Violence, insecurity and hunger are devastating people’s lives in South Darfur, Sudan, according to a new report released today by Médecins Sans Frontières (MSF).

The report, Voices from South Darfur, illustrates in vivid testimony how the impact of pervasive violence, a healthcare system in ruins and an inadequate international response have all combined to push people’s coping strategies to their limits.

“The voices and stories of people reflect the suffering, abuse and cruelty felt throughout communities in South Darfur, but also people’s endurance and compassion,” says Ozan Agbas, MSF emergency manager for Sudan.

“With civilian protection collapsed and humanitarian aid still inadequate, people in South Darfur demand to be listened to, demand attention, and demand action,” says Agbas.

South Darfur experienced intense urban warfare in 2023, which destroyed hospitals and critical infrastructure. The humanitarian presence, substantial before the outbreak of civil war in April that year, disintegrated as fighting took hold. Although ground fighting in South Darfur has ceased for now, insecurity remains, as people are subject to appalling violence on roads and farmland, and in markets and their own homes. Reports of arbitrary detention, theft and looting are also commonplace. Air strikes and drone strikes continue to hit South Darfur and other parts of the country.

Sexual violence is widespread with MSF providing care to 659 survivors from January 2024 to March 2025. Fifty-six per cent of survivors were assaulted by non-civilians.

One woman from South Darfur living in a displacement camp told MSF, “When the women try to go outside the camp to farm… they will beat me, they will torture me... There is no way to go out… My aunt’s daughter, she was raped by six men just six days ago… I feel insecure, because if I go out, I will be raped.”

People describe the fear and anxiety of their children, and their own feelings of helplessness, indignity and of being trapped.

“Our farms are completely destroyed – we have nothing. My husband was killed four months ago. We have nothing now,” an internally displaced woman told MSF in Beleil locality. “For three days, I haven’t eaten anything... I don’t know what will happen to me on the way home. I am afraid, because those people who killed my husband, maybe they will do the same to me.”

The violence has shattered the healthcare system, and adequate care is simply not available for people due to a range of compounding issues: facilities have been destroyed, damaged or abandoned; healthcare workers have fled or are no longer receiving salaries; supplies are absent or interrupted; and people struggle to afford transport to reach what remains of the healthcare system.

Insecurity is intertwined with hunger, as the threat of violence has cut off access to farmland and incomes. Between January 2024 and March 2025 MSF supported programmes in South Darfur that treated over 10,000 children younger than five years old with acute malnutrition and provided nutrition treatment to thousands of malnourished pregnant and breastfeeding women and girls.

The malnutrition crisis is expected to deteriorate even further with the imminent arrival of the rainy and lean seasons. Amid soaring costs of food, families are forced to subsist on one meal a day – sometimes not even that.

“I just depend on what I can find, day to day,” says a woman in Al-Salam displacement camp. “If I get something, we will eat. If I don’t get something, we won’t. This is my life.”

Since the war started, the response from international organisations and UN agencies has been sparse, inconsistent and slow to arrive in South Darfur, as a woman in Nyala explained in November 2024: “We heard that international organisations help people, but they never bring anything for us.”

There have been some recent signs of improvement, with UN agencies increasingly finding ways to bring humanitarian supplies to South Darfur. NGOs are gradually scaling up their presence and activities. However, due to severe access constraints, UN agencies are still not on the ground in South Darfur to lead and coordinate the response, more than two years into the conflict, and NGOs are moving slowly and with caution.

Communities are working in solidarity to overcome the effects of violence. Neighbours support one another, sharing their food. Groups of young people clear away rubble and unexploded ordnance, and purchase medicines for displaced people living in their neighbourhood. Teachers work for free in looted buildings. MSF has supported local initiatives to help run community kitchens, provide meals for school children and support health posts run by volunteers. Health facilities and water systems have been rehabilitated, and MSF ran a programme that provided food to 6,000 families in multiple locations across the state.

These programmes demonstrate it is possible to support local initiatives and improve services when determination, creativity and a willingness to take risks combine.

“Local organisations in Darfur have the knowledge and expertise to provide essential services. Giving these frontline responders supplies, funding and decision-making power will make a substantial contribution to saving lives,” says Agbas.

The testimonies and medical data in Voices from South Darfur were generated through our activities between January 2024 and March 2025.