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Sudan: MSF withdraws from Wad Madani after months of obstruction and harassment

The difficult decision comes after relentless challenges including growing insecurity, denial of travel permits, and repeated security incidents.

The back of an MSF staff member sitting in a room in Wad Madani, Sudan.

Sudan 2023 © Fais Abubakr

PORT SUDAN, May 9, 2024—Doctors Without Borders/Médecins Sans Frontières (MSF) has been forced to suspend work and withdraw staff from Madani Teaching Hospital, which is the only functional hospital for hundreds of thousands of people in the capital of Sudan's Al Jazirah state. 

This extremely difficult decision comes after more than three months of relentless challenges trying to provide care at the hospital, including growing insecurity; the inability to bring new staff and medical supplies into the area due to the denial of travel permits; and repeated security incidents, such as looting and harassment, affecting MSF's ability to provide medical care. 

MSF calls on the warring parties to stop violating health facilities, guarantee the safety of medical personnel, and grant the necessary travel permits for our staff and supplies. 

A void in health care access in Wad Madani 

“The health system and basic services in Al Jazirah state have collapsed as a consequence of the fighting and the systematic blockade on supplies and personnel entering the area,” said Mari Carmen Viñoles, operations manager for MSF in Sudan. “MSF was the only international NGO providing some support in Wad Madani. Our departure leaves a deep void for people struggling to access health care and living in a very insecure environment.” 

Wad Madani was previously controlled by the government-led Sudanese Armed Forces (SAF) and was one of the largest cities in Sudan. In mid-December 2023, it was taken by the paramilitary group Rapid Support Forces (RSF) during a military offensive, causing at least 630,000 people to flee to other parts of Sudan, according to the International Organization for Migration. Many of those who fled had been displaced before. Several hundred thousand people remained in Wad Madani.

MSF was the only international NGO providing some support in Wad Madani. Our departure leaves a deep void for people struggling to access health care and living in a very insecure environment.

Carmen Viñoles, MSF operations manager

In December, MSF evacuated all staff from Wad Madani but sent a team back on January 13. Since then, MSF has supported Madani Teaching Hospital, including its emergency room, pharmacy, surgical care, pediatrics, inpatient therapeutic feeding center, and maternity and inpatient departments. MSF also provided mental health support, care for survivors of sexual violence, food for patients, and training and financial support for 240 Ministry of Health staff. 

From mid-January to the end of April, MSF provided nearly 2,142 prenatal consultations and 10,000 outpatient consultations—malaria was the most common illness treated—and care to 16 survivors of sexual violence. During this period, there was a constant influx of patients in the emergency room, totaling 2,981 admissions. Many of these patients had physical injuries from the ongoing violence.  

MSF has now suspended all support to the facility and has relocated staff to safer areas of Sudan. Over the last three months, our team and the Ministry of Health staff we support have faced repeated security incidents that have been either carried out or tolerated by the RSF, including looting of the hospital, stolen vehicles, and staff being held at checkpoints, among multiple other incidents. 

View of a Al Zahra camp for displaced people in Wad Madani, Al Jazirah state, Sudan.
Al Zahra camp in Wad Madani. Sudan 2023 © Fais Abubakr

Obstructions leave MSF with no other option 

Since January, Sudanese authorities have also persistently denied travel permits to bring new staff and medical and logistical supplies into the city.  

“While the humanitarian and medical needs in Wad Madani and Al Jazirah are immense, we have no other option than to stop our work immediately and leave the area,” said Viñoles. “The deliberate administrative blockages, increasing insecurity, and constant violations of the hospital as a neutral space made it impossible to continue providing services.”  

MSF is willing to return to Madani Teaching Hospital to support people in Al Jazirah if the warring parties commit to respecting our medical work and can ensure safe and uninterrupted access to the area. MSF calls on RSF to stop violating medical facilities and guarantee the safety of Ministry of Health staff and MSF personnel. MSF also calls on the military and civilian authorities led by the government of Sudan to grant the necessary permits for our staff and supplies. 

About our work in Sudan 

MSF currently works in and supports more than 30 health facilities in nine states in Sudan: Khartoum, White Nile, Blue Nile, Al Gedaref, Red Sea, and North, West, Central, and South Darfur. We run programs in both SAF- and RSF-controlled areas. Our teams provide trauma care, maternal and pediatric care, and malnutrition treatment alongside other health care services. MSF teams are also supporting Sudanese refugees and returnees in South Sudan and eastern Chad.

Sudan crisis response