“Sudan: A voice from the bunker”,  Médecins Sans Frontières

MSF staff member Camille Marquis describes the emergency in Khartoum, April 21, 2023

Over the past week, a surge of violence in the capital city of Sudan, Khartoum, has resulted in hundreds of deaths and many wounded people, exacerbating the already alarming humanitarian needs in the country. The situation has escalated rapidly, with reports of armed groups taking control of certain areas, looting buildings, and engaging in deadly confrontations. Staff from Doctors Without Borders/Médecins Sans Frontières (MSF) are treating wounded patients at El Fasher hospital, while others are sheltering in place for their lives. Here, Camille Marquis, MSF’s outgoing advocacy manager, shares her experience below.

Sudan 2023 © MSF/Camille Marquis

On Saturday, when I heard the first gunshots outside at about 8:30 a.m. while having breakfast, I was just starting what I thought was my last day in Khartoum. My luggage was ready, my fridge and cupboards emptied, with just a few hours to go before going to the airport to fly home after one year in Sudan. 

Quickly, we all went down to the safe room of our guesthouse, in the basement. I spent the day there, along with more than 10 colleagues, jumping at the sound of shooting, of low-flying war planes, and subsequent bangs from air strikes. The sounds were echoing on walls and the small windows were shaking. The silences often just meant another blast was coming. 

That first night, sleeping on the floor surrounded by my colleagues, while I was supposed to flying home, I thought of the people stuck inside the airport, where heavy fighting was taking place. I could have been one of them. Some were wounded and have not been able to leave the airport to be treated. 

Photos of life in the bunker including the sleeping area and a stray bullet. Sudan 2023 © MSF/Camille Marquis

I was thinking also of all my Sudanese colleagues and more generally people living in Khartoum who, unlike me, did not have the chance to be sleeping in a bunker, with stocks of emergency food and water. It is now the sixth day of fighting in the streets of densely populated Khartoum, where about 10 million people live. They are running out of food, water, and fuel, taking great risks to get supplies in shops that are already facing shortages. 

Hearing all the destruction outside, reading about the loss of life, about the wounded and sick people who cannot get to a functioning hospital or clinic even in the capital city of Khartoum, makes me incredibly sad for Sudan and for its people, stuck amid fighting between armed forces from their own country. People are struggling to get medication and health care… and these are just the first few days of the violence. The consequences and aftermath of this fighting on the already high humanitarian needs will be absolutely dire. 

For a year, I have been monitoring humanitarian needs in Sudan and documenting the impact of the lack of response to those needs on the health and nutrition of Sudanese people, especially children. We had just released a briefing note to raise the alarm on the dire needs of populations living in West Darfur, calling on humanitarian actors and donors to scale up the response and support Sudan’s already collapsing health system. 

Among my colleagues currently sheltering down in Khartoum, a nurse and a nurse trainer were meant to fly to El Geneina, in West Darfur, to work at the MSF-supported hospital and treat severely malnourished and sick children. MSF’s psychologist working in El Geneina’s hospital is also stuck in Khartoum. Because of the conflict, they may not be able to go back there anytime soon to do their life-saving humanitarian work. 

Teams in West Darfur report an unusually low number of patients in the wards, probably a sign that people fear leaving their homes and come to the hospital in such an unstable security context. Last year, in El Geneina, the malnutrition peak started in early May, just ten days from now.

If humanitarian and health care workers are unable to continue working safely —to provide health care and nutrition support, but also food assistance —and if patients are unable to access assistance and reach a hospital without fear, millions of children and other vulnerable people in Sudan are at risk of severe health consequences. 

A third of the population in Sudan was already deemed food insecure before this ongoing conflict. We can only expect the situation to get worse across Sudan.  

MSF continues to provide medical care in Sudan where possible; however, many staff members currently cannot move due to intense fighting in the capital, Khartoum, and across the country. The safety of our staff and patients is our top priority, and we are supporting staff members according to their specific circumstances. 

We call on all parties to the conflict to guarantee the safety of medical staff, patients, and health facilities, and to allow the safe passage of ambulances, health and humanitarian workers, and people seeking health care.

 In recent years we had projects in the States of Khartoum, Gedaref, Kassala, Blue Nile, White Nile, North Darfur, East Darfur, West Darfur, South Darfur and Central Darfur, with emergency teams launching activities in other states as needed.