MSF: Sudan war claims catastrophic civilian casualties

The ongoing war in Sudan has led to a catastrophic breakdown in the protection of civilians. The population is exposed to indiscriminate violence, killings, torture and sexual violence, according to a report by the aid organization Doctors Without Borders (MSF).

The report, titled “A War Against People – The Human Cost of Conflict and Violence in Sudan,” details how fighting between the Sudan Armed Forces (SAF) and the Rapid Support Forces (RSF) is causing severe violence across the country. Since fighting began in April 2023, hospitals have been attacked, markets bombed, and homes razed, mostly by RSF militias.

MSF, which operates in eight states in Sudan, provided alarming statistics. At Al Nao Hospital in Omdurman, Khartoum State, 6,776 patients were treated for violence-related injuries between August 15, 2023, and April 30, 2024, an average of 26 people per day. Most injuries were caused by explosions, gunshots and stabbings.

An employee at Al Nao Hospital described the aftermath of the shelling of a residential area. “About 20 people arrived and died immediately afterward; some were already dead. Most arrived with their hands dangling or their legs already amputated. One patient had a leg amputated and his caregiver carried the missing limb,” he said.

The report also highlights shocking cases of sexual and gender-based violence, particularly in Darfur. A survey conducted by MSF of 135 survivors treated in refugee camps in Chad between July and December 2023 found that 90% were abused by armed perpetrators, half were attacked in their homes and 40% were raped by multiple attackers.

These findings are consistent with testimonies from survivors still in Sudan, showing that sexual violence against women is widespread in their homes and along escape routes. An MSF patient from Gedaref described the abduction of two young girls from her neighborhood in March 2024. The patient’s brother, who was also abducted, reported that the girls were held and abused for two months.

The report also includes accounts of ethnic violence in Darfur. In mid-2023, RSF and allied militias reportedly attacked Masalit and other non-Arab ethnic groups in Nyala, South Darfur, looting, beating and killing residents. One patient in Nyala reported being stabbed multiple times by men in RSF camouflage uniforms. “When they left my house, they saw me lying on the ground, barely conscious, and said, ‘He’s going to die, don’t waste your bullets,'” the patient recalled.

Throughout the conflict, hospitals have been regularly looted and attacked. In June, the World Health Organization reported that only 20 to 30 percent of health facilities in hard-to-reach areas remained functional. MSF has documented at least 60 cases of violence and attacks on its staff, assets and infrastructure. The MSF-supported Al Nao Hospital in Omdurman was shelled three times. In May, an airstrike caused the roof of the intensive care unit at the MSF-supported Baker Nahar Children’s Hospital in El Fasher to collapse, killing two children and forcing the hospital to close.

Despite the dire state of the health system, humanitarian and medical organizations often face significant obstacles in providing assistance. Although authorities have begun to issue visas more easily to humanitarian personnel, bureaucratic blockages such as denial of travel permits continue to prevent basic medical care.

“The violence of conflicting parties is exacerbated by obstruction,” says Vickie Hawkins, Director General of MSF. “When people need assistance most, when it is blocked, disrupted and prevented, withholding stamps and signatures in Sudan can be as deadly as bullets and bombs.”

“We call on all warring parties to step up humanitarian assistance,” Hawkins added. “Above all, we must end this senseless war against the population by immediately ceasing attacks on civilians, civilian infrastructure and residential areas.”