The humanitarian situation in Sudan remains catastrophic. While the warring parties bear primary responsibility, the limited aid response and the global failure to prioritise the protection of civilians and humanitarian access have exacerbated people’s suffering. Although some progress was made on bureaucratic hurdles during the year, such as cross-border access to Darfur through Chad, it was often impossible to secure visas and travel permits in the east of Sudan, or crossline access, in a timely manner. In some cases, we were deliberately blocked from treating people in need; for example in North Darfur, where the RSF’s campaign of siege forced us to halt activities for patients already in the grip of famine in Zamzam camp.
Cholera and other disease outbreaks
In 2025, MSF continued to tackle the worst cholera outbreak the country has experienced in recent years. Whereas cases subsided in some states, such as Northern and Kassala, in the first half of the year, they rose in White Nile, following strikes against a power plant in February, which put pumps out of service and forced people to rely on contaminated water.
Cholera cases exploded in Khartoum in May, and spiralled out of control in Darfur in August. In response, often in partnership with other aid organisations, our teams set up or expanded treatment centres and oral rehydration points, distributed clean water, donated medical and logistical supplies, and improved sanitation and infection control in the affected areas.
There was also a steep rise in measles cases across Darfur due to a lack of routine and reactive vaccination campaigns. We increased our capacity to isolate and treat measles patients, and conducted several vaccination campaigns, while calling on the authorities and health partners to take urgent measures to curb the outbreak. Many of the children we treated were suffering from acute malnutrition, as well as measles, which increased their risk of developing life-threatening complications.
To strengthen child immunisation, our teams coordinated vaccine supplies and improved cold chain systems. Across the country, we also treated people with malaria, dengue, diphtheria, and whooping cough.
Widespread attacks against civilians and healthcare
No one was safe from the fighting, as both warring parties frequently hit residential areas, markets, aid convoys, and hospitals. Our teams assisted with mass influxes of injured patients in emergency rooms in Khartoum, Nyala, Tawila, and other locations. Our vehicles and places where we operate were also targeted during the year. On 10 January, one of our ambulances came under fire in North Darfur while referring a woman in labour, resulting in the death of a caregiver. In August, during an armed assault inside Zalingei hospital, where our teams were working, a Ministry of Health staff member was injured. This was followed by another shooting and death of a Ministry of Health staff member in the same facility in November.
In 2025, North Darfur and the Kordofans were the epicentres of extreme violence and mass killings, as the SAF and RSF waged a battle for control.
In North Darfur, we had to halt all our activities in Zamzam camp in February, due to the escalating attacks and siege that prevented us from sending in supplies and staff. Following the large-scale RSF assault on the camp in April, we provided emergency and surgical care in the nearby town of Tawila. As people continued to flee the violence in and around El-Fasher and seek refuge in overcrowded camps in Tawila, we significantly scaled up our response, distributing food and water, expanding healthcare services, and setting up a 250-bed hospital.
According to the UN, at least 6,000 people were killed in three days during the RSF’s capture of El-Fasher.1 In the weeks that followed, we assessed the displacement situation in various locations across Darfur and made efforts to locate and help survivors. We also offered comprehensive care to hundreds of victims and survivors of sexual violence.
At the end of the year, following increased security risks, we had to withdraw from Kornoi, Um Baru, and Tina, where we had been running medical and humanitarian services.
In South Kordofan, we provided urgent medical care and relief items, mostly jerrycans and hygiene kits, to displaced people in five camps in the Nuba Mountains. However, at times, bureaucratic delays and restrictions prevented us from reaching communities in dire need of medical support in both North Kordofan and South Kordofan.
In Khartoum state, we resumed our activities in May in Bashair and Turkish hospitals, which we had been forced to suspend for months due to repeated security incidents. Hundreds of thousands of people started to return to the capital city in the second half of the year, often to find their homes destroyed and basic services collapsed.
Healthcare for mothers and children
Pregnant women in Sudan struggle to obtain timely maternal care, due to the conflict, the scarcity of functional clinics, and unaffordable transportation. By the time they reach medical facilities, some have complications that increase the risk of death for them and their babies. In response, MSF focused on strengthening antenatal and inpatient care, referrals, and nutritional support, in Nyala, Tawila, and Zalingei. We also treated children with malnutrition across the hospitals and clinics we support, including in the malnutrition ward we run in Ad-Damazin, Blue Nile state. Originally designed to accommodate 36 beds, the ward expands to as many as 170 during the peak season. Yet even outside these peak periods, it rarely returns to its intended capacity, due to the high demand for inpatient care.
