Life amid bullets and bombs: Stories from Sudan

MSF staff and patients share their experiences living and working in a country during an unprecedented crisis.

April 15, 2024

For a year, the war between the Sudanese Armed Forces (SAF) and the paramilitary group Rapid Support Forces (RSF) has ravaged Sudan, forcing millions of people from their homes and leaving countless civilians dead or severely injured. Airstrikes, drones, and heavy weapons like tanks have destroyed markets, residential neighborhoods, and critical infrastructure, including health facilities.

Doctors Without Borders/Médecins Sans Frontières (MSF) teams have been working across 11 of Sudan’s states, performing surgical procedures, assisting women in birth, and treating children in pediatric wards and inpatient therapeutic feeding centers. We are also working in refugee camps and other places hosting displaced people, improving water and sanitation conditions, carrying out mobile clinics, and vaccinating children. ?

The majority of our staff come from the communities they serve. Here, our staff and patients share stories about what they’ve experienced over the past year.

MSF DOCTOR

Dr. Ahmed Omar Al Jak

"In the early days, we watched the news unfold, seeing streams of displaced people making their way from Khartoum to Wad Madani. We set up field clinics in camps, offering whatever medical aid we could. But as we witnessed the exhaustion etched into the faces of the displaced, we realized their needs extended beyond physical treatment. They needed psychological support, too.?

For seven months, we worked tirelessly in these camps, treating malnutrition, measles, cholera, and other prevalent diseases, and providing mental healthconsultations. We became a lifeline for people until the conflict escalated, forcing us out of the camps...

... In a desperate bid to continue our work, we tried to operate from Wad Madani Hospital, but the lack of power, water, and safe conditions made it impossible. The city became a ghost town, and we had to evacuate.

The journey to Wad Madani for the displaced was heart-wrenching. Some arrived by carts, others on the backs of donkeys. Many had walked for five days without food, arriving in a state of utter exhaustion. Diseases were rampant, and supplies were dwindling.?

Our mobile clinics were filled with patients. Each day, over 200 people waited to see us. Despite the intense pressure, we persevered, sorting cases, transferring dangerous cases to the hospital, and treating the less severe ones on site.?

In the early days of the attack on Wad Madani, we braved the sound of explosions to assist the hospital team, treating bullet wounds, shell injuries, and shrapnel injuries. But as the fighting drew dangerously close to the hospital, we had to evacuate the patients and return to our residence.?

We were interrogated by armed men, our residence searched, and our vehicles taken at gunpoint. The next day, some of our team was evacuated to other states, while the rest of us continued to provide support at Bashair Hospital in Khartoum.?

Today, our biggest challenge is the scarcity of medical supplies. We've run out of surgical equipment, and we are on the brink of stopping all work unless supplies arrive.?

Throughout all this, I took a personal risk, deciding to stay and help while evacuating my own family to Sennar. The decision to continue, despite the gunfire and danger, was a struggle, but I trusted in God and chose to help others.?

Now, I am in Khartoum, working amidst the sound of bullets and bombs. I haven't seen my family for four months, and they're no longer in Sudan. They're safe in Saudi Arabia. I miss them dearly, but I know I have a duty to my country and its people.?

Every day I meet people who remind me of the importance of my work. I remember one mother from a camp in Wad Madani, her face lighting up when she met me again in Khartoum as she recognized me as Dr. Ahmed, who used to visit them in the camp. Her joy was short-lived when she told me a disabled man I used to check on had died from a gunshot wound. ?

Before the war, life was normal. I would go to the hospital, help patients, and then return to my family. Now, my city lies in ruins, my family is gone, and the sense of fear is pervasive.?

In these dark times, my hope remains. I long for the day when the war will stop, peace will prevail, and we can work on building and developing our country without the threat of being forced to leave."

DISPLACED PERSON IN SUDAN

Khadija Mohammad

"I’m Khadija Mohammad and this is my daughter Malaka, I have been displaced by the war in Sudan. Five months ago, I was forced to flee my home in the displacement camp of Hasahissa in Zalingei and sought refuge in [another] displacement camp, Tululu.?

When the problems started between SAF and RSF, I lived at the edge of the [Hasahissa] camp which is close to a military base. The militia would come into our homes and loot our belongings.?

During the fighting, there was no access to health care or food in the camp. I sold my belongings to earn some money for food. Eventually, the security situation became too difficult, and I was forced to move to Tululu camp, one hour away...

... We suffered a lot. For three days, we couldn't sleep. Now, where we are is also bad, because we don't have enough food.?

In Tululu camp, we don't have access to health care for me and my family. I traveled over an hour to Zalingei Teaching Hospital to receive treatment for my child Malaki, who tested positive for malaria at the hospital.?

In Hasahissa camp, we would receive medication for free. Here in Zalingei, it's not the same. But today [for the first time], we received medication for free."

On April 2, Zalingei Teaching Hospital opened a newly refurbished emergency department, where MSF teams support Ministry of Health staff with incentives, training, and rehabilitation of the facility.?

MSF NURSE SUPERVISOR

Alaa Ahmed

"Our team has provided lifesaving activities in the pediatric and maternity wards, the delivery room, and family planning initiatives. Since July 2023, we've reached out with healing to thousands of patients, offering inpatient and outpatient consultations and assisting women through childbirth. This experience has strengthened my commitment to humanity.?

Before the war's shadow fell over us, I worked in another MSF project providing support to Omdurman hospital and its surrounding areas, offering medical assistance wherever it was needed. The war forced my family and me to [flee] to Al Gedaref, from where I later joined the MSF team in the Umdawanban project, and now I’m in Port Sudan supporting our mobile clinic activities and coordinating nursing activities for other projects in the country...

... Despite the devastation, we've continued our mission, and I have stepped into the role of nurse and supervisor, ensuring our nursing services remain running in their support.?

Umdawanban Hospital stands as a main operational facility in this area. Even when faced with challenges, like a patient with severe diabetes arriving unconscious and in critical condition, our medical support proves to be essential to saving [their] life and many other lives. The joy of seeing such patients recover and walk out of the hospital keeps our resolve strong to push forward, reminding us of why we continue this medical humanitarian support.?

Due to the negative shadow of the war, the relationship with patients has not been limited to the professional aspect of doctor and patient but becomes more human, interacting with the suffering they face in accessing the current health facilities.?

As we mark the first year of the war, my heart aches for the suffering it has inflicted—hunger, a lack of health services, and a future uncertain. Yet, it is the personal stories of those we help, their challenges but also hopes, that transform our relationship from merely medical to deeply human."

REFUGEE IN CHAD

Khartouma

"When armed clashes and bombings came close to my village, I had no other choice than to leave. We fled with a group of people but some of them did not make it to the border. With my neighbors, we fled by car and took as much luggage as possible. But along the way, there have been attacks, people have been killed. We were looted by armed men but we were lucky—they took only our belongings and not our lives.?

We arrived late at night and empty-handed at the border. The next day, we went to the Adré transit refugee site where I met my aunt. She shared with us what little she had: a tarpaulin, a few pieces of wood, and three kilos [about six pounds] of flour so at least we could build a shady spot, sleep, and eat. In the past four months, I benefited from two distributions only, with different bags of cereals, flour, oil, and more. But it is not enough to cover our needs...

... Back home I made my living making pottery. So to survive here, I find ways to make pottery, which I then sell in the community and buy a little food with it.?

Life is very hard here. But what worries me the most is the children. I can’t provide for them, even to find shoes. There is no school, so they do nothing all day and go around in circles. They don’t want to stay in the camp, they want to go back to Sudan.?

My husband fled before us as he has another wife in El Geneina. He has been relocated to an official camp in Farshana. I am desperately trying to join him with the children, but I don’t know when it will happen. One day, they told us we will be moving so we packed everything but, in the end, it did not happen. So, we are waiting."

REFUGEE IN SOUTH SUDAN

Chira Casah

"Leaving Khartoum was a harrowing journey marked by desperation for medical aid for my thyroid disorder, which causes fever, dizziness, hormonal imbalances, poor sleep, and weight loss when untreated. Fleeing with my mother, brother, and sister, we lost contact with my father and two other brothers in the chaos of war. I hope they are still alive.?

Life in the camp is a stark contrast to our comfortable existence in Khartoum. Illness plagues my family, necessitating frequent visits to the MSF clinic for assistance. Food and water shortages loom large, forcing us to scavenge for work to survive. You will just die from hunger if you don’t go out and try everything you can to work and get a little money...

... Once a university student studying animal protection, my dreams now seem distant amid the uncertainty of our future. Despite feeling like my family is unraveling, I cling to hope.?

The onset of the war on April 15 trapped us in our home as violence escalated outside. With dwindling resources, we sold our possessions for survival, leaving behind loved ones as we fled from Khartoum to Kosti and finally to the transit center here.?

Life in the camp is harsh, with my mother and sister struggling to adapt to the environment teeming with flies, mosquitoes, rats, and wild animals. Kosti also feels like Khartoum in a way, insecurity and crime is high here. We plan on leaving to Joda, then to Renk. This here is a temporary transit center anyway.?

Despite my efforts to secure medication for my thyroid condition, the camp's hospital lacks the necessary drugs. I explained my condition to the doctor and told him the name of drugs I usually take. He couldn’t help.?

We await my two brothers still in Kosti, one of whom battles schizophrenia. His reluctance to join us stems from financial constraints. The cruel reality is that money dictates our options. Our journey hinges on his ability to join us. This is my story of survival amidst the trials of displacement and illness."

RETURNEE IN SOUTH SUDAN

William Jokite

"I was working in Khartoum when the war broke out in April 2023. The warehouse where I was standing was bombed and 15 out of 20 people were killed in the attack. After we thought it calmed down we crawled out. One of my colleagues tried to stand up and run but we saw him being shot in the neck, he died instantly. With a car we found, I drove until it ran out of fuel, and then we continued on foot. However, a previous injury sustained when I bathing in the river slowed me down, and my friends left me behind to travel faster.?

Alone and in pain, I walked for three days and nights without rest, worsening my injured foot. I fear for [the] future, but I must press on to reunite with my family in Maban, recalling the nights I wake up to memories of my siblings playing in the yard. I just wanted to be with them again...

... Back in Khartoum, when the fighting broke out, we sought to leave, but our boss insisted on group departures only. Rockets struck our compound, leaving only five survivors. We navigated through the conflict zone, witnessing intense battles until we found relative safety.?

We continued with our journey and after some time, we got an abandoned car. We started the car and I drove it until we reached Block 3. There we got out of the car and abandoned it there, and we went into our residential area.?

The next morning, at around 7 a.m., fighting started and there was shooting everywhere. They fought, fought, and fought until they reached the barracks of the army in Korton. We came to witness what was happening. Both the SAF and RSF soldiers showed no intention to harm [us] unless we disobeyed their orders, [then] they threatened to shoot us."

REFUGEE IN ABYEI SPECIAL ADMINISTRATIVE AREA, A REGION CLAIMED BY BOTH SOUTH SUDAN AND SUDAN

Mohammad Abakar

"I was in Darfur and had to flee in 2003. My journey took me to Nyala, and now, [after] escaping from there, I've arrived here [in South Sudan].?

Families trapped in perilous areas are desperate to reach this safe haven, [but] the journey here is fraught with challenges. It's costly and perilous, [with] frequent attacks and rampant looting. The attackers leave nothing behind. We urgently need both transportation and protection. The current circumstances are horrific beyond words...

... The conflict ravaging Sudan is unspeakable. We find ourselves escaping one war zone only to enter another conflict here in South Sudan. We're in dire need of help and wish for our plight to be known. The future remains uncertain, especially for our children. Will they ever return to school??

The war has inflicted severe trauma. I have three children; the youngest, born amidst conflict, is just two months old. The constant worry is unbearable. My children are deprived of their education, unable to grow or learn. Their daily tears are for the longing to study."

MSF HEALTH PROMOTER AND REFUGEE IN CHAD

Sijood

"I saw with my eyes really bad things, it was really dangerous. They killed people without hesitation. If they hid with children, they would kill the children. I saw this with my eyes.

We lost everything, we lost our people, our brothers, our sisters, we lost our money, we lost our house, we lost our country too. It’s very hard to say ... but we must talk about this.

I am a refugee. I live a difficult life, but now by the will of God, I will keep going."

DISPLACED PERSON IN SOUTH SUDAN

Hamad Mohamod

"The rebels were looting the houses and taking everything they could find. If they didn't find money, they killed people in their homes. That is why I fled with my family."

MSF HEALTH PROMOTER IN SUDAN

Mohamed Alaa Aldeen

"This isn't my first stop on the displacement route. I fled from Khartoum to Wad Madani, and now I find myself once again displaced in Port Sudan. ??

Traveling across Sudan and meeting new faces always filled me with joy, yet this displacement from one location to another is just a nightmare...

... But I am trying to find meaning in my presence here in Port Sudan, so I joined MSF as a health promoter for the displaced people. As a nurse, I saw this role as an opportunity to transform the theoretical concepts of humanitarian work, which we studied at university, into practical action. ??

MSF's decision to recruit health promoters from within the refugee community is a good one, as we are well-placed to relay accurate health information to those who fled alongside us, sharing their pain, and understanding their needs. But the humanitarian organizations are not the only supporters in this area. This role is complemented by the remarkable efforts of host communities, who are contributing their utmost."

RETURNEE IN SOUTH SUDAN

Marta Kaliba

"When we arrived in Alagaya camp in Sudan, the children started to fall sick. They had measles. The baby was the first to get a fever and after one week, the three-year-old and later the nine-year-old. They died. ? ?

I had to bury my three children far from home. Far from anyone they knew. Far from where we were going. ? ?

As I continued my journey to South Sudan, I arrived at Renk, where I discovered that my eight-year-old son and my five-year-old daughter were malnourished. The change in food, the long journey, and the grief have been arduous for me and my family. I have lost three children, and the other two are fighting for their lives...

... Every day at the hospital, I find the strength to look after them. I cook what I can with the other mothers who also have their children at the hospital. We sit under a tree. The other children play; they climb trees, and I can't wait for my children to be among them. Many families here struggle for food and water. Hardly anyone has a proper shelter.? ?

As soon as my children feel better, my husband will join us and we will continue our journey, maybe to Malakal. I will try to contact my extended family in South Sudan, but I am uncertain of the future. We would need a lot of courage and help to survive during the coming difficult days to start a new life in South Sudan. ? ?

My house will still be half full."