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.



What Is Known About Polio’s Return to the Gaza Strip 

Displaced kids sort through trash at a street in Deir al-Balah, central Gaza Strip, Tuesday, Aug. 27, 2024. (AP)
Displaced kids sort through trash at a street in Deir al-Balah, central Gaza Strip, Tuesday, Aug. 27, 2024. (AP)
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What Is Known About Polio’s Return to the Gaza Strip 

Displaced kids sort through trash at a street in Deir al-Balah, central Gaza Strip, Tuesday, Aug. 27, 2024. (AP)
Displaced kids sort through trash at a street in Deir al-Balah, central Gaza Strip, Tuesday, Aug. 27, 2024. (AP)

Health authorities in the Gaza Strip confirmed the first case of polio in 25 years earlier this month.

The infection and subsequent partial paralysis of the nearly year-old Abdul-Rahman Abu Al-Jidyan has hastened plans for a mass vaccination campaign of children across the Palestinian enclave starting on Sept. 1.

Three-day pauses in fighting in each of Gaza's three zones have been agreed by Israel and Hamas to allow thousands of UN workers to administer vaccines.

ORIGINS

The same strain that later infected the Palestinian baby, from the type 2 vaccine-derived polio virus that has also been detected in wastewater in some developed countries in recent years, was detected in July in six sewage samples taken in Khan Younis and Deir al-Balah.

It is not clear how the strain arrived in Gaza but genetic sequencing showed that it resembles a variant found in Egypt that could have been introduced from September 2023, the WHO said.

The UN health body says that a drop in routine vaccinations in the Occupied Palestinian Territories, including Gaza, has contributed to its re-emergence.

Polio vaccination coverage, primarily conducted through routine immunization, was estimated at 99% in 2022 and fell to 89% in 2023. Health workers say the closure of many hospitals in Gaza, often because of Israeli strikes or restrictions on fuel, has contributed to lower vaccination rates. Israel blames Hamas, saying they use hospitals for military purposes.

Aid workers say poor sanitation conditions in Gaza where open sewers and trash piles are commonplace after nearly 11 months of war have created favorable conditions for its spread.

MASS VACCINATIONS

Israel's military and the Palestinian armed group Hamas have agreed to three separate, zoned three-day pauses in fighting to allow for the first round of vaccinations.

The campaign is due to start in central Gaza on Sunday with three consecutive daily pauses in fighting, then move to southern Gaza, where there would be another three-day pause, followed by northern Gaza. There is an agreement to extend the pause in each zone to a fourth day if needed.

The vaccines, which were released from global emergency stockpiles, have already arrived in Gaza and are due to be issued to 640,000 children under 10 years of age.

They will be given orally by some 2,700 health care workers at medical centers and by mobile teams moving among Gaza's hundreds of thousands of people displaced by the war, UN aid workers say.

The World Health Organization says that a successful roll-out requires at least 95% coverage.

The Israeli military's humanitarian unit (COGAT) said that the vaccination campaign would be conducted in coordination with the Israeli military "as part of the routine humanitarian pauses that will allow the population to reach the medical centers where the vaccinations will be administered".

A second round is planned in late September.

RISKS

The Gaza case which is vaccine-derived is seen as a setback for the global polio fight which has driven down cases by more than 99% since 1988 thanks to mass vaccination campaigns.

Wild polio is now only endemic in Pakistan and Afghanistan although more than 30 countries are still listed by the WHO as subject to outbreaks, including Gaza's neighbors Egypt and Israel.

The World Health Organization has warned of the further spread of polio within Gaza and across borders given the poor health and hygiene conditions there.

Poliomyelitis, which is spread mainly through the faecal-oral route, is a highly infectious virus that can invade the nervous system and cause paralysis and death in young children with those under 2 years old most at risk. In nearly all cases it has no symptoms, making it hard to detect.