War, a cholera outbreak and shortages of medicine and food have made working conditions difficult for Médecins Sans Frontières (MSF) medics in Darfur, Sudan.
The international medical humanitarian group, which has several teams in the war-torn country, is also struggling with a shortage of vaccines, with children desperately in need of immunisation.
The conflict between the Sudanese Armed Forces (SAF) and the Rapid Support Forces (RSF) erupted into a full civil war in April 2023, displacing millions of Sudanese civilians. Much of the war has taken place in the capital Khartoum but it has spread to other areas, including Darfur.
Dr Ali Almohammed, the group's emergency health manager in south Darfur, spoke to TimesLIVE Premium about the challenges they face.
Almohammed said they are dealing with cases of malnutrition while confronted with limited medical supplies. Some patients have run out of life-saving chronic medicines.
“We are supporting many primary health-care facilities to do community-based activities. Some interventions include food distribution and providing cash grants for some local initiatives,” he said.
MSF is assisting local organisations with vaccination campaigns and managing a cholera outbreak in south Darfur, he said. “It is really too much for MSF to be able to meet all these needs because access is super complicated ... you cannot access south Darfur from Port Sudan.”
As a result of the access issues, MSF is bringing medical supplies from neighbouring Chad, which has its own challenges. “Many organisations are struggling to cross the border because the two warring parties, the RSF and SAF, are using humanitarian access as a tactic of war.”
To be able to cross the border safely, MSF members often need to get approvals from the warring parties, he said. “It is also not easy to get the approvals [to cross] but we are crossing the border because we know there's a need. We are trying to be clear to everyone that there is a need and we need to work on both sides.”
Survivors of sexual violence are also coming forward, with more than 650 treated in the past year, he said. “Most of these women and girls were sexually assaulted while looking for food or collecting wood or even at home.”
MSF's pressing needs include medical supplies, especially vaccines, he said.
“We are one of the few international medical humanitarian organisations in Darfur with supplies. There are a lot of local NGOs ... they are working but they don't have medical supplies because it's a challenge to get these.”
He also cited a recent attack on a WFP and Unicef convoy which has made it “super challenging” to move humanitarian supplies.
UN agencies are usually leading and coordinating the humanitarian response during conflicts [but] unfortunately in south Darfur they are not on the ground
— Dr Ali Almohammed
MSF has been in Darfur since January 2020 but its operations were affected by the escalating conflict, which forced the team to evacuate in early 2023. It returned in January last year. Since then they have only received a few consignments of vaccines — insufficient to cover all the localities of Darfur.
Though food is being distributed, it is not enough and health-care workers are now dealing with increasing cases of malnutrition.
The absence of UN agencies on the ground in several parts of Darfur makes it challenging for humanitarian agencies to work in conflict areas, said Almohammed.
“UN agencies are usually leading and coordinating the humanitarian response during conflicts [but] unfortunately in south Darfur they are not on the ground.”
No other international NGOs are in south Darfur where Almohammed and his team are based.
“They [other international humanitarian organisations] are moving very slowly. They have limited resources and capacity to respond.”
Even before the conflict, Darfur had low levels of immunisation coverage. But since the war broke out, constant administrative impediments and regular blockades of key supply roads have caused vaccine shortages throughout the area. This has led to a disruption in routine immunisation programmes in several locations, sometimes for months.
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