Resident and Humanitarian Coordinator Abdou Dieng, speaking from Port Sudan, told reporters in the briefing room in New York that senior leadership would be returning to the Sudanese capital, as soon as the situation allows.

The needs are urgent, and widespread, he said, as the final few hours of a US-brokered 72-hour ceasefire neared, with fighting continuing. Hundreds have been killed, and thousands wounded as the rival militia of the country’s top two generals continue to battle each other in civilian areas.

Dire needs, before fighting erupted

Before the fighting began nearly two weeks ago, one in three Sudanese was already in need of aid, and it’s proving “extremely difficult” to properly assess the level of need today, Mr. Dieng said.

The pre-conflict Humanitarian Response Plan called for $1.7 billion, of which only 15 per cent has been pledged, he said.

In reply to questions about an uptick in inter-communal violence in West Darfur and food shortages, he said the UN was extremely worried about food supplies, and the deteriorating situation across all of Darfur.

The UN and partners, are establishing a core team in Port Sudan itself, which will be responsible for overseeing humanitarian operations in the country, and negotiating humanitarian access with de facto authorities.

Emergency funding

The Emergency Relief Coordinator, Martin Griffiths, announced on Thursday the allocation of $3 million from the Central Emergency Response Fund (CERF) to urgently respond to the arrival of Sudanese refugees and others in Chad. 

In Khartoum, meanwhile, the World Health Organization (WHO) reported that more than 60 per cent of health facilities are closed and only 16 per cent are operating as normal.

Briefing reporters in New York, UN Deputy Spokesperson Farhan Haq, said that according to UN partners who remain in the capital, the treatment of nearly 50,000 acutely malnourished children has been disrupted. 

Mr. Haq said that shortages of food, water, medicines and food continue, especially in the capital and surrounding areas, where the military stand-off has been most intense, “while access to communications and electricity is limited in many parts of the country.”

Needs grow at Chad-Sudan border

As many as 20,000 people – among them Chadians, Sudanese, and foreign nationals – fleeing the violence in Sudan, have arrived so far in neighbouring Chad, said the UN migration agency, IOM, earlier on Thursday.

The vast border between the two countries extends for 1,400 kilometres.

“The majority of those arriving are in dire need of basic humanitarian aid, namely food, water and adequate shelter,” said Anne Kathrin Schaefer, IOM Chief of Mission in Chad.

“While registration is ongoing by humanitarian actors including IOM, we believe a considerable number of those arriving are Chadians as well as nationals from other countries, who lived in Sudan and will require immediate assistance to return to their communities of origin and reunite with their families,” she adds.

IOM teams have been deployed in Eastern Chad at the border with Sudan and are working around the clock in support of the national and humanitarian efforts to respond to the arrivals.

Volker Perthes, who is also head of UN Transition Assistance Mission UNITAMS, welcomed the lull in fighting in some parts of the country between the Sudanese Armed Forces (SAF) and paramilitaries from the Rapid Support Forces (RSF), noting that “it is not being fully respected”.

He called on both sides to stick to the final day of the agreed ceasefire, “and facilitate humanitarian access” to the UN and partners, who are continuing to provide lifesaving aid as far as conditions allow.

Mr. Perthes, who is remaining in Sudan together with senior UN personnel, said in a statement he was “deeply concerned by recent reports of violence in El Geneina (West Darfur), which increasingly appears to also be taking on inter-communal dimensions with attacks on civilians and looting and distribution of weapons among local communities.”

UN premises looted

He said attacks had also resulted in “other mass looting, including of UN premises.”

He once again called for an immediate end to the conflict between the two factions, who are unable to agree on integrating their forces ahead of a long-awaited transition to civilian rule, before the violence and destruction escalates.

Calling for all humanitarians – their facilities and assets – to be protected, the UNITAMS chief told the generals that it was “crucial” for civilians to be able to safely leave areas of active fighting and have access to “essential supplies.”

He welcomed ongoing efforts by local authorities in the region to de-escalate tensions, and vowed to work with all parties, “towards a sustained ceasefire with a monitoring mechanism, political negotiations, and to alleviate human suffering.”

Speaking in Geneva, the head of the World Health Organization (WHO), Tedros Adhanom Ghebreyesus, said that the violence wracking Sudan had “taken a terrible toll on health”.

More deaths due to disease

“On top of the number of deaths and injuries caused by the conflict itself, WHO expects there will be many more deaths due to outbreaks, lack of access to food and water, and disruptions to essential health services, including immunization”, he said.

WHO estimates that one in four of the lives lost so far could have been saved with access to basic emergency medical treatment for the wounded.

“But paramedics, nurses and doctors are unable to access injured civilians, and civilians are unable to access services. In the capital Khartoum, 61 per cent of health facilities are closed, and only 16 per cent are operating as normal.”

24,000 births, no hospital care

Many patients with chronic diseases, like kidney disease, diabetes and cancer, are unable to access the health facilities or medicines they need and in the coming weeks, around 24,000 women will give birth in the capital, “but they are currently unable to access maternal care”, said Tedros.

The risk of diarrhoeal diseases is high, as the water supply is disrupted and people are drinking river water to survive, noted the WHO chief.

“With nutrition programmes suspended, 50,000 children are at real risk; and the movement of civilians seeking safety threatens the fragile health system throughout the country.”

Since the conflict began, WHO has verified 16 attacks on health, resulting in at least eight deaths so far.

Thousands fleeing the fighting  

As the fighting continues, the UN is preparing for a mass influx of refugees into countries across the region bordering Sudan, including the Central African Republic, Chad, Egypt, Ethiopia, and South Sudan, UN Deputy Spokesperson Farhan Haq told correspondents in New York on Wednesday.

The refugee agency UNHCR, estimates that some 270,000 people could flee into South Sudan and Chad alone.

“In South Sudan, our humanitarian partners are scaling up their presence in key response areas to help the most vulnerable people”, said Mr. Haq. “In Chad, UNHCR is working with the Government to assess the needs of people arriving in the country.”

UNHCR is calling on all countries neighbouring Sudan to keep their borders open to those fleeing the violence, in fear of their lives.

Pity the children: lives must take precedence

In a joint statement, the Special Representative for Children and Armed Conflict, Virginia Gamba, and the Special Representative on Violence against Children, Najat Maalla M’jid, said they were alarmed at the reported numbers of civilian deaths, including children.

“The lives, protection and well-being of children must take precedence over combat operations, and we call on all parties to halt hostilities and to ensure full protection of all children.

“Parties should further refrain from attacking civilian infrastructures in accordance with international humanitarian law, especially those impacting children – this includes schools and medical facilities as well as water and sanitation systems”, said the two officials.

They also reminded military officers engaged in the fighting that “regardless of their roles, under no circumstances should children below 18 years be involved in armed conflict as the recruitment and use of children is prohibited under international law.”