The World Health Organization on Thursday warned that health threats are surging as the war in Sudan escalates and millions of people, many sick and wounded, flee for safety within Sudan and across borders to neighboring countries where health services are fragile and hard to reach.
The war, which erupted April 15 between the Sudanese Armed Forces and paramilitary Rapid Support Forces, is not contained within the country but has profound regional implications.
The conflict has displaced an estimated 3.4 million people, including 2.5 million inside Sudan. Nearly 760,000 people have been forced to flee as refugees to six neighboring countries, with many people reportedly arriving in poor health, carrying infectious diseases and other afflictions.
The Federal Ministry of Health reports at least 1,136 people have been killed and more than 12,000 injured since the conflict began. "Of course, this is very underreported of the number of casualties," said Nima Abid, World Health Organization representative in Sudan.
He said the scale of the health crisis triggered by the conflict in Sudan was enormous, noting that the fragile health system in Sudan was unable to cope with the multiple emergencies that exist as "two-thirds of the hospitals in the affected areas are not functional" and are unable to respond to the huge public health needs.
WHO has verified 51 attacks on health facilities since the conflict began, resulting in 10 deaths and 24 injuries and "cutting off access to urgently needed care."
Abid said that "all the organizational activities have stalled; vector control activities have stalled. Currently, we have a large measles outbreak with more than 2,000 cases and 30 deaths.
"I mean, even before the war, the vaccination coverage was not high," added Abid, noting that the Blue Nile and White Nile states were the most heavily affected. "So, now we have outbreaks affecting almost 10 states."
Abid also said he was concerned that cases of malaria, dengue and rift valley fever will rise during the current rainy season, noting that "all these vector-borne diseases are endemic in Sudan" and control measures have stopped.
"We do have an outbreak of cholera in South Kordofan," he said, "with more than 300 cases and seven deaths. So, all this will have an impact on the health system and public health in Sudan."
Neighboring Chad is hosting a quarter million Sudanese refugees, and the U.N. expects an equal number will arrive in the country by the end of the year. "This will significantly increase the health needs and exert huge pressure on the available health facilities," said Jean-Bosco Ndihokubwayo, WHO representative in Chad.
WHO reports around 2,500 people are arriving in Chad every day, many with serious gunshot wounds, while many others arrive sick with infectious diseases, malaria and cholera.
Ndihokubwayo cited malnutrition as the most serious health problem facing people in refugee camps.
"For the time being, we have more than 4,000 children who are suffering from serious malnutrition. Two hundred and fifty children are being hospitalized, 65 dead … and when this is combined with a disease like measles in children who are poorly nourished, it has huge effects as it does with our other current diseases," he said.
The World Health Organization reports cases of malaria among children under age 5, as well as suspected cases of yellow fever also have been identified among some 17,000 Sudanese who have sought refuge in the Central African Republic (C.A.R.). It added that a suspected cholera outbreak has been reported among many displaced people in northern Ethiopia.
Magdalene Armah, Incident Manager for the Sudan Crisis, WHO regional office for Africa, said the African region has received 65% of the Sudanese population that has fled the country.
She said it was important to establish cross-border operations to ensure that all vulnerable populations are reached with health care. "We want to increase access to health care services by expanding the set-up of emergency teams that are in the various border regions.
"We want to ensure that vaccination campaigns can happen to mitigate further outbreaks. We want to ensure that disease surveillance goes down to the communities," she said, adding that it was important that humanitarian agencies had the funding to enable it to carry out these vital health projects.
WHO and its partners are working to deliver emergency assistance and medical supplies to people in Chad, as well as in C.A.R., Egypt, Ethiopia and South Sudan, as swiftly as possible. But WHO says resources are overstretched, so providing aid to those in need is becoming increasingly difficult.