Nairobi, August 1, 2024 — Repeated attacks on health care facilities in El Fasher, capital of Sudan’s North Darfur state, are causing the already heavy death toll in the city to rise even further while the ongoing blockage of urgently needed medical supply trucks is putting even more lives at risk, warns Doctors Without Borders/Médecins Sans Frontières (MSF). MSF calls for all parties to respect health care facilities and civilians, and to allow the urgent delivery of food and medicines to the area.
A July 29 attack on the MSF-supported Saudi Hospital in El Fasher was the 10th time a hospital has been hit in the city since the fighting escalated on May 10. Three caregivers were killed in the attack and 25 people were injured, including displaced people who were sheltering in a nearby mosque that was also hit. The shelling took place while El Fasher was under attack by the Rapid Support Forces (RSF).
No precautions to spare hospitals
At least nine people have been killed in the 10 attacks on hospitals in El Fasher over the past 80 days, and at least 38 have been injured.
“We do not know if hospitals are being intentionally targeted, but the incident on Monday shows that the belligerents are not taking any precautions to spare them,” said Stéphane Doyon, head of MSF’s emergency response in Sudan. “They are not making any efforts to prevent the death of civilians or to ensure the protection of patients and medical staff. As a result, many more lives are being lost.”
Since the fighting intensified almost 12 weeks ago, over 2,170 wounded people have been treated at MSF-supported hospitals in El Fasher, and over 300 people have passed away from their injuries.
“The warring parties are well aware of the location of Saudi Hospital, and they are also well aware that it is the last remaining public hospital in the city with the capacity to treat the wounded,” said Doyon. “It has been hit four times now, and if it goes out of service like South Hospital did when they raided it in June—the fifth time that facility was attacked—there will be nowhere left in the city for the injured, or women in need of life-saving emergency cesarean sections, to receive surgery.”
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Read more“The pediatric hospital was also made non-functional in May when it was damaged by a bomb that landed close by, killing three people including two children who were in the intensive care unit (ICU)," Dayon added. "Children in need of hospital treatment are now being treated in a small health clinic with limited equipment—or, if they have war injuries, they are being treated in Saudi Hospital.”
Timeline of attacks on hospitals in El Fasher
BABIKER NAHAR PEDIATRIC HOSPITAL
Children in El Fasher lost access to specialized treatment when an airstrike carried out by SAF on May 11 landed 50 meters [164 feet] from the pediatric hospital, Babiker Nahar, which was supported by MSF. This led to the collapse of the roof above the ICU and the deaths of two children who were receiving treatment there, as well as the death of a caregiver. One caregiver was also injured, losing their leg.
SAUDI HOSPITAL
On May 19, Saudi Hospital was damaged by shelling (this was prior to being supported by MSF).
On the night of June 21, the pharmacy at the MSF-supported Saudi Hospital in El Fasher was hit by shelling from RSF. A pharmacist was killed while on her shift, and the pharmacy building was damaged
Saudi Hospital was hit again on June 27 when a bomb landed inside the hospital compound, breaking windows and damaging the water tank. Two bombs also landed just 66 feet outside the facility. A fourth landed 164 feet from MSF's office.
On July 29, two shells hit Saudi Hospital, killing three people and injuring 25.
SOUTH HOSPITAL
On May 25, a mortar landed on the prenatal care unit, killing one person and injuring eight among patients and their families. The next day, on May 26, a shell landed inside the hospital and injured three more people, while fragments from the explosion broke the windows of the delivery room and of the ambulance. Three other shells landed outside the hospital. The third incident took place on May 31, when shelling again impacted South Hospital, and the fourth took place on June 3, when shelling and shooting impacted the hospital. One patient was killed, one was wounded, and the water tank was damaged, impacting water flow in the hospital.
On June 8, a fifth attack took place when RSF soldiers entered the hospital, opened fire, and looted the facility, including taking an MSF ambulance. Thankfully most patients had already been evacuated when this happened. Remaining patients and staff—including MSF staff—escaped the scene and all activities in the hospital came to an end.
Medical supplies are running out as trucks are blocked
In addition to attacks on health facilities, MSF supply trucks have been held by RSF in the town of Kabkabiya for the past four weeks. As more wounded patients continue to flood into Saudi Hospital, medical supplies are running out, putting lifesaving activities at even more risk. Saudi Hospital could soon run out of essential supplies.
“Our trucks left N’Djamena in Chad over six weeks ago and they should have reached El Fasher by now, but we have no idea when they will be released,” said Doyon. “In El Fasher, we only have enough surgical kits left to treat 100 people. If the casualty numbers continue to increase at the same rate as we are seeing now, these supplies will soon run out.”
“We desperately need our trucks to arrive,” added Doyon. “But they do not only contain supplies for Saudi Hospital—they also contain therapeutic food and medical supplies for children in Zamzam camp*, where there is a catastrophic malnutrition crisis. Because these supplies have not yet arrived, we only have enough therapeutic food left to last another few weeks. Already, many children there are at death’s door. These supplies are needed to save their lives. If the blockade on humanitarian aid is not lifted as a matter of urgency, there is going to be an even greater death toll.”
In January, a rapid mortality assessment conducted in Zamzam camp found that a child was dying every two hours. A mass nutrition screening of over 63,000 people carried out in March and April in Zamzam found that a third of children under five years old were suffering from malnutrition, and a similar figure was found among pregnant and breastfeeding women. These findings were double the emergency threshold of 15 percent for both groups, indicating a life-threatening malnutrition crisis in Zamzam camp.
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Read moreWith the current conflict, it is very difficult to obtain updated information, but given prior malnutrition rates, increased displacement of people, and the new difficulties created by heavy fighting in accessing food due to security concerns and market disruptions, the situation is likely to remain alarming. A massive scale-up in the response is needed.
MSF urges all parties to stop attacking hospitals in El Fasher and across Sudan, and the RSF to release MSF trucks from Kabkabiya so that lifesaving medical supplies can be brought to Saudi Hospital and MSF facilities in Zamzam camp. MSF also urges the warring parties to enable the swift arrival of all humanitarian supplies and convoys to El Fasher and Zamzam, where they are vital for preventing the further deterioration of the health of the population
