5 December 2024 – Recent escalations in the conflict and attacks on civilians in Al Jazirah State resulted in the displacement of more than 393 000 people between 20 October and 28 November 2024, around 17 000 of them displaced for the second time.
Many undertook long journeys under harsh conditions, arriving at gathering and displacement sites exhausted and in need of food, water and immediate medical attention. Some suffered from untreated conditions during their days of travel. Tragically, others became ill along the way and died before they could receive the lifesaving health care they needed.
Between 15 and 19 November 2024, a team of experts from the World Health Organization (WHO) Sudan Country Office and state level offices traveled to Kassala and Gedaref states to assess the immediate health needs of internally displaced persons (IDPs) and the capacity of the health system to meet their needs, including addressing cholera. The assessment team visited IDP sites, temporary settlement areas and primary health care facilities in different localities in the 2 states where newcomers arrive every day, and met with state health officials and partners.
The team visited cholera treatment units and dengue isolation centres in Garb Al Gash, Halfa Al Jadeeda (Village 6 Arab) and Al Fao localities, where large numbers of cholera and dengue patients are admitted for treatment. The team also visited a temporary mobile clinic in Village 6 Arab set up in a makeshift shelter where between 100 and 150 patients a day receive essential outpatient care.
Overwhelmed by an earlier influx of IDPs from Sennar State in June and July 2024, almost all the sites and temporary shelters were already overcrowded before the latest wave of new arrivals, with the health system stretched to breaking point.
The team visited stabilization centres, in Al Kuwaiti Hospital in the Garb Al Gash locality of Kassala and in the Al Fao locality of Gedaref, where WHO-supported nutrition stabilization centres are providing care and treatment to severely acute malnourished children with medical complications. Stabilization centre staff who have attended WHO capacity building trainings provide around-the-clock care to children who need close monitoring and management.
Medical and nutrition supplies provided by WHO have helped treat over 34 000 children across Sudan in 2024, including the children receiving care in these centres.
The escalation of conflict in Al Jazirah and influx of IDPs has increased pressure on water, sanitation and hygiene (WASH) in both Al Jazirah and other states – Gedaref, Kassala and River Nile – receiving newly displaced persons, leading to a significant increase in cholera cases.
Recommendations from the assessment mission will be implemented in a scaled up cholera response, including increasing the number of cholera treatment units to manage severe cases and additional rehydration points for the management of mild to moderate cases. WASH interventions will also be scaled up, alongside intensive community engagement and risk communication.
WHO has supported the Federal Ministry of Health request for an additional 2.2 million oral cholera vaccines from the International Coordination Group on Vaccine Provision (ICG) to help curb the cholera outbreak. Earlier cholera vaccination campaigns in Al Jazirah, Kassala, Gedaref, Sennar, Red Sea, River Nile and White Nile states in 2024 reached 6 million people. Vaccine doses have been received for campaigns to be implemented in other priority localities in the coming weeks.
In Gedaref, the WHO team visited one of the 61 primary health care (PHC) centres across Sudan which receive operational, human resource and technical support, supplies and consumables to improve access to essential health care services for IDPs. The 8 WHO-supported PHC centres operational in Gedaref are all located in or near displacement camps. On an average day, the PHC centre pictured above provides care, including management of noncommunicable and communicable diseases, maternal and child health care, minor surgeries, trauma care, response to gender-based violence (GBV) and mental health and psychosocial support, to 150 patients.
The team also met with the Kassala and Gedaref state ministries of health to discuss the scope of the mission, the health response in displacement camps and among host communities, review challenges and ways to improve access to health care and essential medicines for the most vulnerable communities.
During their visit to the IDP camps, the assessment team engaged with site managers to emphasize the critical need to ensure access to WASH in temporary shelters and displacement sites and prevent the spread of cholera in sites and neighbouring communities.
WHO will support the provision of WASH kits, including testing kits, chlorine, soaps and hand-washing facilities, and the renovation of the sewage system in 4 hospitals to ensure appropriate management of human waste. In addition, WHO will support risk communication and community engagement campaigns, including mobilizing affected communities, including IDPs, for camp and neighbourhood cleaning campaigns.
The team visited a WHO warehouse where medicines and medical supplies are stored before distribution to health partners. Over 2024, WHO has distributed 1140 metric tons of medicines and medical supplies, including diagnostic kits, trauma and emergency surgery supplies, medicines for communicable diseases like cholera and malaria and for noncommunicable diseases, nutrition supplies, reproductive health and mental health supplies, blood bags and other essential drugs.
In the displacement sites, the team dispursed to interact with those living in the camps, including children. As the children talked with Hala Khudari, who led the WHO team, the harrowing experiences they have endured were momentarily hidden. But these children, who have endured the horrors of war – losing their homes, witnessing death, disease and violence – urgently need mental health and psychosocial support.
They also need food, shelter, clean water and sanitation. And above all, they need peace.
