Sudan conflict: As famine looms, the hungry survive on soil and leaves

Hunger and starvation are spreading across the country, as the civil war that erupted in April 2023 shows no sign of abating.

Volunteers distribute food to residents and displaced people in Omdurman, Sudan, on March 8, 2024. Nearly five million people in the country are close to famine as Sudan’s civil war passes the one-year mark. | Photo Credit: REUTERS

There is so little food in some areas of Sudan that people are taking extreme measures to survive. In the Al Lait refugee camp, they are eating dirt.

The impoverished camp, located in North Darfur, has seen a new influx of displaced people as Sudan’s year-old civil war has brought fighting to large swathes of the country and a campaign of ethnic cleansing to Darfur. Garang Achien Akok is one of the thousands of new arrivals in the area. Akok, his wife, and their five children abandoned their home in the southern region of Kordofan after Arab militiamen on camels stormed their village and torched their hut, he said.

Akok, 41, reached Al Lait in December, but has no work and cannot feed the family. At times, they go two or three days without eating. When that happens, Akok said, he watches helplessly as his wife and children dig holes in the ground with a stick, slide their hands in, and grab some soil. Then they roll the soil into a ball, put it in their mouths, and swallow it with water. “I keep telling them not to do it, but it’s hunger,” he said. “There is nothing I can do.”

Hunger and starvation are spreading across Sudan, as the war that erupted in April last year between the Sudanese army and the paramilitary Rapid Support Forces (RSF) shows no sign of abating. The outlook is dire, according to interviews with over 160 civilians caught in the fighting and more than 60 aid workers and food security experts, as well as a review of food surveys by aid agencies. Reuters reporters also spent close to a week in Omdurman last month, one of three cities that comprise the capital Khartoum, interviewing people who had suffered severe food shortages.

Parts of Sudan are on the brink of famine—a brewing crisis that is man-made. Agriculture has been ravaged as farmers have had their harvested crops stolen by the RSF and fled their lands due to the violence. Hunger, not just fighting, is now driving displacement as people leave home in search of food. Malaria and other diseases are spreading among the displaced. Key aid hubs have been looted by the RSF and its allied militias. And international aid arriving in Sudan is being blocked by the military from reaching people in areas where starvation has set in.

“Sudan’s war has created the world’s largest hunger crisis,” said Anette Hoffmann, author of a report on the food emergency in Sudan by the Netherlands-based Clingendael think tank. “We will likely see a famine that we haven’t seen in decades.”

The Sudanese army and RSF did not respond to detailed questions for this report. Sudan’s foreign ministry, part of the military-led government, has said it is committed to facilitating the delivery of aid and has accused the RSF of looting and blocking aid. Lieutenant General Ibrahim Jaber, the military’s second in command, has said that Sudan “will not fall into hunger” and has “more than it needs.” Some Khartoum residents said the army has at times provided limited amounts of food relief amid the fighting.

The RSF has denied looting, saying any rogue actors in its ranks will be held responsible, and has blamed the army for obstructing the delivery of aid.

People across Sudan are taking increasingly desperate measures to survive. In West Darfur, farmers whose lands were plundered by the RSF have eaten the seeds they bought for planting because they have run out of food. In the Kordofan region, people have sold their furniture and clothes to get cash for food. In Khartoum, residents under siege in their homes have picked the leaves off trees and boiled and eaten them.

Almost 18 million people in Sudan—more than a third of the nation’s 49 million people—are facing “high levels of acute food insecurity,” according to the Integrated Food Security Phase Classification (IPC), a globally recognised hunger monitor. The IPC also estimates that of this group, nearly five million people are one step away from famine. Immediate action is needed to “prevent widespread death and total collapse of livelihoods and avert a catastrophic hunger crisis in Sudan,” the IPC said in March. The group added that it has been unable to update a projection it made in December because of data gaps in conflict areas and internet and phone outages in much of Sudan.

A view of a street in the city of Omdurman damaged in the year-long civil war in Sudan on April 7, 2024. Residents in the city have found themselves besieged in their homes, trapped between the paramilitary RSF and the army. | Photo Credit: REUTERS

The Clingendael report has drawn three possible scenarios for Sudan. The most optimistic one projected that 6 per cent of the population will face famine. In the worst case, 40 per cent of people would endure famine during the lean season between harvests, which starts in May and runs to September.

In some places, people are already dying. Doctors Without Borders has reported that an estimated one child is dying on average every two hours in the vast Zamzam displaced persons camp in North Darfur—a result of disease and malnutrition.

Despite the deepening food crisis, the situation in Sudan has drawn less international scrutiny than other humanitarian emergencies in places such as Ukraine and Gaza. Some observers have called Sudan’s conflict “the forgotten war”.

“Our biggest challenge is the funding and lack of attention to Sudan,” said Chessa Latifi, senior program advisor in global health at relief organisation Project HOPE. “People are so involved in Ukraine and so involved in Gaza that there is no space for anyone to think, to be open to listen and hear about Sudan.”

Sudan’s General Abdel Fattah al-Burhan salutes as he listens to the national anthem after landing in the military airport of Port Sudan on his first trip away following the crisis in Sudan’s capital Khartoum since an internal conflict broke out, in the city of Port Sudan on August 27, 2023. | Photo Credit: IBRAHIM MOHAMMED ISHAK/REUTERS

International pressure on the warring parties has failed so far to break the aid logjam. Isobel Coleman, deputy administrator of USAID, the U.S. government relief agency, said Sudanese army chief General Abdel Fattah al-Burhan and RSF leader General Mohamed Hamdan Dagalo were responsible for aid not reaching people. “This looming threat of famine hangs on them,” she told Reuters. “People are literally dying by the day because of lack of access to food and other essentials.”

Some aid officials and food experts have expressed concern over the delay by the Integrated Food Security Phase Classification (IPC), the hunger monitor, in issuing its latest appraisal of the food crisis in Sudan. By the time the IPC releases its new analysis, Clingendael’s Hoffman said, it would be “too late to deliver aid and save lives”. She said the IPC should declare that there is a risk of famine.

While a famine alert carries no binding obligations on the UN or governments, it does serve to focus world attention on a crisis situation and galvanise the resources needed to provide emergency aid. Generally, a decision to declare a famine is made by a government and the UN. Fatima Eltahir, the IPC chair in Sudan, who is a government official, said there has been no delay in issuing the group’s analysis and that it would be released in May.

Starving in Khartoum

The deprivation is not confined to the poor. Even before the war, Sudan was facing widespread poverty and rising hunger. Now, Sudan has become the largest displacement crisis, with one in every eight internally displaced persons worldwide, the United Nations says. And the economy has been shattered by the fighting, affecting everyone.

Nearly half the population is unemployed, according to the International Monetary Fund. The formal banking system has collapsed, leaving people without access to money. A telecommunications blackout has deprived people of a key lifeline in the form of online money transfers. According to Jibril Ibrahim, Sudan’s finance minister, the economy has contracted by 40 per cent because of the war.

In middle-class neighbourhoods of Khartoum, life has become a daily battle for survival, defined by hunger and fear, as people find themselves pincered between the military and the RSF. For Lina Mohammed Hassan and her family, starvation set in slowly.

After the war broke out in 2023, mortars rained down around Hassan’s home in the Banat neighbourhood of Omdurman. There were days when the shelling would start at 5 am and last all day, said the 32-year-old Hassan. Venturing outside to look for food became risky.

A view shows the damaged Omdurman National bank in Omdurman, Sudan, April 7, 2024. | Photo Credit: EL TAYEB SIDDIG/REUTERS

The RSF laid siege to areas across the capital like Banat located near Sudanese army bases, in an effort to squeeze troops trying to hold off advances by the paramilitary. Food began to vanish. Markets were destroyed in the fighting. Residents said people ran out of cash after Khartoum’s banks were looted by RSF militiamen, who made off with piles of banknotes and gold. The RSF has denied it was involved in the looting.

Soon, Hassan and her extended family of 11 were surviving largely on a diet of lentils and rice. “Even that was hard to get because prices were five times the normal rate,” she said.

By November, RSF forces had cut off electricity and severed the main water pipeline to Banat, residents said. Soldiers from a nearby army base and civilians began hunting cats to eat. Women carrying food were searched at RSF checkpoints, accused of supporting the army, beaten and sexually assaulted, Hassan said.

Food packages airdropped by the army into the neighbourhood made little difference. “The packages broke up when they hit the ground,” she said. “The food mixed together with the dust.” Over time, “it became impossible to get anything, cash or food.”

Hassan said soldiers sometimes shared their food with the children in her family, but the relief was limited. She and the other adults began skipping meals, sometimes for two days straight, so the children could eat. Tree leaves boiled in water and sprinkled with spices became a part of their diet. “We tried to avoid picking the leaves from poisonous trees,” she said. “We only used the mango, lemon and guava leaves. The children would eat them. They couldn’t say no because they were so hungry.”

In late February, after the army made advances in Banat, Hassan and her family were able to flee to another part of Omdurman under control of the Sudanese military. She spoke to Reuters last month in an apartment there.

People still remain trapped in more than a dozen districts across Khartoum. A global authority on food insecurity, the Famine Early Warning Systems Network, reported in March that areas in the capital are at “risk of famine” as the warring parties have “employed siege-like tactics to cut off supplies to their opponent.”

No haven from hunger

Many of the families who were trapped in the capital told Reuters they wanted to flee but were deterred by stories they had heard of women being raped and young men being detained and killed by RSF forces.

A 24-year-old resident of Banat decided she had no choice but to try escaping when a doctor told her in November that her three-year-old son might not survive if they stayed. The woman said she had been feeding her son a few spoons of chickpeas a day for months, while she was pregnant and skipping meals. After she had a baby girl, she was unable to breastfeed and could only find expired formula to feed her newborn. Her boy had developed a blood deficiency and was vomiting repeatedly, she said.

On the way out of Banat, she had to pass through RSF-controlled checkpoints. Militiamen looking for cash and gold jewellery beat her with whips and ran their hands over her body as they searched her, she said. Some women were forced to strip naked. Soldiers raped a woman in front of her, she said. A neighbour who escaped with her corroborated the account. “I saw women dragged to empty buildings,” said the woman, who spoke on condition of anonymity. “They groped me, three or four times along the way.”

When the family finally reached an army-controlled area in Omdurman, “we collapsed,” the woman said. “We were very hungry, we were sick and dehydrated. So hungry that we couldn’t eat a lot.”

Even those who have escaped the fighting to the army-controlled area of Omdurman say they have little to eat because they are out of work and the available food in the markets is exorbitantly expensive. Teachers, lawyers, and pharmacists were among those who repeatedly lined up in March in front of large cooking pots filled with beans and lentils to get what might be their only meal of the day.

Residents wait to collect food in containers from a soup kitchen in Omdurman on March 11, 2024. Nearly five million people in the country are close to famine as Sudan’s civil war passes the one-year mark. | Photo Credit: REUTERS

Fatma Saleh, a pharmacist, said she stands for hours in a queue to get three scoops of lentils or beans for her family of four, including her sick mother. “I cried hard,” she said, describing the first time she stood in line for food. She said she sold her clothes to get cash to buy food.

Sahar Moussa, who fled with her husband and three children, says she lived a comfortable life in Khartoum before the war. Her husband made a good living as a mechanical engineer. When her children tell her they’re hungry, she tells them their father is coming with food, even though she knows he is not. “Sometimes I just wish a shell would kill me so I don’t have to see my children crying from hunger,” she said.

Port Sudan is now the hub for all aid since the government and aid agencies relocated there after the RSF seized much of Khartoum. Even so, displaced people face malnutrition and disease in the coastal city. According to the UN, since the start of the war nearly a quarter of a million people have fled to the Red Sea state, of which Port Sudan is the capital. Dozens of schools have been turned into shelters for displaced people.

A group of children roast peanuts at a school in Port Sudan that has been converted into a centre for displaced persons, amid a severe food crisis, on March 16, 2024. | Photo Credit: REUTERS

At the Al Shahinat displaced persons camp in Port Sudan, sewage flowed openly when a reporter visited in March 2024. Children with stomachs bloated from malnutrition could be seen walking around. Some were barefoot, with streaks down their legs from diarrhoea.

Looting the ‘food of the people’

Chaos in Sudan’s breadbasket regions is ravaging the national food supply. A March 2024 report by the UN’s Food and Agriculture Organization (FAO) showed Sudan had a 46 per cent drop in cereal production in 2023 compared to the previous year. The harvest is being plundered in El Gezira, a region south of the capital that accounts for over half of Sudan’s wheat production. That is impoverishing farmers and crippling their ability to finance the planting of new crops.

Khaled Mostafa, a farmer in El Gezira state, planted about 10 acres of corn and lentils in his fields last year. He was planning to sell the produce after the harvest in the local market to settle his debts and cover expenses for the next planting season. But in February, RSF members stormed his home, shoved him to the ground, and put a knife to his neck, he said. They forced him to hand over his entire harvest—110 sacks of corn and lentils. They also made off with trucks and other equipment, he said.

Mostafa’s story has played out in dozens of villages across El Gezira since the RSF launched its assault on the state in December, according to testimonies from multiple residents. Farmers described how men in RSF uniforms riding in pick-up trucks and on motorbikes went house to house assaulting people, stripping them of their possessions and forcing them at gunpoint to carry their harvested crops to RSF vehicles.

An elderly man waits to refill his donkey-drawn water tank during a water crisis in Port Sudan in the Red Sea State of war-torn Sudan on April 9, 2024. | Photo Credit: AFP

As they plundered the villages, the militiamen destroyed solar panels used to power generators that helped draw water from deep wells. Fuel for powering flour mills was also stolen, farmers said, leaving villagers without any means of grinding grains to make flour for Aseeda porridge, a staple of the Sudanese diet. “This all leads to hunger,” said Mostafa. “This is the food of the people. They stole it.”

Farmers said their assailants, though often wearing RSF uniforms, did not seem to be part of a clear chain of command. They operated vigilante-style, in small cells of about 20 people, each with its own leader. The RSF has also imposed a travel tax in places like Darfur and El Gezira, forcing farmers to pay a levy as they move around.

The “unprecedented” damage caused to farming by RSF attacks in El Gezira will affect the next harvest, said Ahmed Omar, who represents a group of farmers in the state. “There is nothing left in El Gezira to start the new season. No farmers, no machinery.”

Other crucial cereal-producing regions that are largely under RSF control, including Darfur and Kordofan, are suffering similar output declines. Immediate action is required to “prevent widespread death related to hunger and the collapse of livelihoods,” said Rein Paulsen, the FAO’s director of emergencies and resilience.

The fighting has also destroyed flour mills, food factories and ranches. The only factory in Sudan making therapeutic food for children suffering from malnutrition was destroyed in the fighting. The plant burned down after being hit by a shell in May 2023, said Nada Yagoub, the deputy manager of Samil and daughter of the factory owner. All production of the product, which treats wasting in small children, has since been halted. According to UNICEF, Samil used to produce 60 per cent of this therapeutic food for children in Sudan. “It’s a huge loss at a time when famine is coming,” Yagoub said.

Frozen aid

As hunger grips more and more Sudanese, international aid agencies are struggling to get food and medicines to areas where people are sick and starving. It can take up to 40 days for an aid truck to reach Darfur from Port Sudan in the east, where most of the aid is stored, according to Justin Brady, the Sudan head of OCHA, the UN’s office for the coordination of humanitarian affairs. This includes delays for “obtaining necessary travel permissions,” he said. Aid vehicles have to traverse multiple areas controlled by different groups, including the RSF, criminal gangs, and tribesmen.

Since December 2023, aid from the east has failed to reach much of Darfur, the Kordofan region or Khartoum, aid workers say. And only a few dozen trucks have come in via Chad in the west. Overall, humanitarian assistance has reached only 16 per cent of people who need it, according to a survey conducted in late 2023 by Humanitarian Outcomes, a group that advises aid agencies and donor governments.

Aid officials say the Sudanese army has made it increasingly difficult to get food and medical supplies to areas where they are most needed. In response to RSF’s appeals for agencies to deliver aid to areas under its control, army chief Burhan said in February 2024: “This will not happen until we end this war and defeat these criminal rebels.”

“Aid is not allowed to go from SAF to RSF,” said Mohammed Qazilbash, Sudan director for humanitarian group Plan International, using the acronym for the Sudanese Armed Forces. “Food is being used as a weapon of war.”

Reuters reported in late February that the army had issued an order prohibiting aid deliveries through Chad into Darfur. The military-led government later said that a humanitarian corridor into North Darfur was open. But Qazilbash told Reuters in late March that the amount of assistance moving through the North Darfur route was “a trickle”.

Since the start of the war, the military-led government has put in place a thicket of bureaucratic rules that are severely hampering food distribution, dozens of aid officials told Reuters. The government formed new committees to handle aid that have overlapping powers with the Humanitarian Aid Commission (HAC), the government’s main aid arm. The move has caused confusion and delays as approvals are now needed from multiple departments, according to humanitarian officials.

It took World Vision, a relief agency, four months to secure the required signatures and stamps from authorities to allow the organisation to open a cholera treatment centre in El Gezira, following reports of an outbreak there. “I fear that we lost children and mothers to cholera while waiting for the paperwork to be done,” said Geoffrey Babughirana, health and nutrition manager at World Vision.

The cholera centre finally opened in December, but was operational for just six days. On the seventh day, the RSF and its allied militias stormed Wad Madani, the capital of El Gezira, and all aid agencies were forced to evacuate. “It was devastating when we left,” said Babughirana.

Boxes containing aid are stockpiled in a warehouse run by Sudan Humanitarian Aid Commission, following the crisis in Sudan’s capital Khartoum, at Port Sudan on May 30, 2023. | Photo Credit: STRINGER/REUTERS

Aid agencies have also been pressed to hire local government employees to oversee work done by the agencies, such as food assessment surveys, humanitarian officials said. One agency was forced to hire a HAC team and pay them salaries during a needs assessment survey in the River Nile state, which is controlled by the Sudanese military, an official from that agency said. “We are paying money that we shouldn’t be paying,” the official said. Food supplies in major aid hubs like El Gezira have also been looted, largely by RSF forces, aid officials said.

When the RSF invaded El Gezira in December, UN officials gave the paramilitary’s commanders the coordinates of warehouses where thousands of metric tons of aid were being stored—enough to feed close to 1.5 million people for a month in the State. They shared the locations in the hope that the aid would be protected and received assurances from the RSF that it would, said Brady, the Sudan director for OCHA.

But almost all the aid in the warehouse was stolen. And what remained couldn’t be accessed by the agency that distributes it, the UN World Food Program, because of the fighting, said Eddie Rowe, the WFP’s director for Sudan. Ezzaddean Elsafi, an RSF advisor, denied that the paramilitary had looted aid warehouses, saying this was a “media exaggeration.”

The rainy season in Sudan is also approaching, which will make roads impassable and entire areas in places like Darfur and Kordofan inaccessible, Rowe said. “We are in a race against time.”

Death in Darfur

Al Lait camp, where people have been eating dirt, is just one of a cluster of 13 refugee camps in a remote area of North Darfur where inhabitants have resorted to consuming soil and tree leaves, according to residents, medics, and aid workers who spoke to Reuters by phone. The original inhabitants of the camps are refugees from South Sudan who fled conflict and hunger. They have now been joined by thousands of displaced Sudanese fleeing the fighting.

Faisal Mohammed, who works for the Sahari Organization for Development, a local aid group, said he had a hard time believing people were eating soil until he saw it himself in several camps. “When the stomach is empty, people try to fill it with anything,” he said. Children who’ve been eating soil have been vomiting and getting diarrhoea, multiple residents told Reuters.

Before the war, the camp’s residents worked on farms and were paid for harvested crops, getting 20 per cent of the yield. They also relied heavily on aid from the World Food Program. But as the fighting spread, humanitarian aid was blocked. And farmers, squeezed by the spiralling costs of fertilizers and insecticides and a lack of financing, cut back on the areas they planted, depriving farm labourers of their jobs.

Some of the women work in a nearby town washing clothes. They make up to a dollar a day—enough to buy flour and sugar to make a pudding called Madeeda. When there is no work, they do not eat, residents said.

People prepare food in a Khrtoum neighbourhood on June 16, 2023. | Photo Credit: AP/File Photo

While there is food in nearby markets, prices have skyrocketed during the war, making much of it inaccessible to camp residents. A plate of beans costs six times what it did before the war. In mid-April 2024, after a year without food assistance, eight aid trucks from the WFP arrived in the area carrying cereals, oil, and flour. It is not enough. Malnutrition and disease are killing people, residents said.

Achek Kuol Ngor, a 30-year-old South Sudanese woman from the Abu Jarra camp, said her twins died just 12 days after she gave birth to them in May 2023. Asked how they died, she replied: “Sick and hungry.” She was malnourished and unable to breastfeed them, and had no baby formula, she said. A medical assistant who was present when the twins died at a hospital in a nearby town confirmed Ngor’s account.

Lual Deng Majok, another resident of Abu Jarra, said his family started eating tree leaves after they ran out of money in late 2023. When his son David, 17, started vomiting and developed a fever, Majok put him in a cart and travelled four hours to a hospital where doctors diagnosed the teen with malaria. Malnourished people are more likely to develop severe cases of the disease. Two days later, his son was dead, Majok said. He put the boy’s body in the cart and took him back to the camp to bury him.

Reuters was unable to independently confirm the cause of death for Ngor’s and Majok’s children.

A Sudanese family who fled the conflict in Murnei in Sudan’s Darfur region, sit beside their belongings while waiting to be registered by UNHCR upon crossing the border between Sudan and Chad in Adre, Chad, on July 26, 2023. | Photo Credit: ZOHRA BENSEMRA/REUTERS

In North Darfur’s Zamzam camp, where Doctors Without Borders found high mortality rates among children, the situation continues to deteriorate. The camp is now home to at least half a million people.

A survey conducted there earlier this month by Doctors Without Borders found that nearly a third of children under the age of five are acutely malnourished, according to Jerome Tubiana, an adviser to the organization on refugee issues. Eight per cent of these children “are at risk of dying within three to six weeks if they don’t get immediate treatment,” he told Reuters.

Zakariya Ali, a doctor there, said he commonly sees “three or four cases of severely malnourished children” a day, and typically, “one of them falls dead.” As Ali spoke with a reporter by phone, a 9-month-old baby girl named Mawaheb was brought into the clinic. Ali gave her a quick test for malnutrition, placing a measuring tape around her mid-upper arm to gauge its circumference.

He shared a photo of the result. Mawaheb’s arm was so thin, she was placed in the red zone: severe acute malnourishment, at risk of death.