons (IDP) caseload was observed in 6,771 locations across all of Sudan’s 18 states. The highest proportions of IDPs were observed across South Darfur (12%), River Nile (11%), East Darfur (11%), White Nile (8%), North Darfur (7%), Sennar (7%), Central Darfur (7%), Gedaref (6%), Northern (6%), and Aj Jazirah (6%).”

As of March 1, 2024, there have been more than 14,742 reported fatalities, according to the Armed Conflict Location & Event Data Project (ACLED). These numbers include military deaths.

ACLED says, “This number is a conservative estimate due to methodological limitations of real-time reporting in a conflict of this nature.”

The Guardian emphasized this point, saying, “But that figure is a significant underestimate, because much of the country is too dangerous for observers to enter. A leaked UN report seen by Reuters last month suggested that in three months last year between 10,000 and 15,000 people were killed in one city, West Darfur’s El Geneina, alone.”

The health care system in Sudan was already weak, and the fighting has significantly reduced medical access as health facilities have been attacked, destroyed or had to close their services. The shortage of food, fuel and supplies is also concerning, as are power outages and dangers to staff and patients.

The World Health Organization (WHO) “reports that 15 million people across the country lack access to health care and between 70 – 80 per cent of health facilities are not functioning due to the ongoing conflict.”

According to the WHO Surveillance System of Attacks on Healthcare, details further the attacks mentioned above. Since the start of the conflict until March 7, 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.

Types of attacks are broken down into several categories including individual weapons (33 attacks), psychological violence (30), assault (17) and heavy weapons (13).

These attacks have lessened as the conflict has continued with the highest number occurring in April (27) but only two in December 2023. They are not solely related to the current conflicts as there were 23 in 2022 and 29 in 2021. There was one other attack before April 14, 2023.

According to UN OCHA, there have been more than 10,730 suspected cholera cases and 296 deaths as of Feb. 17, 2024.

In December 2023, the Health Cluster in Sudan reported escalating cholera and dengue outbreaks in addition to ongoing provision of sexual and reproductive services, mental health services, vaccination campaigns, and working to enhance Infection Prevention and Control (IPC) preparedness and response. All of this work is being done amid significant challenges ranging from ongoing insecurity and constrained healthcare access to “poor roads, inaccessible stocks, and bureaucratic barriers;” from destruction of health infrastructure to “a shortage of medicines, disrupted childhood vaccinations, malnutrition affecting one in seven children, and heightened sexual and reproductive health risks for 4 million individuals”.

Of the more than eight million people displaced in Sudan, it is estimated that at least five million of these are children and nearly half (2.1 million) are under five years of age. The ongoing conflict will have an outsized and enduring impact on children. They are losing out on education (approximately 19 million are out of school), they are being exposed to trauma and war, and even being used in the fighting as child soldiers. Some young girls are being married off, in a desire to prevent sexual exploitation, although that act itself can also be seen as exploitative.

Children are dying of preventable diseases because of the lack of medications, health care professionals and vaccines. They are also being killed in the fighting. Philanthropists funding in Sudan must be understand that the enduring effect of war on children will require long-term solutions, including building local capacity in the children’s care sector.

Ted Chaiban, UNICEF Deputy Executive Director for Humanitarian Action and Supply Operations stated, “Every day children are being killed, injured, abducted and seeing the schools, hospitals and the vital infrastructure and life-saving supplies they rely on damaged, destroyed or looted.”

At least 18.9 million people are in need in the WASH sector, according to the 2024 Humanitarian Needs and Response Plan (HNRP) for Sudan. The amount of funding needed has grown from $129 million to $230.9 million and only 7% has been received. “The significant shift in operating costs can primarily be attributed to increased expenses for transportation, supply management, and fuel, and the operation of water stations and public water facilities, especially in urban areas.”

UNICEF has found that, “Inadequate water, hygiene and sanitation practices poses major risks for communities especially children. Moreover, water and sanitation related diseases are one of the leading causes of death for children under five … Sanitation coverage has stagnated [which] poses a major hazard to children and communities and has a significant impact on food security, rising malnutrition, disease outbreaks, conflict, and ultimately child morbidity and mortality.”

Key infrastructure, including pipes, has been damaged by the fighting (although it was not well maintained prior). Residents are using the Nile River for all water needs, including drinking, bathing and cleaning.

Sudan, as an agricultural nation, uses 97% of its water to support that industry, but climate change – including water scarcity and desertification – is affecting that water supply as well.

According to the 2024 HNRP, “WASH partners prioritise addressing the critical needs of IDPs, host communities, and residents living in partially accessible and hard-to-reach areas with limited access to safe WASH services. These regions encounter difficulties such as reliance on surface water (severity 5), utilization of unsafe water sources (severity 4), rampant open defecation (severity 5), subpar sanitation (severity 4), and poor access to handwashing with soap and water (severity 4 and 5).” One of the key goals of the WASH sector will be to create better gender-sensitive sanitation and basic water services for millions of women and girls.

Even prior to the outbreak of conflict in April 2023, Sudan’s economy suffered from rampant inflation and shortages of basic goods. Sudan’s economy remains in crisis, with high inflation, a shortage of foreign currency and a large national debt. The country is struggling to provide basic services to its citizens, and many people are experiencing food insecurity and poverty. Even prior to the latest civil war it had the highest poverty rate in Northern Africa.

The 2022 poverty rate was 15.3% when looking at the $2.15/day marker. But when increased to the lower middle-income poverty rate of $3.65/day, the rate jumped to 49.7%. The upper middle-income poverty rate of $6.85 shows a rate of 86.2%. While the GDP were expected to grow in 2023, the war has caused the economy to freeze. Food prices have increased dramatically and the banking system has essentially collapsed. The informal economy is behind much of the employment currently.

According to the World Bank, “The secession of South Sudan [in 2011] led to multiple economic shocks, including the loss of oil revenue that had accounted for more than half of the Sudan government’s revenue and 95% of its exports. This has reduced economic growth and resulted in double-digit consumer price inflation…”

There are ongoing concerns about human rights abuses in Sudan, including reports of extrajudicial killings, arbitrary detentions, and restrictions on freedom of expression and association. The government has taken some steps to address these issues, but progress has been slow. The protection issues have been amplified by the war, with fighting happening in urban areas leading to civilian deaths.

According to Amnesty International, there have been “extensive war crimes including mass killings of civilians, rape and sexual slavery of women in the ongoing conflict … Amnesty detailed waves of violence in West Darfur province —one of five constituting the Darfur region — including the killing of civilians, looting and destruction of homes and facilities such as the main hospital and markets.”

The Council on Foreign Relations reports that the group most at risk varies by location. They said, “With places like El-Obeid, Kadugli, and El-Geneina becoming arenas of conflict, many Sudanese civilians have been caught in the crossfire. The Washington, D.C.-based Search for Common Ground (SFCG) found that children were most impacted in Blue Nile and North Kordofan, elders were most affected in Khartoum, and women were disproportionately affected in Gadarif and Kassala.”

Comparing Sudan to Syria, David Miliband, President and CEO of the IRC, said that funding and humanitarian action “is also a chance to de-escalate the conflict before a major, multi-year crisis takes hold. The risk is that the West will only start paying attention when the crisis reaches its gates. The international community must not squander the opportunity to engage with regional powers for a concerted diplomatic push to halt the slide towards catastrophe.”

With 10.7 million people displaced by conflict, as of March 7, 2024, Sudan has the highest rate of displacement in the world. This includes 9 million people within the country and others who have traveled to neighboring countries seeking support and safety.

The majority of IDPs were displaced from Khartoum state (56%), followed by South Darfur (15%), North Darfur (9%), Aj Jazirah (8%), Central Darfur (5%), West Darfur (4%), South Kordofan (2%). East Darfur (1%) and North Kordofan (1%).

The World Food Program (WFP) announced that 90% of the population is facing emergency levels of hunger, and 18 million are acutely food insecure.

UN OCHA reported, “Devastating conflict and organized violence, coupled with the continued economic decline, have driven about 17.7 million people across Sudan (37 per cent of the population) into high levels of acute food insecurity, classified in the Integrated Food Security Phase Classification (IPC) Phase 3 or above (Crisis or worse) between October 2023 and February 2024. This includes about 4.9 million people (10 per cent of the population) who are in IPC Phase 4 (Emergency) and almost 12.8 million people (27 per cent of the population analyzed) are in IPC Phase 3 (Crisis). The Food and Agriculture Organization (FAO) sounded the alarm about the escalating food security crisis in Sudan, urging immediate and collective action to avert an impending humanitarian catastrophe.”

The IPC also said that food insecurity has increased because of the looting and attacks on markets, water facilities, banks and public buildings. “The price of food and essential commodities has soared, limiting access to the market for the population. According to reports from numerous states, including those unaffected by the ongoing fighting, the conflict between SAF and RSF in Sudan is endangering the production of staple crops this year.”

The roles of women and men in conflict-affected regions of Sudan differ significantly. Women regularly encounter social and cultural restrictions on mobility, access to markets, education and training, and healthcare, not to mention basic social interaction with neighbors and friends.

Women are also excluded from roles that would provide them with opportunities to resolve conflict and build peace; roles like tribal council members, native administrations and representation of women’s issues in development agendas.

A Rapid Gender Analysis on Power and Participation conducted by CARE in Sudan’s Kassala State showed women are often not consulted in decision-making, and social norms are a key barrier towards greater inclusion. The report highlights opportunities to enhance women’s participation and leadership. Bringing women (and youth) into community organizing can reduce extremism.

Gender-Based Violence (GBV) is increasing. As many as 4.2 million women and girls face the risks of GBV.

There are several types of gender-based violence present in Sudan. CARE’s Rapid Gender Analysis was conducted in early 2023, ending just as the conflict was beginning. They are clear that the conflict will have only increased the risks for women and girls in the country and in surrounding countries.

In particular, the report calls attention to, “The types of GBV identified in Sudan include domestic / family violence (e.g., hard beating, psychological abuse), community social violence (e.g., exclusion, humiliation), harmful traditions and customs (e.g., early marriage, FGM/C [female genital mutilation/cutting]), and violence during war (e.g., rape, killing). Women experience several challenges related to GBV – beyond the act of violence itself – such as stigmatization of reporting and the normalization of domestic violence. GBV is so prevalent due to unequal laws the enable it, patriarchal gender norms, economic hardship, insecurity and conflict, and the absence of law enforcement. It is driven internally by the family by the deep need to protect family honor.”

In August 2023, UN experts raised concerns at reports of multiple serious violations perpetrated in particular by the RSF. This included reports of sexual exploitation, slavery, trafficking, rape and acts tantamount to enforced disappearances, which in some cases may have been racially, ethnically and politically motivated, including for expressing opposition to the presence of armed groups in an area. Since then, reports of forced prostitution and forced marriage of women and girls have also emerged.

They also warned that victims and survivors of such crimes, in particular children, may suffer long-lasting traumatic impacts on their physical, mental, and sexual health and development. Their access to adequate support services must be ensured as well as access to gender-sensitive reparations for the harm and violations suffered.

Sudan is also subject to the impacts of climate change. Sudan is one of the ten countries in the world 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. Available evidence suggests that climate change has also heightened competition for access to water sources, pastures and traditional grazing lands.

Practical Action released a report in May 2023 highlighting the linkage between conflict, displacement, climate change, and environmental damage. It stated, “War and displacement exacerbate environmental damage. As people flee war and then return to their villages, they rebuild using scarce resources vital to the eco system. Trees are cut down, ancient migratory routes and pastureland are turned into farmland, accelerating desertification, worsening drought and reigniting conflict. […] Climate change is bringing additional pressures, such as new diseases and pests, making those few crops – and those that farm them – even more vulnerable to extreme weather patterns. Yields of the local staple crop, sorghum, are likely to fall without changes to the ways in which it is farmed.”

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.”