On Monday, World Health Organisation (WHO) Representative Rik Peeperkorn told UN News about the desperate conditions he had seen at Al-Ahli before the attack, and the severe restriction on movement that is preventing thousands being evacuated for medical treatment outside of Gaza.

“I was in Gaza several weeks ago and I came out in early March, just before the aid blockade started and the attacks started up again.

When I was there, during the ceasefire, we were organising polio vaccinations and medevacs (medical evacuations), and we stocked up on essential medicine and medical supplies. This was also the only time there were proper food stocks in Gaza.

There was almost a ray of hope among all the misery. Places I’d been before, like Rafah in the south, or Jabalia in the north, were utterly devastated wastelands, but people, including our own staff, were going back to their homes, trying to repair destroyed houses or building makeshift camps. You saw commercial activities restarting, and a choice of food.

But then, of course, with the blockade, food, water and essential medicines very quickly began running out. Even though we stocked up during the ceasefire, we are now critically low on supplies and it is challenging to keep hospitals even partly open.

We have completely run out of therapeutic milk, antibiotics, to treat severe infections, trauma painkillers, insulin, ambulance spare parts, oxygen tanks etc.

Medical evacuation of patients from Gaza (file)

A couple of days before the attack on Al Ahli, a medical specialist there told us that the hospital was already overflowing because it’s one of the key hospitals in the north for trauma patients [those who have suffered severe and life-threatening injuries], and that they were forced to perform surgery under questionable sterile conditions.

They were lacking enough surgical gowns, drapes or gloves. They even had to wear the same gloves from one operation to the next. Because of the lack of equipment, surgeries could take hours, increasing the risk of permanent disability or amputations.

The staff asked us for the supplies that we have in our two warehouses in the south of Gaza, but we were not allowed.

This aid blockade needs to be lifted, and we have to get back to an arrangement whereby we can have humanitarian corridors throughout Gaza, without being denied or delayed entry. Even when a war is going on, humanitarian supplies should be allowed in and aid workers should be able to do their work.

Today I spoke to my team leads in Gaza, who have been to Al-Shifa hospital. Al-Shifa, now the major surgical and trauma centre for the north, is completely overwhelmed and under-supported. We are looking at the possibility of getting some patients from Al-Shifa to the south but everything is complex.

Far too few patients have been able to leave Gaza for the urgent care they so desperately need. We estimate that up to 12,000 patients need medical evacuation but, since the blockade we have only been able to evacuate 121 people, including 73 children.

“We call for the immediate resumption of medical evacuation through all possible routes. That should happen now.”

The latest attacks, which began on 11 April, saw Rapid Support Forces (RSF)-affiliated forces launch coordinated assaults on Zamzam and Abu Shouk – two of the largest camps for internally displaced people (IDPs) in Darfur – as well as the regional capital, El Fasher.

Among those killed were 23 children as well as nine humanitarian workers who were operating one of the last remaining health posts.

No end in sight to suffering

The UN Independent International Fact-Finding Mission (FFM) for Sudan condemned the violence, warning that the situation is deteriorating as ethnically driven violence and hate speech escalate.

“The world has witnessed two years of ruthless conflict which has trapped millions of civilians in harrowing situations, subjecting them to violations and suffering with no end in sight,” Mohamed Chande Othman, FFM chair, said in a statement on Monday.

“Amid the rising tide of hate speech and ethnically driven violence and reprisals, we fear the darkest chapters of this conflict have yet to unfold.”

Bring perpetrators to justice

UN Secretary-General António Guterres also condemned the latest violence, stressing that attacks on civilians, humanitarian and medical personnel are strictly prohibited under international law.

“The perpetrators of these attacks must be brought to justice,” he said, calling for urgent, safe and sustained access to besieged areas like Zamzam camp, where famine conditions have already been identified.

Two years of atrocities

The Darfur attacks are the latest flashpoints in a conflict that erupted on 15 April 2023, when fighting broke out in Khartoum between the Sudanese Armed Forces (SAF) and the RSF.

The power struggle quickly descended into a nationwide civil war, killing thousands and displacing over 12.4 million people – more than 3.3 million as refugees into neighbouring countries.

According to the FFM, both sides have committed serious violations of international humanitarian law, including deliberate attacks on civilians, rape and sexual violence, starvation tactics, mass looting and destruction of civilian infrastructure.

Aid workers targeted

Clementine Nkweta-Salami, UN Humanitarian Coordinator in Sudan, described the escalation as “deadly and unacceptable,” and condemned the deliberate targeting of civilians and aid workers.

“These families – many of whom have already been displaced multiple times – are once again caught in the crossfire, with nowhere safe to go. This must end now,” she stressed.

Survivors from Zamzam camp – once home to over 750,000 people, half of them children – were reported as being placed under siege-like conditions, according to the FFM.

Humanitarian access inside the camp remains nearly impossible, while children are reported to be dying from hunger and the few remaining health outposts have been overrun or destroyed.

Protect children

The UN Children’s Fund (UNICEF) also sounded the alarm.

“These unconscionable acts of violence against civilians, children and aid workers must end immediately,” said Executive Director Catherine Russell.

“Children must be protected from this senseless violence, and humanitarian workers must never be targets.” 

Ms. Russell warned that with aid blocked and violence surging, famine is already “stalking children,” placing over one million people at high risk in and around El Fasher and Zamzam camp.

© UNICEF/Proscovia Nakibuuka

Clashes and insecurity in Sudan has forced millions to flee their homes in search of safety. (file photo)

Situation beyond Darfur

Violations are not confined to Darfur.

The SAF and its allies have allegedly committed reprisal attacks in areas recently recaptured from the RSF, particularly in Sinja and Al-Dinder in Sennar state and Wad Madani in Al-Jazirah (also spelled Gezira).

Witnesses described arbitrary detentions, mass arrests and public executions, including in newly controlled areas of southern Khartoum, the FFM said. Many of those detained have reportedly disappeared.

“These acts highlight the urgent need to prevent further escalation and to protect civilians and the lifesaving systems they rely on,” said FFM member Mona Rishmawi.

Stop encouraging the war

In the midst of the violence, the Fact-Finding Mission alongside humanitarian agencies continue to call for international accountability and support.

As key regional and global actors set to meet this week in London to discuss humanitarian funding and strategies for civilian protection, the FFM reiterated the need for all States to “respect and ensure respect” for the Geneva Conventions – the core of international humanitarian law.

“This means that States should neither finance the war nor provide weapons, as this may encourage, aid and assist the warring parties in committing violations,” said Ms. Rishmawi.

The Human Rights Council – UN’s primary human rights forum – established the Independent International Fact-Finding Mission for Sudan in October 2023 and extended its mandate until October this year.

Its core task is to investigate all alleged human rights violations and violations of international humanitarian law linked to Sudan’s ongoing conflict since April 2023.

“It has now been a month and a half since any supplies were last allowed through the crossings into Gaza,” UN Spokesperson Stéphane Dujarric told journalists at the daily media briefing in New York. 

OCHA said about 70 per cent of the Gaza Strip is currently under displacement orders or in “no go” zones.

Over the weekend, the Israeli military issued four new displacement orders, some of them following reports of Palestinian rocket fire.  

The UN was able to “relocate some existing fuel stocks from areas under displacement orders to locations where they are more easily accessible by humanitarian workers,” said Mr. Dujarric.   

A surge in attacks causing mass civilian casualties has been reported by UN partners on the ground, according to OCHA. 

The Al Ahli hospital in Gaza City was targeted by an Israeli strike and has now gone out of service, the World Health Organization (WHO) said. 

Additionally, a UN warehouse in Gaza City and a community food distribution point in Khan Younis were hit and damaged by Israeli strikes over the weekend.   

South Sudan: UN responds to deteriorating security in Upper Nile state

Peacekeepers with the UN Mission in South Sudan (UNMISS) are stepping up patrols, and engaging with various communities and authorities, amid a deteriorating security situation, the global organization reported on Monday.

This comes as clashes continue in areas of Upper Nile State between the South Sudan People’s Defense Forces (SSPDF) and the Sudan People’s Liberation Movement in Opposition (SPLA-iO), causing casualties and displacement.

Elsewhere, intercommunal violence in Warrap and Lakes states is also rising, with over 200 deaths reported in recent weeks.

Accord in Abyei

Meanwhile, the UN is highlighting positive developments in Abyei, the disputed oil-rich region straddling Sudan and South Sudan.

Sixty youth leaders from the Ngok Dinka community of Abyei and the Twic Dinka community of Warrap State in South Sudan recently signed an agreement committing to an immediate cessation of hostilities.

The parties agreed to re-open key routes enabling the free and secure movement of both people and goods. They also pledged to collaborate to counter misinformation and hate speech.

The accord was the result of a four-day dialogue attended by key peace partners including the UN Interim Security Force for Abyei (UNISFA) and UNMISS.

Both missions reaffirmed their full support towards these efforts and to strengthening dialogue and harmony between communities. 

Ecuador oil spill affects 150,000, UN assessment finds

A massive oil spill in Ecuador last month has left at least 150,000 people in need of humanitarian assistance, according to an assessment by UN aid coordination office OCHA.

The disaster was caused by the rupture of the SOTE pipeline in Esmeraldas province in March, resulting in the spilling of over 25,000 barrels of oil.

The UN Disaster Assessment and Coordination (UNDAC) team, which is part of OCHA, carried out the assessment.

In addition to the thousands affected, the team also pointed to a concerning increase in respiratory and gastrointestinal diseases, as well as limited access to safe drinking water.

People’s livelihoods have been particularly hit hard, especially in fishing, agriculture and shellfish harvesting. 

OCHA said more than 37,000 women have lost their means of earning a living. Many are shellfish gatherers and now face growing health risks and exposure to gender-based violence.

The UN is testing water from affected rivers, treatment plants and seafood from the ocean for hydrocarbons and heavy metals, as it could have long term environmental and health repercussions.

UN Resident Coordinator in Ecuador, Lena Savelli, has shared the findings and recommendations with Government ministers and the national humanitarian forum.

The top official also reiterated the UN’s commitment to support the Government with technical assistance. 

With fighting showing no sign of abating and humanitarian access extremely limited, the crisis in Sudan has become one of the world’s largest emergencies, the UN Office of the High Commissioner for Refugees (UNHCR) warned on Monday.

“This is a very, very sad milestone,” Mamadou Dian Balde, UNHCR Regional Director for East Africa said, marking two years since the outbreak of war.

“We are seeing massive violations, massive displacements and a devastating impact on millions of people.”

A humanitarian catastrophe

The war, which erupted in April 2023 between the Sudanese Armed Forces (SAF) and the paramilitary Rapid Support Forces (RSF), has triggered a full-blown humanitarian catastrophe.

More than half the population – around 25 million people – require humanitarian assistance and protection, but funding shortfalls and insecurity have left vast swaths of the country beyond reach.

The UNHCR-led $1.8 billion Regional Refugee Response Plan for 2025 – which aimed to support 4.8 million refugees and host community members – remains only 10 per cent funded, Mr. Balde said, jeopardizing essential services such as food, shelter, education and healthcare.

“Communities that have very little are sharing what they have with the refugees. It is an extraordinary show of solidarity,” he added, urging the international community to step up support for the most vulnerable across the region.

Thousands of lives at risk

Hunger has reached catastrophic levels in Sudan, with famine confirmed in 10 areas and 17 more at risk, according to the UN World Food Programme (WFP).

In some areas, emergency food assistance is the only barrier preventing starvation. However, vital operations are constrained by insecurity and lack of funds.

“Without immediate assistance, especially in famine or famine-risk areas, thousands of lives are at risk,” said Makena Walker, WFP Acting Country Director in Sudan.

“We can scale up – but we need all parties to guarantee safe, unhindered access for humanitarian convoys,” she added.

Children hit hardest

Children remain among the hardest hit.

According to the UN Children’s Fund (UNICEF), child casualties this year have surged by 83 per cent compared to early 2024. Children are also at severe risk of sexual and gender-based violence or being forced into armed groups, on top of already losing out on education.

In addition, an estimated 146,000 children are projected to suffer from severe acute malnutrition this year, leaving them up to 11 times more likely to die than a well-nourished child.

A public health emergency

The crisis has also spiralled into a public health emergency, with over 20.3 million people now in urgent need of medical care. Cholera, measles, malaria and dengue are spreading rapidly across two-thirds of Sudan’s states, with cholera alone claiming over 1,500 lives.

This situation is unravelling against a health infrastructure on the brink of collapse: 38 per cent of hospitals in the worst affected regions are non-functional and the remaining only partially operational, according to the UN World Health Organization (WHO).

Attacks on healthcare have surged, with 156 attacks verified over the past two years, resulting in hundreds of deaths and injuries.

“In addition to being a famine crisis, the humanitarian situation in Sudan is also a protection and health crisis,” said Shible Sahbani, WHO Representative in the country.

The UN health agency is determined to continue working to improve health access for Sudan’s people. However, recent funding cuts have forced WHO to scale back operations, potentially affecting health services.

If funding does not flow, 4.7 million people targeted for health interventions this year will be affected. Services at 335 health facilities will also have to be reduced, including trauma and emergency care.

© UNICEF/Mohammed Abdulmajid

A woman carries water to her shelter in a camp for internally displaced persons in eastern Sudan.

Working against the odds

Despite the challenges, UN humanitarians and partners continue their efforts to reach the most vulnerable communities with lifesaving assistance.

Since the war began, WFP has provided over 13 million people with food and nutrition support. For its part WHO, has supported over one million people with health services, treated 75,000 severely malnourished children and helped vaccinate 11.5 million children against polio and measles.

But aid workers warn the situation is deteriorating fast, particularly in the states of Darfur and parts of Khartoum and Al-Jazirah (also spelled Gezira), where active fighting and sieges are cutting civilians off from assistance.

Mr. Balde reiterated the urgent need for the international community to help silence the guns, “we call for peace, protection and sustained support – [only then] normalcy can return, and refugees can return home.”