Canadian doctor after devastating Sudan assignment: 'The worst humanitarian crisis in the world'
Sudan is facing an emergency of staggering proportions, one that has displaced over 12 million people and decimated the nation's healthcare system. But unlike other global crises, this one seems to be happening almost entirely in silence.
'This is not just a war between two parties,' says Sana Bég, executive director of Médecins Sans Frontières (MSF) Canada. 'It's a war on the people of Sudan.'
What began as a power struggle between the Sudanese Armed Forces (SAF) and the Rapid Support Forces (RSF) in April 2023 has spiralled into what aid workers now describe as the world's largest displacement crisis. According to the World Health Organization, 70 to 80 per cent of the country's healthcare facilities are either nonfunctional or overwhelmed. In parts of Darfur, even the UN is absent, leaving MSF — also known as Doctors Without Borders — as the only international organization delivering aid on the ground.
'Having to choose between one life-saving activity for another are the kinds of decisions our teams are left to make because of this increasingly isolated environment where we're the only ones being relied on to carry out an entire scope of what should be an ecosystem of aid,' Bég says.
This is not just a war between two parties. It's a war on the people of Sudan.
For Dr. Reza Eshaghian, a Vancouver-based physician who recently returned from Darfur, the devastation is unlike anything he has seen before. 'What's happening in Sudan is the worst humanitarian crisis in the world, full stop,' he says. 'There are bombings, sexual violence, armed robbery. There's a lack of protection and international humanitarian law.'
Eshaghian, who began working with MSF in 2014, was stationed in Nyala, a city in South Darfur.
He noted that it's not just the violence itself that is killing people: 'So much of the suffering and death is from preventable illness. We saw women dying from eclampsia and postpartum hemorrhage. People are dying of malaria, malnutrition, diarrhea, dehydration, sepsis. These are things we know how to treat, but there's no infrastructure left to do it.'
The hospital Eshaghian helped support saw overwhelming gaps in supplies and staffing. Although MSF brings in its own equipment, the logistics are gruelling, and his team saw supply shipments often delayed. There was also never enough.
People are dying of malaria, malnutrition, diarrhea, dehydration, sepsis. These are things we know how to treat, but there's no infrastructure left to do it.
Despite the danger, MSF has continued to provide help where it can, but the work has come at immense personal cost, especially for local staff.
'Eighty percent of our workforce globally is locally hired,' Bég notes. 'These are people whose homes are war zones. [They] tell us they have a fear of retaliation or repercussions for any actions that could be interpreted as siding with one warring party or the other. Having to live in fear on a regular basis is far different than what some of our teams that have the ability to get on a plane and leave face.'
In other words, simply providing medical care can be seen as a political act. But that doesn't make it any more secure. The safety protocols MSF follows — clearly marked medical uniforms, identified facilities — are no longer a guarantee.
'We used to rely on international humanitarian law to protect aid workers and patients,' she says. 'That's not the reality anymore. Not in Sudan. The sad reality now is that we are no longer able to guarantee safety in the countries that we're operating in, so we're taking it day by day.'
Among the most at-risk in Sudan, as is often the case in most war zones, are women and children. In one year alone, MSF supported approximately 8,500 births and performed over 1,600 emergency C-sections across Sudan. 'But the numbers don't tell the full story,' Bég says. 'We're talking about women walking 100 kilometres on foot, often pregnant or with sick children, just to reach care.'
Eshaghian recalls one such woman who fled violence in Khartoum and arrived in Nyala with her three-year-old daughter — the last surviving member of her family.
'Her child had a fever. We were able to treat her. But the mother had lost her husband and other children along the way. Everything had been taken from them. And there are endless stories like this one."
In many cases, the trauma goes even deeper. MSF staff are seeing widespread evidence of sexual violence being used as a weapon of war. 'Women have been raped while fleeing,' Bég says. 'Survivors end up giving birth to babies born out of rape, then they have to deal with the shame and fear of stigma and retaliation.'
The scale of the trauma has pushed MSF to adopt community-based care models that, for example, can look like training trusted women in each village to serve as peer counsellors and connectors to formal care.
'We can't be everywhere,' Bég says. 'But we can empower people to help each other.'
Both Bég and Eshaghian say that the world's silence on Sudan is not accidental — it's systemic.
'There are no foreign correspondents in Sudan. No international media,' Bég says. 'We are the eyes to the world, and we see that as a responsibility to speak out about what we're seeing and to call for an urgent scaling of aid.'
That lack of visibility means less pressure on governments and organizations like the UN to act. 'UNICEF, UNFPA — their response is small and, in the case of Darfur, they're barely present,' Eshaghian says. 'There's clearly a lack of political and diplomatic pressure from governments who have the power to push for the end of this war.'
Bég doesn't mince words. She asks, 'Who gets the privilege of our attention? There are certain conflicts that make it to our feeds, to our social media, to the news. There is an inherent inequity and racism in that itself. Where you live shouldn't determine whether you live, and that is what we're seeing in Sudan — willful ignorance.'
Where you live shouldn't determine whether you live.
Still, there are reasons to keep going — glimpses of joy, even in the bleakest corners.
'When you visit patients in the hospital, especially children who bounce back from illness and are quite resilient, you see their happiness. [We] took a lot of pride in ... being able to support the community, to see the impact,' Eshaghian says.
What MSF is now demanding is clear: A significant increase in humanitarian access, stronger diplomatic pressure on Sudan's warring factions, and more support from countries like Canada.
'Our patients have no choice but to wake up with hope every day,' Bég says. 'The least we can do is show up for them and provide care. Hope is not optional, it's our moral imperative. We have to reject apathy.'
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