MSF staff provide medical consultations at one of the gathering sites in Kassala, Sudan. This site has received a large number of people with disabilities, who were relocated due to violent clashes in areas of Khartoum and Wad Madani with the help of local Sudanese activists and charitable groups. © MSF

Urgent humanitarian intervention needed: The plight of internally displaced people in Kassala, eastern Sudan

As of February 2024, close to 190,000 people have been displaced in Kassala state alone (International Organization for Migration IOM), underscoring the urgent need for comprehensive humanitarian assistance. Among them are approximately 40,000 people who fled recent violence in Al Jazirah state.

The plight of internally displaced people in Kassala is emblematic of the broader humanitarian crisis in Sudan resulting from the ongoing brutal conflict. People are experiencing widespread loss of life and livelihoods and food insecurity.

Doctors Without Borders/Médecins Sans Frontières (MSF) planned a 10-week program to provide targeted medical and humanitarian aid in response to the acute emergency.  This work concluded on March 10. The scale of the crisis is beyond the capacity of any single organization, demanding urgent and coordinated action from the international community. The journey to Kassala was not easy for displaced persons, many of whom suffered displacement several times before reaching there; one displaced person explains the risky trip of him and his family to Kassala.

“After having the money to move from Wad Madani to Kassala, moving became difficult. We searched for four days to provide a vehicle and couldn’t find any. We used the karoo (a wooden cart pulled by a donkey), and then we used the tuk-tuk, where people were divided into groups,” says Abdul Ghani a displaced person in Kassala. “As I remember, we were in the area of Bekah bridge for the evacuation, a warplane flew over us and in return, they (Rapid Support Forces) used anti-aircraft guns and we were 20 meters away. This was one of the most difficult situations we went through.”

Living conditions of displaced people in Kassala are extremely dire, marked by overcrowded shelters, limited access to food and clean water, and inadequate healthcare services and access to them. Since the end of December 2023, MSF teams have treated 2,126 patients for respiratory infections in the different gathering sites for displaced people in the city – while this is a common morbidity in the cold temperatures, this is made worse for people who have no choice but to sleep in shelters that do not sufficiently protect them from the cold and wind. Many rely on the generosity of host communities for necessities, heightening their vulnerability to disease and deprivation. The spectre of cholera, typhoid, and dysentery looms large, threatening the health and well-being of displaced people.

The MSF intervention included the provision of primary healthcare services, sexual and reproductive healthcare, mental healthcare, and health promotion initiatives. Mobile clinics were deployed to reach remote gathering sites, ensuring that essential medical care reached those who needed it most. For one month (Feb. 11 to March 10), teams provided 2,545 medical consultations to displaced people, and offered psychological first aid to 1,334 people (172 group sessions, and 167 individual sessions), who were affected by violence and were suffering from the conflict and multiple displacement experiences. 

“Significant challenges persist. The soaring cost of medical services, particularly for women in need of reproductive healthcare, presents a formidable barrier to access. Furthermore, the protection of survivors of sexual and gender-based violence remains a pressing concern, with limited access to safe spaces and support services exacerbating their vulnerability.”

Claire San Filippo, MSF deputy country director in Sudan

Access to treatment for non-communicable diseases such as hypertension and diabetes is severely compromised, further exacerbating the health crisis in Kassala. Almost 800 patients (13 per cent of the overall number of outpatient consultations) were treated for chronic diseases by MSF teams during the 10 weeks of emergency intervention. On top of that, limited movements of supplies and inflated costs have rendered essential medications inaccessible for many. “I am sick, I have hypertension; because of the conflict I have not taken my medication for 10 months. Where would I get the money for it? I can’t afford it. I tried to collect some money, do some work here. The assistance we receive is not sufficient,” says Moana*, a woman who has lived through multiple displacements together with her family, since the war started.

The need for expanded humanitarian efforts extends far beyond the confines of Kassala state. Urgent action is desperately needed across all of Sudan, – in harder-to-reach areas like Darfur and Khartoum, but also in Eastern Sudan, where more access is possible but still only a trickle of assistance in proportion to the vast humanitarian needs gets through. More assistance and strengthened coordination between the few existing actors present is needed in order to ensure basic access to healthcare, a sustainable supply of food, clean water, and sanitation must be prioritized to alleviate the suffering of displaced communities and prevent further loss of life.

* Patients names have been changed to protect their identity

In eastern Sudan. MSF runs health facilities in Taneidba and Um Rakouba camps serving refugees, internally displaced people and local communities. In Blue Nile, we support Ad Damizine teaching hospital.

MSF teams work in 11 states: Khartoum, Port Sudan, Al-Jazeera, White Nile, Blue Nile, River Nile, Al Gedaref, West Darfur, North Darfur, Central Darfur and South Darfur state. MSF teams are also providing assistance to refugees and returnees across Sudan’s borders in South Sudan and Chad