On 15 April 2023, clashes erupted between the Sudanese Armed Forces (SAF) and the Rapid Support Forces (RSF) in multiple areas of Sudan. While multiple ceasefires have created temporary lulls in fighting, violence continues. As at 6 June, the conflict had resulted in at least 866 deaths and 6,000 injuries according to the Federal Ministry of Health (FMoH).

Since 15 April 2023, intense fighting has been occurring in the capital Khartoum and other parts of the Sudan. The heavy fighting has resulted in forced displacement into neighbouring countries, including Ethiopia, and will have broader implications for conflict in the region. 

As at 14 May 2023, the conflict that began on 15 April in Sudan had displaced more than 57,000 people to South Sudan. 90% of this number were conflict-displaced South Sudanese returnees. The majority of the displaced are settling in border towns in Upper Nile state. 

As at 1 May 2023, at least 30,000 people were reported to be displaced to Ouaddai, Sila, and Wadi Fira provinces in Chad because of military clashes in Tandulti area in Ag Geneina locality and Foro Baranga town in West Darfur state, Sudan.

The report provides a snapshot of the humanitarian access situation in Sudan following the start of fighting on 15 April 2023, focusing on conflict-affected areas. It also provides some insights into the overall humanitarian access situation in the country since the military takeover in October 2021.

This report provides an update on the impact of conflict on Sudan’s healthcare system using a secondary data review of public sources. Operational constraints and political sensitivities hinder data and information gathering among humanitarian responders, resulting in information gaps and the lack of a holistic understanding of the crisis impact. 

On 15 April 2023, a violent power struggle broke out in Sudan’s capital of Khartoum. As at 18 April, at least 200 people were dead, and 1,800 were injured. The violence has led to the closure of hospitals and movement restrictions ordered by the army across Khartoum.

Since the rainy season started in June, heavy rains have been causing flash floods across Sudan, affecting 16 of the 18 states in the country. As at 5 September, the floods had killed more than 100 people, affected more than 278,500 people across the country, and totally or partially damaged over 58,600 houses. The risk of further flooding remains high.

Since December 2020, there has been a significant increase in resource-based intercommunal violence between Arab and non-Arab tribes in the Darfur region, located in western Sudan. Between January–July 2022, more than 470,000 people were internally displaced in Darfur, with violence cited as the main reason. 

The latest intercommunal violence in Blue Nile state began on 13 July 2022. As at 25 July, the violence had killed at least 90 individuals and injured more than 300. It had also led to the displacement of 31,000 people. 

Possible developments in people’s ability to live safely and meet their basic needs over the next 12 months.

On 15 January, armed clashes broke out in and around Ag Geneina, West Darfur’s state capital. Attacks on three Krinding IDP camps and other areas on the outskirts of Ag Geneina resulted in the displacement of 108,800 people to Ag Geneina town and surrounding villages. 

Sudan is affected by a combination of political and economic instability, conflict, climate change-related shocks including heavy flooding and severe drought, endemics, and an influx of refugees from neighbouring countries. These factors have contributed to heightened poverty, increased population displacement, and food insecurity. 

As of 20 August, some 179,000 people have been affected by heavy rains and flooding across 15 states in Sudan according to the government’s Humanitarian Aid Commission. Worst affected is White Nile state with nearly 66,500 people who are impacted by flooding. Flood water destroyed or damaged at least 34,500 homes and impacted WASH and health facilities.

Since President Al-Bashir was overthrown in early April a transitional military council has been in place. Demonstrations against military rule are ongoing as people call for a transfer of power to civilians. Since the demonstrations started in December 2018, protestors have faced severe human rights violations committed by Sudanese security forces. 

Sudan has faced severe economic challenges since the beginning of 2018. The elimination of wheat and flour subsidies in February 2018, coupled with continual devaluations of the Sudanese pound caused shortages of essential commodities and hard currency. The economic crisis is disrupting public services, impacting agricultural activities, and resulting in dramatic price increases for staple foods. 

Heavy rainfall from 23–25 July caused flooding in El Nuhud town, West Kordofan state. An inter-agency rapid assessment concluded on 2 August estimated that more than 23,000 people had been affected in El Nuhud alone. Shelters and WASH infrastructure have been significantly damaged. 

Conflict between the government and armed groups in Darfur has been ongoing since 2003. The government has renewed the ceasefire on 2 July for a further four months. The armed groups they are clashing with, also signed a ceasefire agreement on 3 May. Despite these declarations, clashes occurred in both May and June, highlighting a lack of commitment to the ceasefire agreements on both sides.

A cholera outbreak that started in Blue Nile state in August 2016 began to spread rapidly as of April this year. Conservative estimates suggest a minimum of between 15,000-23,000 people infected, with 280-820 deaths. It is currently affecting Gedarif, White Nile, Khartoum, Sennar, River Nile, North Kordofan, and Gezira states. 

Floods during the rainy season from June until at least October will affect about 200,000 people, mostly in southern Sudan. Particularly vulnerable are the displaced in southern Sudan, where there are 2.3 million IDPs and about 400,000 South Sudanese, 110,000 of whom arrived in 2017. Floods will damage key WASH infrastructure and increase the caseload of diseases including cholera and malaria.