The visit of two senior directors from the World Health Organisation (WHO) to Sudan on 8 September has highlighted what seasoned observers have known for months: the situation is dire. Director-General Dr Tedros Adhanom Ghebreyesus and Regional Director for the Eastern Mediterranean, Dr Hanan Balkhi, were appraised of the issues in a country where ten million people have been displaced and a man-made famine has begun.
Until just recently, the conversation on Sudan had been dominated by the political complexities, but fighting has now intensified after US-led ceasefire negotiations in Geneva in August were aborted when one of the two warring parties failed to attend.
The threat of disease
The WHO visit comes at a particularly crucial time, after flooding hit various parts of Sudan, exacerbating the situation for civilians with the spread of several epidemic diseases across most of Africa’s third-largest state. Not least among these diseases is cholera. The Sudanese Ministry of Health has now reported 8,350 confirmed cases. The WHO announced an outbreak back in May, with over 11,300 cases and at least 300 deaths.
Little is known about the situation in areas of active conflict, especially in the capital, Khartoum, Al Jazeera, and the states of the Darfur region. The crisis is not limited to cholera—there have also been widespread outbreaks of malaria, measles, and dengue fever—but with a healthcare sector that has been hit hard by the war, civilians often cannot get treatment.
From the very beginning, the Rapid Support Forces (RSF) militia has deliberately targeted the country's healthcare infrastructure, including the destruction of warehouses containing medicines and vaccines. Even maternity, women's, and children's hospitals have been repeatedly bombed by the RSF, along with other healthcare facilities. Around three-quarters of these establishments have now ceased to function.
Compounding the problem
Just as the Sudanese people felt it could not get any worse, the flooding brought extra misery and devastation. The heroic resilience of Sudanese doctors and healthcare workers stands as a beacon of hope, representing the endurance of the Sudanese people to confront disasters with courage, bravery, and dedication. Caught on video, Dr Mudathir Ahmed Yahya, the medical director of Tokar Hospital, even swam through floodwaters that had cut off access to the hospital in order to reach his patients and resume his work.
The WHO visit earlier this month coincided with the release of a report by the UN Independent Fact-Finding Mission on Sudan, established by the United Nations Human Rights Council. It documented widespread violations and horrific crimes committed by both the RSF and the Sudanese Armed Forces (SAF). RSF crimes included the targeting of civilians and aid workers, rape and sexual violence, arbitrary arrests, torture, mistreatment, ethnic targeting, and numerous acts that amount to war crimes and crimes against humanity, including mass killings, enslavement, and forced displacement.
The report concluded that civilians in Sudan face acute, unprecedented, and continuous threats and recommended the creation of an independent force to protect civilians and ensure safe access to humanitarian aid.
This reflects a traditional method the international community uses to protect civilians during wartime: deploying peacekeeping or peacemaking missions with military forces on the ground. Such missions are typically established on the back of a UN Security Council (UNSC) decision.
