Civilians in Sudan endure 15 months of ‘indiscriminate and widespread’ violence

Civilians across Sudan are enduring "indiscriminate and widespread" violence as fighting between the Sudanese Army (SAF) and the Rapid Support Forces (RSF) paramilitary group and allied militias approaches its 16th month, a new report by Doctors Without Borders said Monday.

The report -- created by curating months of operational data, medical data and first-hand accounts from civilians and MSF teams on the ground -- has found civilians across the Northeast African nation have faced "horrendous levels of violence" over the past year, "succumbing to widespread fighting and surviving repeated attacks, abuse and exploitation" by warring parties, according to the organization, which is also known as Médecins Sans Frontières (MSF),

"The situation has deteriorated exponentially," Ada Yee, MSF's emergency coordinator, told ABC News over the phone from Nyala, South Darfur. "The situation in Sudan was not easy before, but now it is much worse. It has been staggering to witness this level of violence and the impact on women, children and vulnerable persons who have been left with no choice but to endure it."

The report found the conflict has had "disastrous consequences" on the health and well-being of civilians in Sudan, physical and mental wounds of the violence exacerbated by a collapsing health system and a flow of humanitarian aid and lifesaving care routinely hindered by "widespread obstruction" by warring parties, insecurity, and looting of medical supplies.

The report highlights that many civilians are now dying from preventable complications; many unable to reach medical facilities on time due to factors such as conflict, and skyrocketing prices which have left them unable to afford medicine, if available.

"People are resilient, trying to carry on with their everyday life. But who knows what their personal story is? The ordinary person has probably been forced to relocate multiple times. Who knows how many of their family members have died or been injured? All that they have lost?"

A snapshot of the violence is illustrated through a small hospital near Sudan's capital Khartoum: The Al-Nao Hospital in Omdurman. From August 2023 to April 2024, the hospital -- one of the last functioning health facilities in Omdurman -- admitted at least 6,776 war-wounded patients according to MSF, most suffering from gunshot, shrapnel or stab wounds.

In October 2023, Al-Nao Hospital's emergency department was stuck by shelling, leaving two patient caretakers dead and at least 5 people injured. At least 399 have died from their injuries at the hospital, according to the report.

Sexual and gender-based violence was found to be "pervasive but critically underreported" due to factors such as social stigma and silence due to fear of retaliation, according to the report.

It comes as monitors warn the conflict is spreading across the Northeast African nation: Fighting recently intensifying in Sennar State as active conflict areas also continue in Sudan's capital Khartoum , and across Darfur states.

The war broke out in Sudan in April of 2023, following months of simmering tensions between Sudan's military and the RSF paramilitary group and allied militias over a planned transition to civilian rule.

The conflict has resulted in more than 16,000 deaths, precipitated one of the ' world's worst humanitarian crises in recent history ' and sparked the world's 'largest displacement' crisis forcing over 10 million from their homes, according to the International Organization for Migration (IOM).

"The humanitarian situation is horrible," Yasin, who recently fled the besieged city of El Fasher , capital of North Darfur, told ABC News over the phone. "People no longer have homes, they need shelters."

Like many Sudanese civilians, Yasin has been displaced at least three times since the onset of the war.

"As always in times of war, it is civilians who are bearing the brunt," said Radhouane Nouicer, the designated expert on Sudan of the U.N. High Commissioner for Human Rights. "The scale and magnitude of human rights violations and abuses committed in Sudan are appalling."

The U.N. says recently concluded talks with warring parties in Geneva have proven an "encouraging" first step towards an end to the war, with U.N. Secretary-General Antonio Guterres' personal envoy to Sudan, Ramtane Lamamra, meeting separately with delegations from the Sudanese army and the RSF under a proximity format.

U.S. Ambassador to the United Nations Linda Thomas-Greenfield announced last week that the United States is providing nearly $203 million in additional humanitarian assistance to the people of Sudan and refugees who have fled to neighboring Chad, Egypt and South Sudan.

"The people of Sudan are facing the worst humanitarian crisis in the world," Thomas-Greenfield said, adding that "only two-thirds" of the over $2.1 billion in humanitarian aid pledged during the Paris conference in April have so far been disbursed, and only "a quarter" of the response funded.

"We hope this new round of aid serves as a call to action for others to follow suit," said Thomas-Greenfield.