Sudan’s el-Geneina Hospital speaks: “I am still standing for the people”

This report was produced in collaboration with Doctors without Borders (Médecins Sans Frontières, MSF)

A year has gone by, the needs are still there

In el-Geneina, the capital of West Darfur state near the eastern border with Chad, stands el-Geneina Teaching Hospital, despite the war, violence and looting. This central specialized facility is a couple of hours' drive from Adré and serves local populations as well as displaced people, mostly women and children.

Despite being looted and out of service in the early weeks of the April 2023 war, it has remained the only functioning hospital in the city, providing free lifesaving medical care to vulnerable populations, addressing the consequences of last year’s mass violence and the continuous increase in humanitarian needs.

This same time last year, ethnically targeted violence in West Darfur led to two major massacres, horrific war injuries, sexual violence, and a massive exodus of people from el-Geneina into Eastern Chad. The MSF-supported hospital in Adré received over 800 war-wounded persons in just three days.

El Geneina Hospital affiliated with Doctors Without Borders MSF

Around the same time last year, ethnically targeted violence in West Darfur led to two major massacres, horrific war injuries, sexual violence, and a massive exodus of people from el-Geneina into Eastern Chad. The UN High Commissioner for Human Rights condemned the violence and called for a thorough investigation and accountability. After being trapped in el-Geneina for two months, people managed to escape in June. As they flooded across the border, the MSF-supported hospital in Adré received over 800 war-wounded persons in just three days. MSF teams provided lifesaving surgical activity and expanded inpatient care and medical services to cope with the mass arrivals of injured and vulnerable people.

"The number of admissions to the inpatient therapeutic feeding centre has also doubled from January to April 2024. Initially, the hospital had 20 beds; this number was increased to 34 in mid-March and to 50 in April 2024” — MSF Dr. Baharldeen

Present moment

The Doctors without Borders (MSF) team in el-Geneina Teaching Hospital has been providing crucial medical assistance, power, and water supplies, and rehabilitation to the premises, despite the evacuation of some staff in April last year. From January to May 2024, our team conducted approximately 23,000 outpatient consultations. In April and May alone, the hospital saw an 11 percent increase in the number of patients compared to the first three months of this year. This increase coincides with the start of the ‘lean season’ and food insecurity.

The dire situation of Sudanese refugees on the border with Chad

Malnutrition levels on the rise

The malnutrition situation in West Darfur, mirroring conditions in the greater Darfur state, remains critical.

For months, MSF has been the main health provider in most areas of Darfur with a total lack of international attention.

On this, Dr. Habib Baharldeen, MSF medical activity manager reports, "Data from MSF-supported paediatric outpatients and inpatients departments at el-Geneina Teaching Hospital show increased levels of severe acute malnutrition at an average of 5 percent, moderate acute malnutrition at 16 percent, and global acute malnutrition at 21 percent, among children screened for acute malnutrition between January and May 2024.”

"The number of admissions to the inpatient therapeutic feeding centre has also doubled from January to April 2024. Initially, the hospital had 20 beds; this number was increased to 34 in mid-March and to 50 in April 2024,” Dr. Baharldeen concluded.

In response to the increase, MSF launched community-based activities, such as door-to-door malnutrition screening, as part of active case finding and treatment, for children aged 6-59 months (about five years). The number of children screened doubled in March and April compared to January and February, correlating with an increased number of outpatient department consultations.

At el-Geneina hospital, MSF teams deliver a comprehensive package of paediatric care to both outpatients and inpatients and run an inpatient therapeutic feeding center for severely malnourished children. MSF also supports the Ministry of Health staff in the hospital through incentives so that they can sustain a range of medical services essential for addressing emergency healthcare.

The dire situation of Sudanese refugees on the border with Chad

In villages distant from el-Geneina, abandoned health facilities underscore the urgency of our mission. This lack of medical services prompted our team to conduct exploration assessments to extend medical support. In May 2024, our outreach team visited locations such as Jabal Moon, Sirba, Beida, Habila, and Fora Baranga, where we conducted nutritional screenings, treated severe malnutrition, assessed rural healthcare facilities, and distributed medical and nutritional supplies. This period marked an increase in consultations, admissions, and overall workload, likely due to the lean season and a spike in malnutrition cases.

Doctors without Borders’ activities in el-Geneina Teaching Hospital have extended into areas usually covered by UN agencies, such as providing water and power. MSF stepped into the gap left by the limited response of other humanitarian partners. The question remains: until when?

A massive scale-up is needed

Nearly a year has passed since the violence and exodus from el-Geneina to Adré occurred. Since June 2024, another area of Darfur, El Fasher, has been experiencing violent turmoil, leading to displacement and loss of hundreds of lives. As the fighting between the two warring parties of Sudan continues to ravage El Fasher, the city’s hospitals are damaged and shut down. Meanwhile, thousands of people have been fleeing in search of safety, with many arriving at Zamzam camp, where there is already an acute malnutrition crisis.

The dire situation of Sudanese refugees on the border with Chad

For months, MSF has been the main health provider in most areas of Darfur with a total lack of international attention.

Our activities in el-Geneina Teaching Hospital have extended into areas usually covered by UN agencies, such as providing water and power. MSF stepped into the gap left by the limited response of other humanitarian partners. The question remains: until when?