The Sudanese civil war that began in April 2023 has produced a severe humanitarian crisis. The conflict is fought between the Sudanese Armed Forces (SAF) and the Rapid Support Forces (RSF). Ten days into the fighting, communities faced severe shortages of food, water, medical supplies and fuel, with Khartoum and its surroundings hit hardest. Within the first months of the war, about 25 million people out of a population of roughly 50 million required humanitarian assistance. The World Food Programme struggled to deliver aid as large quantities were looted. By September 2024, roughly 80% of healthcare facilities in Sudan were no longer functional. The conflict has caused nearly 12 million people to be forcibly displaced, both inside Sudan and across its borders, making it one of the largest displacement crises in recent history. In April 2025, the famine in Sudan had severely affected nearly 25 million people, and almost 4 million children under five were acutely malnourished. By September 2025, the number of people requiring humanitarian aid had increased to 30.4 million. The fatality numbers are highly uncertain, with some assessments suggesting the true number may exceed 150,000.
International aid agencies have expressed concerns about the scale and severity of the crisis in Sudan. In August 2024, Médecins Sans Frontières said that "international humanitarian organizations and donors" had failed to address "the country's escalating medical needs, from catastrophic child malnutrition to widespread disease outbreaks." According to a UN representative, the conflict has pushed Sudan into the world’s worst humanitarian crisis. Observers called for an increase of humanitarian aid, the enforcement of international law to protect humanitarian workers, the establishment of clear pathways for refugees to seek safety, as well as halting the delivery of weapons to the RSF by the United Arab Emirates. By January 2026, it was estimated that 70% of the population was urgently in need of assistance.
Regional impacts
Khartoum
At the outset of the war, intense heat, drought and the timing of the clashes during the final days of Ramadan worsened living conditions. Many people were unable to leave their homes to obtain food or supplies because of the risk of crossfire. Hospitals were under severe strain from the beginning as wounded civilians arrived while medical teams struggled with staffing shortages and dwindling stocks of essential materials.
On 17 April, the Sudan Medical Association said that bombs struck al-Shaab Hospital and al-Khartoum Hospital, forcing both hospitals to stop the services of their emergency departments. Dozens of hospitals in Khartoum were forced out of service through bombings, evacuations and seizures by the warring parties. At least five ambulance crews were attacked while on duty. The association described the attacks as a clear violation of international humanitarian law and called on the international community to help. The World Health Organization (WHO) said that the warring sides seized ambulances. The vice president of the Sudan Doctors' Trade Union told Al Jazeera that doctors and other healthcare personnel were finding it very difficult to reach hospitals because the major bridges on the Nile were blockaded.
Residents were asked to limit their electricity usage as the state's distribution authority said the servers that manage online purchases of power were out of service and engineers could not reach them because it was too dangerous. Two water plants were reportedly damaged in the fighting, forcing residents to collect water directly from the Nile River instead. A grassroots movement using the hashtag #NoToWar offered people food, medication and information about safety routes to escape the city.
On 28 April 2023, Volker Türk, the UN High Commissioner for Human Rights accused the RSF of evicting people from their residences during the fighting in Khartoum. The RSF was also accused of harassing pro-democracy artists during the conflict.
On 20 May 2025, the SAF took full control over Ombadda and the rest of Omdurman, bringing an end to fighting in the Khartoum State.
Darfur
The governor of North Darfur called the humanitarian situation in the region dire. The Project Coordinator for Médecins Sans Frontières (MSF) in the state's capital El-Fasher said that the only remaining hospital in North Darfur was "rapidly running out of medical supplies to treat survivors" while other hospitals have had to close due to their proximity to the fighting or the inability of staff to get to the facilities because of the violence. MSF said that its compound in Nyala, South Darfur, had been raided by armed men who "stole everything including vehicles and office equipment".
Save the Children said that the charity's compound in Darfur was looted by armed men, saying staff were not hurt but medical supplies were taken, as well as food and laptops. Islamic Relief's office in Central Darfur was looted by armed men, and cars were stolen. The World Food Programme reported the deaths of three of its employees and the looting of its facilities and vehicles during clashes at Kabkabiya, North Darfur. United Nations Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator Martin Griffiths said that they were "receiving reports of attacks and sexual violence against aid workers", adding that the UN aid office in South Darfur was looted on 17 April. A car carrying employees of the Norwegian Refugee Council was attacked in El-Fasher on 20 April but there were no injuries. A hospital supported by MSF in Geneina was looted during fighting on 26–28 April. On 3 May, Griffiths said that six trucks belonging to the World Food Programme were looted in Darfur. In June, the Sudanese Health Ministry said all hospitals in West Darfur had been closed due to the fighting.
Siege of El Fasher
The Siege of El Fasher was an 18-month blockade of the city of El Fasher in North Darfur by the Rapid Support Forces (RSF), lasting from 13 April 2024 to 26 October 2025. At least 600,000 people fled El Fasher and nearby camps during the siege, yet around 260,000 civilians, about half of them children, remained in the city in extremely harsh conditions without humanitarian access. An estimated 6,000 children suffering from severe acute malnutrition were at risk of dying.
On 1 August 2024, the Integrated Food Security Phase Classification (IPC) Famine Review Committee (FRC) concluded that IPC Phase 5 famine conditions are prevalent and ongoing in parts of North Darfur, including the Zamzam camp south of El Fasher. The committee also warned that there was a high risk of similar conditions throughout internally displaced persons camps.
Between July and October 2025, the humanitarian situation in El Fasher reached catastrophic levels as the prolonged siege tightened and civilian suffering escalated. In late July, the World Food Programme (WFP) reported that although it was attempting to deliver aid to those trapped in the city, shrinking funding, impassable roads due to seasonal flooding and security constraints made operations increasingly untenable. Food‑prices continued their sharp rise: by late September a kilogram of rice in El Fasher had risen to 500,000 Sudanese pounds, meat to 100,000 pounds per kilo, and sugar reached 70,000 pounds per pound — in a city of approximately 250,000 civilians at risk of starvation.
In early September, volunteers managed to distribute food to around 90 displaced families, but these small efforts fell far short of the need. Women, children and older people were among the hardest hit. Hospitals in the city were operating under near‑impossible conditions: the blockade severed supply routes for medicine and equipment, malnutrition among children and pregnant women soared, and disease such as cholera and malaria proliferated in the camps and city wards.
The siege ended on 26 October 2025 with the El Fasher massacre, during which more than 2,000 people were executed, including many children, women, and older people.
Famine
Before the current conflict, Sudan was already struggling with high levels of malnutrition, food insecurity and poor access to safe water and basic services. The war has made these problems far worse and pushed a much larger share of the population into severe hardship. Widespread violence severely disrupted food systems across Sudan. Markets and food-processing facilities were destroyed by explosive weapons and arson, and large-scale looting targeted markets, food aid and livestock. Civilians were attacked in and around marketplaces and on routes used to access them. Blockades cut supply chains and hindered the delivery of humanitarian food assistance, while insecurity prevented access to agricultural land. The combination of prolonged violence and severe restrictions on humanitarian operations contributed directly to the emergence of famine conditions in several areas of Sudan in 2024.
In June 2024, UN experts stated that both the SAF and the RSF were deliberately withholding food and contributing to civilian starvation. The UN urged an end to the use of starvation as a method of warfare. In April 2025, the famine in Sudan had severely affected nearly 25 million people – about half of the country's population. Nearly four million children under five were acutely malnourished.
Water, sanitation and hygiene
Even before the war, access to safe water and sanitation in Sudan was extremely limited. Around 17 million people lacked basic drinking water services and roughly 24 million had no adequate sanitation, with more than 10 million practising open defecation. Conditions were particularly poor in states such as Blue Nile and White Nile, where fewer than half of households had safe water, and in parts of Darfur, Kassala and Kordofan, where shortages and uneven coverage left many communities without reliable sources. Internally displaced people faced especially severe shortages, with limited access to safe water in many displacement sites.
By the end of August 2024, heavy rains and flooding during that year's rainy season had affected an estimated 317,000 people nationwide, displacing more than 118,000 from their homes. Nearly 27,000 houses were destroyed and over 31,000 more were damaged, along with thousands of latrines, severely disrupting access to safe water and sanitation. Flooding also struck displacement sites, and in North Darfur more than 4,000 people were forced to flee camps after rising waters destroyed around 900 tents and washed away sanitation facilities. In rural and underdeveloped areas, including parts of Blue Nile, Kassala and White Nile states, residents were often required to walk through floodwaters, greatly increasing exposure to waterborne diseases.
Ethnic cleansing
During the conflict, the Rapid Support Forces (RSF) and allied Arab militias carried out systematic campaigns of ethnic cleansing across Darfur, beginning with large-scale attacks on non-Arab communities in West Darfur in 2023 and in 2024. Further mass killings took place in 2025 during the siege of El Fasher, where repeated assaults on the Zamzam and Abu Shouk IDP camps and on surrounding non-Arab neighbourhoods resulted in mass casualties. After the fall of the city in October 2025, tens of thousands of people, mostly non-Arab civilians and particularly the Zaghawa people, were killed in the El Fasher massacre. Similar ethnically driven attacks were reported in villages around Tawila and Kutum and in other rural parts of Darfur, as well as in areas of Kordofan and in parts of central Sudan. Accusations of genocide have additionally been made regarding the wanton massacres of civilians in villages in Gezira State and states around the White Nile.
Large-scale, targeted violence was directed at the Masalit people in West Darfur, described as genocide by Genocide Watch, the United States, and others. Beginning in 2023, the RSF and allied Arab militias carried out coordinated attacks on Masalit communities in and around Geneina, including the massacres in Ardamata, Misterei and other towns. UN and survivor accounts reported mass killings, the burning of neighbourhoods and markets, and widespread targeting of men and boys to eliminate Masalit lineage, with attacks specifically directed at Masalit and other dark-skinned inhabitants of Darfur rather than Sudanese Arabs. Witnesses described Arab fighters going house to house, killing darker-skinned Masalit civilians while shouting “Kill the slave, kill the slave!”.
A UN Security Council estimate suggested that 10,000–15,000 people were killed in El Geneina alone. Additional killings occurred on roads leading to the Chadian border, many of them carried out at RSF checkpoints. In the November 2023 Ardamata massacre, RSF and Janjaweed fighters killed between 800 and 2,000 people, mostly Masalit but also other non-Arab groups, displacing around 20,000 civilians to Chad.
Apart from ethnic cleansing, numerous accounts also described civilians being killed indiscriminately and prisoners of war being subjected to torture.
Healthcare and disease burden
Before the war, Sudan's health system was severely underfunded and fragmented, marked by acute shortages of medical staff, vast inequalities in access and quality of care, and a reliance on out-of-pocket payments by nearly the entire population. Despite these weaknesses, Sudan had made important gains in controlling infectious diseases such as malaria, cholera and measles, following years of sustained work by national authorities and international health partners. Much of this progress has been quickly reversed as a result of the conflict.