Sudanese Citizens Between Hunger and Deteriorating Health Services
Report: Maashaer Idris
Residents of Khartoum State are suffering from deteriorating health and humanitarian conditions, alongside the spread of diseases like dengue fever and malnutrition, which have claimed dozens of lives due to the lack of healthcare. Additionally, the shutdown of dozens of kitchens that provided food to citizens in these areas has exacerbated the situation. All these problems and challenges faced by the citizens result from the ongoing fighting in Khartoum State.
Ongoing Fighting
Fatima Ali (a pseudonym), a resident of Al-Haj Yousif area east of the Nile, complained about the lack of health and humanitarian services in the area due to the ongoing fighting. She said, "The kitchens in the area significantly contributed to providing food for the residents of Al-Haj Yousif neighborhood for 15 months since the outbreak of the war. But due to the lack of sufficient funds, dozens of kitchens have stopped, worsening the health and humanitarian situation in the area." Fatima confirmed that three of her children have been suffering from malnutrition for more than two months, alongside her husbands low income, which is insufficient to provide suitable food for the children. She called on both sides of the conflict to reach an agreement to save the children of Sudan from death.
The United Nations reported that around 755,000 people are facing famine in 10 states of Sudan, including the five major Darfur states, as well as South and North Kordofan, Blue Nile, Gezira, and Khartoum State. Additionally, 8.5 million people are in an emergency state (Phase 4 of the Integrated Food Security Phase Classification). The war in Sudan has been ongoing since mid-April of last year, significantly affecting the agricultural season as the war expanded across the country.
Dengue Fever Outbreak
A member of the emergency room in Khartoum Bahri revealed the emergence of more than 15 cases of dengue fever and spoke about the collapse of the health situation due to the lack of medicines in the area. In April last year, the Khartoum Bahri emergency room, the third city in Khartoum State, announced the detection of 384 suspected dengue fever cases. A member of the Halfaia emergency room stated that the room had recorded more than 15 cases of dengue fever among citizens over the past week, in addition to cases among Rapid Support Forces personnel spread throughout the area. He confirmed the widespread outbreak of the epidemic in the past two days and feared the worsening of the health situation due to the lack of medicines. He pointed out a real problem facing the room, namely the shutdown of the health center, the lack of solutions, analgesics, and medicines, and the absence of a pharmacy in the area since the outbreak of the war, along with the Rapid Support Forces preventing an ambulance from entering to transport the injured for tests in Bahri.
He mentioned that the nearest hospital to save patients is Al-Dawli Hospital in the Al-Muasasa area, which is difficult to access, especially since the Rapid Support Forces control the area. He pointed to the increased violence perpetrated by the Rapid Support Forces against civilians recently. The health situation is extremely complex due to the closure of many hospitals in conflict areas, reaching up to 80%, which has limited the healthcare systems ability to respond to outbreaks and diseases.
Rising Malnutrition Rates
Similarly, a member of the emergency room in Al-Jarif East announced rising malnutrition rates due to a shortage and scarcity of food supplies in the area. The emergency room member, who preferred not to be identified for security reasons, reported that there were 74 cases of malnutrition, including 41 boys and 33 girls. Additionally, 35 children were suffering from anemia, 4 from partial or total night blindness, and 5 from osteoporosis. She acknowledged the challenges they face, such as a lack of laboratories and the unavailability of some medicines.
Shutdown of Kitchens
A member of the East Nile Locality emergency room in Khartoum State revealed that a large number of kitchens in the area have been shut down since last April until the current month of June, due to a lack of support to fund these kitchens. On April 23rd, volunteers announced the death of three children from hunger in the Um Badda locality of Omdurman, the third city in the capital, Khartoum. The trapped residents there rely on communal kitchens supported by emergency rooms, which are run by volunteers. An East Nile emergency room member confirmed that 85 out of 175 kitchens have stopped for several reasons, including a lack of funding, high prices, security risks, and water shortages, as well as insufficient funding that only allows for food provision for four days. He added that 80% of the kitchens depend on support from emergency rooms, which is limited, and there are difficulties in obtaining cash, in addition to deductions made from these funds when withdrawn through banking applications.
He highlighted the deteriorating living conditions in East Nile, especially after the large number of kitchens the citizens rely on in their daily lives have stopped. He confirmed an increase in the number of families in the East Nile area recently, along with many cases of malnutrition appearing in the "Um Dwanban" and "Alban Jadeed" hospitals. An East Nile emergency room member complained about constant power outages in some neighborhoods, while in other areas, the electricity is cut off for long periods during the day. United Nations agencies have continued to warn of the growing hunger crisis in Sudan due to disrupted livelihoods and the obstruction of humanitarian aid to millions of affected people by the warring parties.
Continued Suffering
Last Thursday, the South Belt Emergency Room reported that the communal kitchen in the Al-Azhari West area, Block 24, served its last meal and announced it would completely shut down after running out of food supplies and support. The emergency room stated that the kitchen had been providing meals since last August, with daily meal counts ranging from 250 to 1,000. The supervisor of the Al-Azhari West kitchen said, "The meals were never enough, and many families left with empty containers." The statement highlighted that the kitchen was a beacon of hope amidst the hunger in the area and faced numerous challenges, occasionally shutting down and then resuming operations. They hope it can reopen soon.
According to the emergency rooms statement, the situation of the Al-Azhari kitchen is similar to other kitchens in the South Belt area of Khartoum, including the Kababish kitchen, which is also at risk of shutting down. Kababish kitchen has been providing meals for five months, serving 120 meals daily. The emergency room noted that Kababish kitchen is likely to stop operations due to a lack of financial and food supply support, similar to many kitchens in the area that have recently closed. The South Belt Emergency Room called on international humanitarian and relief organizations and local initiatives to unite and provide support for millions of hungry people in Khartoum State and tens of thousands in the South Belt area south of Khartoum.
Service Disruptions
Dr. Heba Al-Makki, Deputy Director of the Sudanese Health Promotion Department, predicted a deterioration in health and humanitarian conditions in Khartoum State due to the halt in health services resulting from the ongoing fighting between the army and the Rapid Support Forces for the past 15 months. She confirmed that no health services are being provided in Khartoum, but some hospitals, including Al-Nau and Omdurman, which are now out of service, are offering treatment services. She added that health services, including waste removal and water and food monitoring, have stopped. Essential services, such as water and electricity, have been disrupted in some areas, directly and indirectly affecting health conditions. She emphasized the impact on the nutritional status of citizens in Khartoum due to the shutdown of many kitchens. Dr. Heba acknowledged the challenges in conflict areas due to the inability to deliver humanitarian aid and the closure of markets, making it difficult to obtain food and medicine, thus affecting citizens health.
Dr. Heba highlighted that the role of international and regional organizations should not be limited to issuing condemnation statements. She stressed the need for measures to assist civilians according to international agreements, which state that civilians are not involved in armed conflicts and should be protected and provided with all their needs. She noted that they could not provide any assistance to civilians at the moment due to the lack of safe routes and the insecurity of roads for service providers, particularly activists who provide services in some areas facing danger.
Agreement to Protect Civilians
Sudanese legal expert Osman Al-Basri stated that the suffering of civilians in armed conflicts persists despite their protection under the four Geneva Conventions, particularly Article 32, which stipulates that civilians should not be subjected to any hardship, whether living or health-related. Osman Al-Basri added that the targeting of medical staff and humanitarian workers during the war, exemplified by incidents like the Red Cross attack and the bombardment and occupation of hospitals by the Rapid Support Forces, along with the looting and theft of shops and civilian facilities, are all clear violations of the Geneva Conventions.
He pointed out that the Rome Statute of the International Criminal Court, in Article 7, classifies crimes against humanity, including in paragraph (d), which prohibits exposing civilians to suffering and health problems as crimes against humanity. This is exactly what is happening in Khartoum State, making it one of the criteria for systematic and widespread crimes against humanity. He added that the suffering of civilians due to both warring parties constitutes a violation of international law under the four Geneva Conventions and the Rome Statute.
Role of International Organizations
Political activist Arwa Al-Sadiq states, "The United Nations agencies and offices, along with international and regional organizations, have various roles they play in Sudan, which fluctuate in scope from one area to another. These roles include monitoring, discussing, and clarifying the humanitarian situation, condemning human rights violations, and issuing denunciations. This process is influenced by the presence of personnel and staff from these agencies on the ground." He adds that these organizations typically respond with monitoring and action when severe human rights violations or major humanitarian crises occur, especially in major cities. The concerned organizations often take a cautious and multifaceted approach in their interventions and statements to ensure equality and justice in addressing the various humanitarian issues. Consequently, their impact is often felt more in Khartoum and places where these missions are located.
He mentioned that there is often neglect towards other areas, even within the capital. Some areas have been in darkness since the beginning of the war, lacking communication and the basic necessities of life. Thus, it is crucial to address all situations and problems facing Sudan comprehensively without selectivity or exclusion. Arwa highlights the need for international and regional efforts to increase awareness of important issues across all these areas and to work on finding international and regional solutions to these crises. It is also important to involve the local community in the solutions and to select volunteers to work within the offices of the United Nations agencies and organizations, especially in areas where the international staff cannot operate due to high-risk conditions.
Arwa calls on the United Nations to fulfill its financial and logistical commitments and to encourage cooperation between countries and international organizations to improve conditions and achieve stability in the affected areas, rather than monopolizing and restricting solutions and support to Khartoum alone. Arwa Al-Sadiq emphasizes that all parties bear the responsibility for the ongoing deterioration in Khartoum, in terms of health, security, and environment. The Rapid Support Forces have taken over the three cities and appointed a civilian administration that has failed to provide food and medicine for the residents, in addition to the lack of security and the spread of organized crime protected by armed groups.
In the areas controlled by the army, despite being the stronghold of the government, the efforts to provide clean water are far less than what the residents need. There is also a lack of essential medical supplies and life-saving drugs, and the cost of medical treatments is extremely high. Epidemics are spreading, and there is a complete failure in conducting cleaning campaigns and protecting the environment, especially with the arrival of the rainy season and the proliferation of mosquitoes and flies. Additionally, international support does not reach as needed due to complete control and domination by official authorities.
