MSF in Sudan: ‘It’s very hard to reach people in need’
Internally displaced Sudanese people carry water in the Al Heshan camp, on the outskirts of Port Sudan, on April 15, 2026.
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Mohamed Ahmed, head of mission in Sudan for Médecins Sans Frontières (MSF) Switzerland, talks about the difficulty of working in a conflict where aid organisations are under increasing pressure and aid workers often become targets themselves. We met him in Geneva.
Mohamed Ahmed, head of mission in Sudan for Médecins Sans Frontières (MSF) Switzerland.
SWI swissinfo.ch / Dorian Burkhalter
“Words cannot describe what we are witnessing, the suffering we can see,” Mohamed Ahmed, head of mission in Sudan for MSF Switzerland, told Swissinfo during a visit to the organisation’s headquarters in Geneva. “And, unfortunately, it’s always the most vulnerable – women, children, the elderly – who bear the brunt in this conflict.”
Since April 2023, Sudan has been engulfed in a devastating civil war between the Sudanese Armed Forces and the Rapid Support Forces, a paramilitary group. Although it has received far less media coverage than other conflicts, the war in Sudan has triggered the largest humanitarian crisis in the world today. Some 15 million peopleExternal link have fled their homes, including more than 11 million who have been displaced within the country.
Famine, epidemics and restricted access to healthcare: humanitarian needs are huge in Sudan and in refugee camps in the neighbouring countries, including Chad, where living conditions are “dire”, according to the MSF head of mission. Yet reaching those in need is increasingly difficult because of the fierce fighting, administrative restrictions and lack of funding. “It’s the kind of assignment where I have a list of priorities for my list of priorities,” said Ahmed.
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Aid workers targeted
The fighting in Sudan is also taking a heavy toll on those who are there to help. “There’s been an upsurge in attacks against the healthcare system and aid workers,” Ahmed said. He is, meanwhile, no stranger to difficult situations, having previously worked in Yemen, among other places.
On March 20, Sudanese military drones struck the hospital in El-Daein, the capital of East Darfur, killing 70 people, including 15 children, according to MSFExternal link. Two weeks later, on April 2, the Rapid Support Forces in turn targeted the hospital in Al-Jabalain, in White Nile state, killing seven staff members.
“These are just a few examples of health professionals and humanitarian workers being deliberately targeted,” said Ahmed, who condemns these “flagrant violations” of international humanitarian law that are taking place against a backdrop of impunity.
Last year, during the siege of El-Fasher by the Rapid Support Forces, MSF had no choice but to pull out of Zamzam, Sudan’s largest displacement camp, just outside the capital of North Darfur.
“These are just a few examples of health professionals and humanitarian workers being deliberately targeted,” said Ahmed, who condemns these “flagrant violations” of international humanitarian law that are taking place against a backdrop of impunity.
Last year, during the siege of El-Fasher by the Rapid Support Forces, MSF had no choice but to pull out of Zamzam, Sudan’s largest displacement camp, just outside the capital of North Darfur.
“It’s a difficult decision for any humanitarian worker to make, and even more so for a head of mission,” said Ahmed, because of the “serious consequences and ethical and moral dilemmas” associated with such choices.
Known for working in some of the world’s most dangerous places, MSF is usually one of the last to stay on the ground. “Yes, we work in extremely difficult environments,” the head of mission acknowledged. “But we also have our limits. When a hospital is attacked and we lose patients and staff, it’s a sign that we’re no longer able to protect them. We have to know when to stop so as not to make things worse.”
Médecins Sans Frontières is present in nine out of the 18 states that make up Sudan. Its teams provide emergency medical treatment and maternal and paediatric healthcare, respond to disease outbreaks and offer water and sanitation services. With 1,750 Sudanese staff and 250 international staff, MSF currently runs two hospitals and two clinics, and supports 13 hospitals, 17 basic healthcare facilities and various clinics and mobile clinic sites.
Other humanitarian organisations, including UN agencies, the ICRC and other NGOs, are active in Sudan and neighbouring countries.
Source: MSF, April 2026External link
Bureaucratic hurdles
Humanitarian organisations also have to contend with considerable administrative constraints. Thus, MSF depends on the Sudanese Humanitarian Aid Commission, a government body, for visas and permits for travel and the import of medical supplies.
“Unlike in other places, you can’t just jump into a car and go save lives. You first have to clear a set of administrative hurdles,” Ahmed explained. “It is very hard to reach people in need.”
Despite ongoing dialogue with the parties to the conflict, MSF is today unable to deliver aid across the front lines. According to the government, this is to protect humanitarian staff; but the head of mission sees another reason. “We are also present on the ground to bear witness to the atrocities being committed, to disseminate information and to speak out on behalf of civilians who cannot do so themselves.”
In March, MSF published a report documenting sexual violenceExternal link against women in Sudan.
Like other humanitarian NGOs, MSF walks a fine line between its desire to expose violations of international law and the risk of losing access to the very people it wants to help. “We do not compromise on our principles, and we make our voice heard whenever we deem it necessary,” Ahmed stressed.
Funding crisis
The humanitarian sector is facing a severe funding crisis sparked by budget cuts in several countries, including the United States – historically the leading donor – which significantly reduced its contributions last year. MSF, which relies mainly on private donations, is indirectly affected by the closure of programmes on the ground.
“We’re not the only ones, but the situation is getting tougher,” said Ahmed. “Our teams are under huge pressure to do more and more, which also involves risks.”
In the areas where few humanitarian organisations are still active, MSF has expanded its work beyond medical care. This is the case in Tawila, North Darfur, a transit area for displaced people, where the organisation also provides nutritional support, distributes water and sets up sanitation facilities. According to NGOs, the number of displaced people there is estimated at several hundred thousand.
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Last year, UN-coordinated humanitarian response plans for Sudan and neighbouring countries were funded at 40% and 18%External link of needs respectively.
“Budget cuts have very real consequences. Take, for example, a child who cannot receive treatment for malnutrition, who has to be brought to our hospital and who does not survive because she got there too late,” he said.
“Over 60% of the Sudanese population depends on humanitarian aid. If this safety net disappears, then these people are at risk of dying,” the MSF head of mission warned.
Edited by Virginie Mangin/sj. Adapted from French by Julia Bassam/ds
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