Sudan’s War Began a Year Ago. Children Are among Its Most Fragile Survivors

Children walk at the school housing displaced Sudanese who fled violence in war-torn Sudan, near the eastern city of Gedaref, on March 10, 2024. (AFP)
Children walk at the school housing displaced Sudanese who fled violence in war-torn Sudan, near the eastern city of Gedaref, on March 10, 2024. (AFP)
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Sudan’s War Began a Year Ago. Children Are among Its Most Fragile Survivors

Children walk at the school housing displaced Sudanese who fled violence in war-torn Sudan, near the eastern city of Gedaref, on March 10, 2024. (AFP)
Children walk at the school housing displaced Sudanese who fled violence in war-torn Sudan, near the eastern city of Gedaref, on March 10, 2024. (AFP)

The war in Sudan began a year ago. Here in a remote camp for tens of thousands of people who have fled into neighboring Chad, the anniversary is marked by near starvation.

Assadig Abubaker Salih is a 42-year-old mother of six. The family survived the hot, dusty journey from their home to this sprawling camp of wind-whipped blue tents stretching in rows toward the horizon.

“We are in a very bad situation. We have suffered since we left our country. My husband died," she said. “There is nothing here. We need the essentials. We don’t even have sugar.”

Back home, Sudan's military, led by Gen. Abdel Fattah Burhan, is fighting the paramilitary group known as Rapid Support Forces, commanded by Gen. Mohammed Hamdan Dagalo, for greater resources. Sudan is home to around 45 million people.

Close to 9 million people have fled their homes, according to the United Nations, and more than 1 million have left the country. Thousands have been killed in a conflict overshadowed by the ones in Gaza and Ukraine. The UN says it has asked for $2.7 billion in funding to respond to humanitarian needs but has received $155 million — or 6%.

“It has been everyday Sudanese who have — often at great personal risk —stepped up to support each other,” Eatizaz Yousif, country director with the International Rescue Committee, said in a joint statement by aid groups urging the world to give more.

The UN has warned of an impending generational catastrophe. An estimated 3 million Sudanese children are malnourished. About 19 million children are out of school. A quarter of Sudan's hospitals are no longer functioning.

Aid organizations say women and children are bearing the worst of the conflict.

Even here, across the border, resources are stretched thin after more than 570,000 Sudanese arrived over the past year. Aid workers warn they are set to run out of some supplies within weeks. Shortages of water and ways to keep clean mean a growing risk of disease.

A growing number of children are arriving at the pediatric unit run by the Doctors Without Borders charity with pulmonary complications, a result of the harsh environment. The organization has also documented rising cases of hepatitis E, which can be deadly for pregnant women.

"Many, many of our babies are severely malnourished,” said Cordula Haffner, the Doctors Without Borders hospital coordinator at the camp. “The reason is hygiene, not enough food, not enough water. This is a crisis that will continue. We will see even more children like this.”

More than 16,000 children younger than 5 arriving in Chad from Sudan have had severe acute malnutrition, according to the UN — a stage where the effects of hunger are clearly visible.

Many people in this camp fled some of the conflict’s worst fighting in Sudan’s vast western region of Darfur. But the most desperate are trapped behind the front lines.

“We are seeing a catastrophe unfolding in North Darfur, where our teams have estimated that 13 children are dying each day of malnutrition and related health conditions at a camp for displaced people,” Avril Benoît, executive director of Doctors Without Borders in the US, said in a statement. She urged Sudanese authorities to stop blocking aid.

Some Sudanese manage to get help in time. One mother of six, Rachid Yaya Mohammed, said she came to the hospital at this camp in Chad because she is six months pregnant.

Two of her smallest children — twins — slept beside her.

Conditions are expected to worsen in the coming lean season between harvests, when food reserves are depleted and rains drive up rates of malaria.

Sudan plunged into chaos a year ago when clashes erupted in the capital, Khartoum, and spread.



3 days, 640,000 Children, 1.3M Doses...the Plan to Vaccinate Gaza's Young against Polio

FILE - Palestinians displaced by the Israeli air and ground offensive on the Gaza Strip, walk through a dark streak of sewage flowing into the streets of the southern town of Khan Younis, Gaza Strip, on July 4, 2024. Health authorities and aid agencies are racing to avert an outbreak of polio in the Gaza Strip after the virus was detected in the territory's wastewater and three cases with a suspected polio symptom have been reported. (AP Photo/Jehad Alshrafi, File)
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3 days, 640,000 Children, 1.3M Doses...the Plan to Vaccinate Gaza's Young against Polio

FILE - Palestinians displaced by the Israeli air and ground offensive on the Gaza Strip, walk through a dark streak of sewage flowing into the streets of the southern town of Khan Younis, Gaza Strip, on July 4, 2024. Health authorities and aid agencies are racing to avert an outbreak of polio in the Gaza Strip after the virus was detected in the territory's wastewater and three cases with a suspected polio symptom have been reported. (AP Photo/Jehad Alshrafi, File)

The UN health agency and partners are launching a campaign starting Sunday to vaccinate 640,000 Palestinian children in Gaza against polio, an ambitious effort amid a devastating war that has destroyed the territory's healthcare system.

The campaign comes after the first polio case was reported in Gaza in 25 years — a 10-month-old boy, now paralyzed in the leg. The World Health Organization says the presence of a paralysis case indicates there could be hundreds more who have been infected but aren’t showing symptoms.

Most people who have polio do not experience symptoms, and those who do usually recover in a week or so. But there is no cure, and when polio causes paralysis it is usually permanent. If the paralysis affects breathing muscles, the disease can be fatal.

The vaccination effort will not be easy: Gaza’s roads are largely destroyed, its hospitals badly damaged and its population spread into isolated pockets.

WHO said Thursday that it has reached an agreement with Israel for limited pauses in the fighting to allow for the vaccination campaign to take place. Even so, such a large-scale campaign will pose major difficulties in a territory blanketed in rubble, where 90% of Palestinians are displaced.

How long will it take? The three-day vaccination campaign in central Gaza will begin Sunday, during a “humanitarian pause” lasting from 6 a.m. until 3 p.m., and another day can be added if needed, said Dr. Rik Peeperkorn, WHO’s representative in the Palestinian territories.

In coordination with Israeli authorities, the effort will then move to southern Gaza and northern Gaza during similar pauses, he said during a news conference by video from Deir al-Balah in central Gaza, according to The AP.

Who will receive the vaccine? The vaccination campaign targets 640,000 children under 10, according to WHO. Each child will receive two drops of oral polio vaccine in two rounds, the second to be administered four weeks after the first.

Where are the vaccination sites? The vaccination sites span Gaza, both inside and outside Israeli evacuation zones, from Rafah in the south to the northern reaches of the territory.

The Ramallah-based Health Ministry said Friday that there would be over 400 “fixed” vaccination sites — the most in Khan Younis, where the population density is the highest and there are 239,300 children under 10. Fixed sites include healthcare centers, hospitals, clinics and field hospitals.

Elsewhere in the territory, there will also be around 230 “outreach” sites — community gathering points that are not traditional medical centers — where vaccines will be distributed.

Where are the vaccines now? Around 1.3 million doses of the vaccine traveled through the Kerem Shalom checkpoint and are currently being held in “cold-chain storage” in a warehouse in Deir al-Balah. That means the warehouse is able to maintain the correct temperature so the vaccines do not lose their potency.

Another shipment of 400,000 doses is set to be delivered to Gaza soon.

The vaccines will be trucked to distribution sites by a team of over 2,000 medical volunteers, said Ammar Ammar, a spokesperson for UNICEF.

What challenges lie ahead? Mounting any sort of campaign that requires traversing the Gaza strip and interacting with its medical system is bound to pose difficulties.

The UN estimates that approximately 65% of the total road network in Gaza has been damaged. Nineteen of the strip's 36 hospitals are out of service.

The north of the territory is cut off from the south, and travel between the two areas has been challenging throughout the war because of Israeli military operations. Aid groups have had to suspend trips due to security concerns, after convoys were targeted by the Israeli military.

Peeperkorn said Friday that WHO cannot do house-to-house vaccinations in Gaza, as they have in other polio campaigns. When asked about the viability of the effort, Peeperkorn said WHO thinks “it is feasible if all the pieces of the puzzle are in place. ”

How many doses do children need and what happens if they miss a dose? The World Health Organization says children typically need about three to four doses of oral polio vaccine — two drops per dose — to be protected against polio. If they don’t receive all of the doses, they are vulnerable to infection.

Doctors have previously found that children who are malnourished or who have other illnesses might need more than 10 doses of the oral polio vaccine to be fully protected.

Are there side effects? Yes, but they are very rare.

Billions of doses of the oral vaccine have been given to children worldwide and it is safe and effective. But in about 1 in 2.7 million doses, the live virus in the vaccine can paralyze the child who receives the drops.

How did this outbreak in Gaza start? The polio virus that triggered this latest outbreak is a mutated virus from an oral polio vaccine. The oral polio vaccine contains weakened live virus and in very rare cases, that virus is shed by those who are vaccinated and can evolve into a new form capable of starting new epidemics.