The war, which erupted in April 2023 between the Sudanese Armed Forces (SAF) and the paramilitary Rapid Support Forces (RSF), has devastated civilian infrastructure, collapsed basic services and triggered one of the world’s largest displacement crises.

A nutrition survey conducted this month in Um Baru locality in Sudan’s North Darfur state – one of the regions worst affected by the fighting – found that more than half of children under five are acutely malnourished.

These are among the highest rates ever recorded in a standardized emergency assessment, the UN Children’s Fund (UNICEF) said, warning that without urgent, unhindered humanitarian access, children face an immediate risk of death from preventable causes.

The survey screened nearly 500 children and found acute malnutrition rates of 53 per cent – more than three times the World Health Organization’s emergency threshold. Eighteen per cent of children were suffering from severe acute malnutrition, a life-threatening condition that can kill within weeks if untreated.

“When severe acute malnutrition reaches this level, time becomes the most critical factor,” said UNICEF Executive Director Catherine Russell. “Children in Um Baru are fighting for their lives and need immediate help.”

Displacement from El Fasher fuels crisis

North Darfur has become the epicentre of Sudan’s hunger crisis following intensified fighting in and around El Fasher, the state capital and last major government stronghold in the region, which fell in October after more than 500 days under siege.

Many families now sheltering in Um Baru are newly displaced, having fled El Fasher and surrounding areas since October.

UNICEF said many children among the displaced have missed routine immunizations, including against measles, leaving them highly vulnerable to disease. The survey also recorded emergency-level crude mortality rates, underscoring the deadly convergence of hunger, illness and lack of basic services.

Although life-saving supplies such as ready-to-use therapeutic food have been pre-positioned, UNICEF stressed that nutrition treatment alone is insufficient. Holistic health and nutrition services are urgently needed given the scale of the emergency, the agency said.

Access remains severely restricted

Humanitarian access remains one of the greatest obstacles.

On 26 December, following prolonged negotiations, a UN team conducted its first security assessment inside El Fasher since the siege began, spending several hours visiting the Saudi hospital and speaking with residents trapped in the city.

UN staff reported a severe lack of basic supplies and services.

Humanitarian convoys carrying food and medical aid have been blocked from entering El Fasher for months, forcing hundreds of thousands of civilians to flee while those remaining face extreme deprivation.

Refugee flows into Chad continue

As conditions worsen, displacement beyond Sudan’s borders is accelerating.

The Office of the UN High Commissioner for Refugees (UNHCR) reported that nearly 19,400 Sudanese refugees have crossed into eastern Chad since attacks escalated around El Fasher at the end of October.

Women and children make up 87 per cent of new arrivals, many reaching the border exhausted and traumatized after fleeing violence, sexual abuse and extortion. Since late October, more than 2,700 unaccompanied or separated children and more than 1,100 people with disabilities have been registered.

Despite insecurity and movement restrictions along major routes, an average of about 250 refugees per day has crossed into Chad in recent weeks. UNHCR warned that cross-border movements are likely to continue as fighting, economic collapse and protection risks intensify.

A recent security incident at the Tiné border crossing – where a Sudanese army drone struck a position held by Chadian troops – briefly forced the suspension of humanitarian activities, highlighting the volatile conditions under which aid is being delivered.