MSF Chief: Sudan’s Situation Worst We’ve Ever Seen

International President of Doctors Without Borders (MSF) Christos Christou
International President of Doctors Without Borders (MSF) Christos Christou
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MSF Chief: Sudan’s Situation Worst We’ve Ever Seen

International President of Doctors Without Borders (MSF) Christos Christou
International President of Doctors Without Borders (MSF) Christos Christou

The health situation in Sudan is “the worst ever,” according to Christos Christou, the international president of Doctors Without Borders (MSF).
Speaking to Asharq Al-Awsat, Christou warned that conditions are deteriorating rapidly due to severe challenges in movement, a limited presence of international aid organizations, and inadequate funding from donors.
Christou reported that more than 70% of health facilities have shut down, and malnutrition is on the rise.
He predicted a surge in malaria and cholera cases with the rainy season approaching.
The ongoing conflict between the Sudanese army and the Rapid Support Forces (RSF) has caused the world’s fastest-growing displacement crisis, worsening malnutrition among children and pregnant women.
Remaining health facilities are overwhelmed and at risk of collapse due to increasing violence, attacks, and looting.
During his recent visit to Sudan, Christou met with Deputy Chairman of the Sovereignty Council Malik Agar and senior health officials to discuss ways to improve humanitarian aid delivery.
Christou described the patterns of displacement, malnutrition, and other humanitarian needs in Sudan as “deeply troubling.”
He noted that humanitarian aid is not reaching enough people and stressed the urgent need to “scale up the humanitarian response.” This, he added, requires guarantees of protection from all warring parties.
According to Christou, one in three patients treated by the organization suffers from war-related injuries, with most being women and children. He called on all fighting parties to “do everything possible to protect civilians.”
“We have heard many patient testimonies about violence driven by ethnic motives, especially in Darfur,” Christou said.
MSF is in constant contact with all warring parties to ensure healthcare continues.
“We must remind them to follow international humanitarian law, protect civilians and infrastructure, and not use weapons in health facilities,” added the MSF president.
Christou emphasized that MSF provides life-saving healthcare to all in need in Sudan, remaining neutral and impartial.



Fakhri Karim: My Complaint to Sistani on Corruption Spurred Suggestion of Saddam-Era Minister

Fakhri Karim, senior adviser to late Iraqi President Jalal Talabani, speaks to Asharq Al-Awsat. (Asharq Al-Awsat)
Fakhri Karim, senior adviser to late Iraqi President Jalal Talabani, speaks to Asharq Al-Awsat. (Asharq Al-Awsat)
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Fakhri Karim: My Complaint to Sistani on Corruption Spurred Suggestion of Saddam-Era Minister

Fakhri Karim, senior adviser to late Iraqi President Jalal Talabani, speaks to Asharq Al-Awsat. (Asharq Al-Awsat)
Fakhri Karim, senior adviser to late Iraqi President Jalal Talabani, speaks to Asharq Al-Awsat. (Asharq Al-Awsat)

In post-Saddam Hussein Iraq, the prime minister's office gained significant power. It became customary for the prime minister to be Shiite, the president Kurdish, and the speaker of Parliament Sunni.

This power-sharing arrangement, focusing on sectarian representation over institutional structure, has remained strong.

Attempts to break this norm have failed, including when former US President Barack Obama and his Vice President Joe Biden tried to support Ayad Allawi, a Shiite politician, for the presidency. The aim was to keep Prime Minister Nouri al-Maliki in power with support from both Washington and Tehran.

Despite Allawi’s parliamentary majority win, he didn’t become president.

Arab states were slow to react to changes in Iraq, allowing Iran to step in. Iran supported the US-created Iraqi Governing Council and sought to bring together Shiite factions to join the political process.

Its influence grew due to its backing of groups that opposed Saddam Hussein. Iran gained a key role in Iraq, effectively having veto power over decisions and a say in forming governments, while also expecting an eventual US military withdrawal.

Fakhri Karim, senior adviser to late Iraqi President Jalal Talabani, said Iran stepped in to fill a vacuum in Iraq, solidifying its role and protecting its interests.

This made Iran’s Quds Force commander Gen. Qassem Soleimani a key figure in Iraq, shaping everything from the reduction of US military presence to the formation of governments.

A foreign power’s influence in a neighboring country grows only if locals accept its role.

Soleimani and deputy leader of Iraq’s Popular Mobilization Forces (PMF) Abu Mahdi al-Muhandis were killed in a US strike near Baghdad airport in January 2020.

Speaking to Asharq Al-Awsat, Karim noted that Soleimani “was dedicated to serving his country’s interests, and the other side should have defended its own role and interests.”

He recalled Soleimani as being “skilled, effective, and able to earn trust, shifting from flexibility to rigidity when needed.”

This was clear in a letter Soleimani sent to Talabani when he considered supporting a no-confidence motion against Maliki’s government.

Karim also mentioned that al-Muhandis was deeply trusted by the Iranian general.

Talabani assigned his senior adviser various missions in Iran, focusing on forming Iraqi governments and relations with Kurdistan.

During a visit to Tehran, Adil Abdul Mahdi, who would later become prime minister, informed Talabani and Karim that “Soleimani’s claim that Iran supports Nouri al-Maliki for prime minister is false.”

“I was told that Iranian Supreme Leader Ali Khamenei supports me,” argued Abdul Mahdi at the time.

Talabani felt awkward despite being close to Abdul Mahdi. He asked Karim to visit Tehran, where he met Soleimani and al-Muhandis. Soleimani denied Abdul Mahdi’s claims, saying he could take Karim to the Supreme Leader to hear the truth.

For his part, Karim said the Supreme Council didn’t support al-Maliki and that influential cleric Moqtada al-Sadr’s stance was hardening. Soleimani assured that the Iranians were in contact with al-Sadr and would handle the issue of the Supreme Council.

When Karim returned, he informed Talabani and Kurdish leader Masoud Barzani that the Badr Organization, led by Hadi al-Amiri, had left the Supreme Council to join Maliki, shifting the balance and allowing the formation of a government without the Council’s interference.

Karim remembered that Iran initially supported Ibrahim al-Jaafari for prime minister (2005-2006). However, Jaafari quickly became a burden on the political process and Shiite leaders then signaled the need for change.

The US Ambassador advised Jaafari to resign, threatening him if he didn't comply.

Maliki’s name wasn’t initially considered; Ali al-Adib from the “Dawa” party, of which Maliki was a member, was the favored choice. But Maliki didn’t support Adib, so after deliberations, the party settled on Maliki instead.

Breakfast with Soleimani

Karim remembers a breakfast meeting with Soleimani and al-Muhandis. He brought up Maliki’s performance during his second term and the widespread corruption in Iraq.

Soleimani suggested discussing it further, but Karim insisted the issue was urgent.

He questioned why, if all major Shiite forces agreed, change couldn’t happen. Soleimani indicated that decisions within the Shiite alliance were made by those who remained in it, prompting Karim to ask if Soleimani was implying it was him. Soleimani then replied : “Think what you wish.”

Sadr’s misstep

In the post-Saddam Hussein era, Sadr emerged as a major political force in Iraq. He led a large popular and armed movement.

Dealing with Sadr was challenging for political factions, especially among Shiites. Some disputes even culminated in armed conflicts. Managing Sadr’s influence was difficult both internally and for external interests, especially given his unpredictability.

When asked about Sadr’s decision to quit politics in 2022, Karim called it a major mistake.

He believed Iraq suffered greatly from this move, as it left parliament without any influential Shiite force capable of standing up against decisions not aligned with common goals.

Karim highlighted that filling seats with losing candidates seemed odd and turned the minority into the majority, undermining the constitutional process. He also noted the Shiite community’s fragmentation, with many Shiites not participating in recent elections due to their disenchantment with the political parties.

Karim warned against underestimating the potential for renewed protests and uprisings among the marginalized against the government and ruling powers.

Sistani’s unexpected proposal

When discussing top Shiite Religious Authority in Iraq, Ali al-Sistani, Karim highlighted his political astuteness, surpassing the majority of other Shiite leaders. Sistani’s Friday sermons, delivered by his representatives, reflect this forward-thinking approach.

Karim noted a key observation about Sistani’s mindset. Despite corruption concerns, Sistani surprised Karim by suggesting bringing back the former Minister of Trade for his effectiveness in managing the ration card distribution.

He even proposed considering a Christian minister if they were honest and prioritized the people’s interests.

Furthermore, Sistani emphasized the importance of inclusivity in the new Iraq, advocating for the rights of Sunni and Kurdish components. He rejected marginalization and insisted on their participation and rights.

Sistani’s fatwa and the PMF

Karim believes that Sistani issued a fatwa on “jihad” to rally people against the significant threat posed by ISIS in 2014. He didn’t specifically mention the Popular Mobilization Forces (PMF) or any other organization but referred to volunteers.

“Many responded to Sistani’s call and made significant sacrifices alongside the armed forces and Peshmerga. Volunteers participated in liberating areas once occupied by the terror group,” said Karim.

Karim further noted that there was a belief that those who made sacrifices had the right to be part of the armed forces and receive state support.

“The idea of integrating militias or military entities into the armed forces is not new,” explained Karim.

“US diplomat Paul Bremer [the first post-invasion governor of Iraq] proposed something similar to factions and organizations under the banner of integration into the army, and steps were taken in this direction,” he added.

“The goal was to eliminate the threat of ISIS, not to create a parallel army or establish another institution.”