6 months of conflict in Sudan leave millions of children at risk of cholera, dengue, measles, malaria and other diseases without sufficient containment capacities
18 October 2023, Port Sudan, Sudan – Since the outbreak of the conflict in Sudan on 15 April 2023, UNICEF, WHO and partners have been supporting the Federal Ministry of Health and state ministries of health in Sudan to maintain vital services across the country but are increasingly challenged by the limitations in safety and security, access and resourcing.
The agencies warn that further health system disruptions will result in unacceptably high numbers of preventable deaths among children and vulnerable populations. Urgent action is needed now to preserve Sudan’s health systems, especially at community and primary health care levels.
Six months into the conflict, health workers have gone without pay for months, and health facilities are occupied, looted or destroyed. About 70% of hospitals in conflict-affected states are not functional. WHO has verified 58 attacks on health care to date, with 31 deaths and 38 injuries of health workers and patients.
On top of the active fighting ongoing in Khartoum, Darfur and Kordofans, the rainy season is further limiting access to vulnerable communities, while creating conducive space for the spread of water- and vector-borne diseases.
Millions of families are caught in the middle of the fighting, and more than 5.8 million people, 2.5 million of them children, are newly displaced and on the move. With over 7.1 million people displaced internally – 4.5 million of them since the outbreak of conflict – Sudan now has the largest number of internally displaced people in the world. Lacking access to food, safe drinking water, a clean and healthy environment, health care and many basic services, the risk of death due to birth complications, reduced vaccination, disease outbreaks and malnutrition is rapidly rising.
While there are insufficient data for their verification, projections based on Johns Hopkins University’s Lives Saved Tool modelling indicate that at least 10 000 children under 5 years of age may die by the end of 2023 due to the increase in food insecurity, and disruptions to essential services since conflict broke out in Sudan – well over 20 times the official number of children of all ages killed by the fighting.
The number of hungry families has almost doubled, 700 000 children are suffering from severe acute malnutrition and 100 000 children require life-saving treatment for acute malnutrition with medical complications. The Federal Ministry of Health announced on 26 September an outbreak of cholera in Gedaref State, and later, on 7 October, in Khartoum and South Kordofan states. Suspected cases are also reported from Gezira State. Cholera is a highly contagious and deadly disease for vulnerable populations, including children, which has already killed 65 people, many of them children out of 1310 cases in the 4 states, and if not quickly contained will take many more lives. UNICEF and WHO are deeply concerned about cholera, measles, malaria and dengue spreading across the country, posing lethal risks to malnourished children. State health authorities have already reported 4296 suspected cases of measles and 108 deaths, 4307 suspected dengue cases and 16 deaths, and over 710 000 clinical malaria cases with 27 deaths.
Limited access to affected localities and difficulties with transporting samples to the only functional public health laboratory in Port Sudan, upgraded to provide a national referencing service through WHO support, are proving a challenge to confirming these outbreaks.
WHO, UNICEF and health partners are working to ensure primary health care, life-saving medical supplies and nourishment are accessible to displaced people and other vulnerable populations. They are also supporting the health authorities’ response to the cholera outbreak. However, current resources can only help reach a fraction of those in need of these critical services.
“Maternal, newborn and child health and nutrition service delivery – a lifeline in a country where nearly 14 million children urgently require humanitarian support – has been decimated in some areas,” said UNICEF Country Representative in Sudan, Mandeep O’Brien. “Health workers have not been paid in months. Supplies are depleted. Critical infrastructure is still under attack. The fighting needs to stop now; the toll on children is unacceptable. Health partners urgently need access and resources to help Sudan save the health and well-being of its youngest citizens.”
“Primary health care is beyond the reach of millions of Sudanese at a time when they need health care the most,” commented Dr Nima Saeed Abid, WHO Representative in Sudan. “Health partners are on the ground with full commitment to provide life-saving services and prevent needless loss of life from preventable and treatable diseases. The time is now to stop attacks on health care, ensure safe and unhindered access, and adequately resource health operations. Ultimately, though, peace is the answer.”
About WHO
The World Health Organization provides global leadership in public health within the United Nations system. Founded in 1948, WHO works with 194 Member States, across six regions and from more than 150 offices, to promote health, keep the world safe and serve the vulnerable. Our goal for 2019-2023 is to ensure that a billion more people have universal health coverage, to protect a billion more people from health emergencies, and provide a further billion people with better health and wellbeing.