Sudan: A forgotten camp inside a forgotten war
MSF warns humanitarian presence is fading as needs rise in El Gedaref
Across Sudan, healthcare, nutrition, clean water and other basics for survival are in desperate need. As the situation becomes more desperate, local crises must reach near-catastrophic levels just to attract attention and unlock emergency funding.
Um Rakuba refugee camp in eastern Sudan has not yet reached catastrophic levels, but
walk through the Doctors Without Borders/Médecins Sans Frontières (MSF) hospital in the camp and the most common sound you hear is the crying of newborn babies being treated for malaria, malnutrition and other medical emergencies. The warning signs are there.
Um Rakuba has hosted Ethiopian refugees since 2020, when conflict erupted in Ethiopia’s Tigray region. The camp now hosts about 17,000 refugees, most of them women and children.
“Our health promotion teams consistently hear concerns about the decline in essential services. Communities continue to place strong trust in MSF, but they are asking for greater advocacy to address growing gaps.”
Zelie Antier, MSF project coordinator of Um Rakuba camp hospital
MSF has supported the camp hospital and provided emergency medical care since the beginning of the response. When Sudan’s war erupted in 2023, the hospital became far more than a refugee health facility. Today, about 80 per cent of consultations are drawn from a surrounding population of around 100,000 people.
“I came here because three or four hospitals in our area have closed,” says Manasak, a Sudanese woman seeking care for both her aunt and her child in the camp hospital. “Where else should we go? We need more support and not only for Sudanese communities, but also for refugees.”
One by one, the NGOs left
At the height of the Ethiopian refugee response in 2021, around 35 national and international organizations were operating in and around Um Rakuba camp. Today, fewer than 10 remain.
Many relied heavily on UNHCR funding. As foreign aid budgets shrank, humanitarian services followed suit.
Protection referral pathways for the refugees have weakened, particularly for women and children, including unaccompanied minors. Water and sanitation shortfalls affect both the community and MSF’s hospital. Refugees report reductions in food assistance, while treatment interruptions at primary healthcare facilities are leading to more severe medical complications by the time patients reach MSF.
“Sudan was once called the food basket of the area. Yet every day we were treating children with severe acute malnutrition. I have never seen this level of despair in my career.”
Tanya Hajj Hassan, MSF pediatrician
“Our health promotion teams consistently hear concerns about the decline in essential services,” says Zelie Antier, MSF project coordinator of the camp hospital. “Communities continue to place strong trust in MSF, but they are asking for greater advocacy to address growing gaps. Local organizations supporting women and children often lack the resources to meet increasing needs.”
A war over resources
In 2024, more than one million Sudanese people were displaced from areas that witnessed harsh fighting, such as Khartoum, Sennar and Al Jazirah. This placed enormous pressure on a struggling health system that was already stretched to the limit with cholera outbreaks.
Tanya Hajj Hassan, an MSF pediatrician who visited El Gedaref nearly a year ago, recalls driving through fertile green fields on her way to the hospital.
“Sudan was once called the food basket of the area,” she says. “Yet every day we were treating children with severe acute malnutrition. I have never seen this level of despair in my career.”
That despair included the loss of hope among mothers.
“The first time I observed it was when a mother brought her child to the emergency department in a very critical condition,” she says. “While we were resuscitating the child, she asked if she could leave. We explained that the child might die, and she simply accepted it. I think that reflects how tragically normalized child deaths have become in Sudan.”
We cannot stand alone
Almost a year after Hajj Hassan’s visit, many of the same challenges remain in the camp.
Food assistance remains insufficient. Refugees currently receive about four kilograms of wheat per person per month, dropping to around two-and-a-half kilograms in some months. In early 2023, before the war in Sudan broke out in April, they received around 14 kilograms.
There are also not enough latrines and shelter remains inadequate.
“Without increased funding and a stronger humanitarian presence, people will continue to face preventable suffering. MSF alone cannot meet these needs.”
Mohamed Ahmed, MSF country director
MSF remains the only provider of secondary healthcare and comprehensive services for sexual and gender-based violence in the camp. Access to HIV, tuberculosis and neglected tropical disease care remains severely constrained, while recurrent outbreaks of cholera, measles, malaria and meningitis continue to threaten communities in vulnerable situations.
“Across sectors from healthcare and protection to water, sanitation, food and education, people are telling us they feel increasingly abandoned,” says Mohamed Ahmed, MSF country director. “Without increased funding and a stronger humanitarian presence, people will continue to face preventable suffering. MSF alone cannot meet these needs.”
MSF had already raised the alarm in El Gedaref, warning humanitarian organizations and UN agencies about the deterioration of living conditions and essential services in and around Um Rakuba camp. Yet, despite the warning signs and growing needs, no clear plan to scale up assistance has materialized.
Sudanese local organizations continue to provide crucial support, often with extremely limited resources. Their contribution is essential, but they cannot replace a fully funded humanitarian response.
“Our appeal to donors and humanitarian organizations is to match words with action,” Ahmed says. “Communities cannot survive on promises. We need stronger protection services, restored primary healthcare and greater investment in essential services. Refugees must not be forgotten within the broader Sudan crisis.”
The people of Um Rakuba are not asking for sympathy. They are asking for the minimum every human being deserves: healthcare, protection and the chance to live with dignity.
The cries of newborns still fill Um Rakuba’s hospital wards. Mothers who are refugees and members of the host community continue to arrive seeking care.
The question is not whether the needs exist. The question is whether anyone is still willing to respond.
