SUDAN: MSF outraged and alarmed over repeated attacks on hospitals in El Fasher and blockade on urgently needed medicines and food

On July 29, an attack on Saudi hospital in El Fasher, supported by MSF, marked the tenth time a hospital had been hit in the city since the fighting escalated more than 80 days ago, 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).

Since the fighting intensified almost 12 weeks ago, s more and more wounded continue to flood into Saudi hospital and MSF’s trucks continue to be held by the RSF in the town of Kabkabiya, medical supplies are rapidly running out, putting the life-saving activities even more at risk.

“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.”

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.

“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. 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 it was attacked – there will be nowhere left in the city for the injured, or women in need of life-saving emergency C-sections, to receive surgery. The paediatric 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. 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.”

In addition to attacks on health facilities, MSF supply trucks have been held in Kabkabiya by the RSF for the past four weeks, which could soon leave Saudi hospital without 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,” says 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. 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 deaths 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.”

MSF urges all parties to stop attacking hospitals in El Fasher and across Sudan, and the RSF to release its trucks from Kabkabiya so that life-saving medical supplies can be brought to Saudi hospital and the 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.

Notes to editors

The malnutrition crisis in Zamzam camp

In January, a rapid mortality assessment conducted in Zamzam 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-5 were suffering from malnutrition, and a similar figure was found among pregnant and breastfeeding women. For both these population groups, these findings were double the emergency threshold of 15 per cent, indicating that there is a life-threatening malnutrition crisis in Zamzam camp.

With the current conflict, it is very difficult to obtain updated information, but given the prior malnutrition rates, the 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 be alarming. It remains the case that a massive scale-up in the response is needed.

A timeline of the attacks on hospitals in El Fasher

1. Babiker Nahar Paediatric Hospital: Children in El Fasher lost access to specialist treatment when an airstrike carried out by the SAF on May 11 landed 50 metres from the paediatric hospital (called Babiker Nahar), which was supported by MSF. This led to the collapse of the roof above the intensive care unit (ICU) and the death of two children who remained receiving treatment there, as well as the death of a caregiver. One care giver was also injured to the extent that they lost their leg

2. Saudi Hospital: on May 19 Saudi hospital was damaged by shelling (this was prior to it being supported by MSF)

3. South Hospital: First, on May 25, a mortar landed on the ante-natal care unit killing one person and injuring eight among patients and their families

4. South Hospital: 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

5. South Hospital: The third incident took place on Friday 31 May, when shelling again impacted South Hospital

6. South Hospital: The fourth took place on Monday 3 June, 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.

7. South Hospital: On June 8, a fifth attack took place: 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.

8. Saudi Hospital: On the night of Friday 21 June, the pharmacy of the MSF-supported Saudi hospital in El Fasher was hit by shelling from the RSF. A pharmacist was killed while on her shift, and the pharmacy building was damaged

9. Saudi Hospital: Saudi hospital was hit again on Thursday 27 June when a bomb landed inside the hospital compound, breaking the window glass and damaging the water tank

o Two bombs also landed just 20 metres outside the facility. A fourth landed 50 metres from MSF's office

10. Saudi hospital: on Monday 29 July, two shells hit Saudi hospital, killing three people and injuring 25