Sudan: Humanitarian impact of Armed Violence in Aj Jazirah - Flash Update No. 04 (As of 11 November 2024)

Highlights

• Tens of thousands of civilians have been displaced from parts of Aj Jazirah State since 20 October following a wave of armed violence and attacks in the area.
• Local authorities and humanitarian partners report that the number of displaced people arriving in Gedaref, Kassala and River Nile states continues to increase.
• The main needs of the displaced people from Aj Jazirah are food, shelter, essential household supplies, access to safe water, sanitation, health, and protection services.
• According to paramedics in the Butanah area in Gedaref State, there is a suspected cholera outbreak among displaced people from eastern Aj Jazirah State.
• Humanitarian partners are providing hot meals, food rations, health, water, sanitation and other services to thousands of displaced people in Gedaref and Kassala states.

SITUATION OVERVIEW

Tens of thousands of civilians have been displaced from parts of Aj Jazirah State since 20 October following a wave of armed violence and attacks in the area. The International Organization for Migration (IOM) Displacement Tracking Matrix (DTM) reported on 1 November that about 135,400 people were displaced from Aj Jazirah and arrived in Gedaref, Kassala and River Nile states. Local authorities and humanitarian partners report that the number of internally displaced persons (IDPs) arriving in these states continues to increase.

According to health community focal points in the Butanah area in Gedaref State, there is a suspected cholera outbreak among displaced people from eastern Aj Jazirah State. The disease is reportedly rapidly spreading among the displaced community as the IDPs do not have access to clean drinking water and are forced to drink contaminated water from open water sources. At least 150 suspected cholera cases were reported in Al-Sabbagh Rural Hospital, a small facility with limited capacity to accommodate numerous patients. The village of AlSabbagh continues to see a large influx of displaced people arriving daily, which puts more pressure on local health services.

Moreover, there have been reports of 54 civilians who have reportedly died and another 90 that got sick allegedly due to poisoned food in Hilaliya village in Sharg Aj Jazirah locality in Aj Jazirah State.

Humanitarian partners continue to scale up the response to meet the immediate needs of the displaced people and host communities in areas where they are seeking safety, protection, shelter and other assistance. The influx of IDPs has overwhelmed already limited local services, including healthcare, education, water, and sanitation, placing immense pressure on the capacity and resources of the local authorities and humanitarian partners to respond. Prior to this IDP influx from Aj Jazirah, the eastern states of Gedaref and Kassala already hosted about 1.3 million IDPs from Khartoum, Aj Jazirah and other parts of Sudan.

HUMANITARIAN IMPACT AND NEEDS

The violence in Aj Jazirah has rendered tens of thousands of people displaced and destitute as they fled in haste fearing for their lives, losing all their possessions and livelihoods, and dealing with trauma, especially women and children. There are major protection concerns, with reports of IDPs being separated from other family members, looting, and sexual and gender-based violence (GBV). Some of the displaced people reported passing through checkpoints, where they were searched and screened by male armed persons. In addition, children have symptoms of psychological distress, with families reporting signs of mental trauma. The main needs of most displaced people in Gedaref and Kassala are access to food, shelter, safe water and sanitation, health and protection services. Most of the IDPs are staying with host communities or in rented housing, while others are forced to sleep in public spaces or vehicles due to a lack of shelter and high rents.

Gedaref State

Displaced people continue to arrive in Gedaref from Sharg Aj Jazirah’s Tambul, Rufa’ah, Junayd town and surrounding villages, although the scale of the influx has reportedly reduced compared to previous weeks. The IOM DTM reported on 1 November that about 76,900 displaced people had taken refuge in Al Fao, Al Mafaza, Al Butanah, Ar Rahad, Galabat Ash-Shargiah, Madeinat Al Gedaref, and Wasat Al Gedaref localities in Gedaref after 20 October 2024. Local authorities, however, estimate that the actual number is much higher. DTM states that its displacement flash alerts provide initial estimates only, pending verification by DTM field teams.

Following the influx of IDPs, several assessments have been carried out in parts of Gedaref State to identify the needs of displaced people arriving from Aj Jazirah. On 1 November, a health and water, sanitation and hygiene (WASH) rapid needs assessment targeting IDPs from Sharg Aj Jazirah was carried out in eight villages and neighbourhoods in Madeinat Al Gedaref and Wasat Al Gedaref localities. The IDPs were provided with access to safe water through water trucking and the assessment team recommended the immediate provision of health, nutrition, shelter and non-food items (S/NFI), and WASH assistance to the affected people.

On 2 and 3 November, inter-agency assessments led by the government’s Humanitarian Aid Commission (HAC), with the participation of cluster partners, covered IDP locations in Wasat Al Gedaref locality. The key findings of the assessments revealed significant gaps on humanitarian assistance being provided to the IDPs. The IDPs drink water from the open well drilled by the landlord for cultivation purposes and the priority needs are shelter, nonfood items, food, access to WASH, health and protection services (including physiological and psychosocial counselling and recreational activities for children). The IDPs have complained of the lack of clothes, emphasizing that the weather is cold, particularly at night. A rapid needs assessment was carried out on 3 November by a UN agency in Al Fao town and El Harira area focusing on GBV, reproductive health (RH), and health assistance. The assessment team identified the need for reproductive and neonatal health services, including post-natal care for newborn children, as well as the need for psychosocial support as some of the IDPs experienced trauma.

Kassala State

In Kassala State, according to the estimates from humanitarian partners, about 80,750 people from Aj Jazirah have arrived in Halfa Aj Jadeedah (27,000 people); Reifi Nahr Atbara (50,000 people); and Reifi Khashm Elgirba (3,750 people) localities. Most of the new IDPs have taken refuge in 97 gathering sites – 27 sites in Reifi Nahr Atbara and 52 in Halfa Aj Jadeedah, while there are five gathering sites in Reifi Khashm Elgirba locality. Local authorities estimate that the number of IDPs from Aj Jazirah is much higher.

In Reifi Nahr Atbara locality (a rural area) some of the IDPs are staying with host communities, and the local authorities have allocated two plots of land totalling 100 feddans (about 420,000 square meters) to host the new IDPs. One plot of land (about 20 feddans) is in Village 6 Arab and another (about 80 feddans) is in Domiat village. In Halfa Aj Jadeedah (an urban area) IDPs are hosted in gathering sites, including schools and public buildings. While the displaced people can access health services at the closest health facilities, the capacity and staffing of these facilities are not sufficient to meet the increasing needs, especially access to medicines for chronic diseases, reproductive health, and vaccination services. There is limited access to clean water and people are forced to use unsafe water from canals and groundwater sources. There is also a lack of latrines and dignity kits for girls and women. Nutrition facilities are far from areas where the IDPs have gathered, and supplies are not enough to cater for the new needs.

Food is another major need for the new IDPs who require sustained provision of food assistance as they have lost their supplies and livelihood opportunities. Families have been forced to reduce the number of, consume cheaper and less nutritious meals, and prioritize food for their children. The IDPs fled their homes carrying nothing and the majority do not have proper shelter to protect them from the weather conditions. IDPs living among host communities live with two to three families in a room, and men sleep outdoors while women and children sleep indoors. IDPs in gathering sites live in the open or under trees or walls of people’s homes.

HUMANITARIAN RESPONSE

Humanitarian partners in Kassala and Gedaref are scaling up response and mobilizing resources to meet the immediate needs of the newly arrived displaced people from Aj Jazirah. Health and GBV sub-cluster partners are scaling up support to reach 30,000 people displaced from Aj Jazirah in Gedaref and Kassala as well as host communities with sexual and reproductive health, and GBV services. Essential reproductive health supplies have been distributed to health facilities across Kassala, Gedaref and Aj Jazirah states to support safe births for 1,700 women. Supplies to support safe deliveries, the management of obstetric complications, the clinical management of rape and treatment of sexually transmitted infections (STIs) for 50,000 reproductive health cases are in the pipeline from Port Sudan.

Response in Gedaref State

At IDP locations in Wasat Al Gedaref locality, community initiatives and national NGOs are providing hot meals to the new IDPs. A mobile clinic provides primary healthcare services once a week, including reproductive health and laboratory services. The mobile clinic has antibiotics and medication for chronic diseases. In addition, the State Ministry of Health (SMoH) – with UNICEF support – provides nutrition services, including mid-upper arm circumference (MUAC) screening, treatment for malnutrition and referral for severe acute malnutrition (SAM) cases. Due to reports of active cholera cases, the SMoH and a health partner deployed a Rapid Response Team (RRT) to conduct surveillance and immediate interventions for suspected cholera cases, including active case finding. The SMoH has also established an Oral Rehydration Therapy (ORT) corner and Médecins Sans Frontières (MSF) is providing support for patient referrals to its Cholera Treatment Unit (CTU). WASH partners constructed 20 emergency latrines in one of the IDP locations, however, there is a lack of showers. Partners are implementing water trucking, supplying about 50 barrels a day, and have distributed dignity kits, soap, and jerry cans.

Supplies for the clinical management of rape (CMR) are available at El Fao Hospital, covering the needs of about 50 survivors, with additional supplies available for 30 survivors at Eltahely Hospital.

Meanwhile, about 3,140 dignity kits are being distributed through community-based protection networks in Village 6 Arab in Gedaref and New Halfa locality. Youth volunteers from Y-PEER are supporting the distribution of kits and conducting community awareness activities, including home visits.

In Al Fao locality, two mobile clinics have been deployed; two Women and Girls Safe Spaces (WGSS) have been established; and dignity kits have been distributed to the new IDPs. Some food assistance is being provided by charitable organizations, but it is insufficient to meet the daily dietary needs of the displaced people.

Response in Kassala State

In Kassala State, Food Security and Livelihoods (FSL) Cluster partners have provided 122 metric tonnes (MT) of sorghum to about 33,900 IDPs in Halfa Aj Jadeedah for 15 days as well as 0.4 MT of Plumpy Doz for 267 women and children.

Health Cluster partners are working with the SMoH to respond to the cholera outbreak and other health emergencies, dispatching emergency medicine and trauma kits to the area. Health partners have also provided medical supplies to enhance case management and reduce fatalities due to cholera. The supplies include four cholera kits central modules, four cholera kits peripheral modules and two cholera kits community modules. The supplies provided are enough to manage 2,000 cholera cases, including 1,000 mild, 440 moderate and 560 severe cases. Cluster partners have established two temporary clinics to serve 7,500 people at four main IDP gathering sites. The partners have established primary health care (PHC) clinics in Village 1 Arab in Reifi Khashm Elgirba locality and Village 5 Arab in Reifi Nahr Atbra locality for a period of two months. This is intended to address the acute health care requirements of newly arrived IDPs. In addition, three temporary clinics serving Sharg Aj Jazirah IDPs, namely Village 6 Arab, Dimyat and Egyptian school gathering sites, were established to provide primary healthcare services, including consultations, reproductive health, immunization services and preventative and curative nutrition services. In addition, 34 health personnel have been seconded for the response and supplies of essential medicines, lab reagents and non-communicable disease drugs for the treatment of 3,500 people have been dispatched from Kassala to New Halfa.

At New Halfa and Khashm El Girba hospitals in Kassala, three trained doctors at each facility are equipped with essential kits for the clinical management of rape.

GBV sub-cluster partners have eight GBV mobile teams, with two teams stationed in Halfa Aj Jadeedah and Reifi Khashm Elgirba localities and the remaining six teams deployed across Kassala, Halfa Aj Jadeedah, Reifi Nahr Atbra, and Reifi Khashm Elgirba based on emerging needs. About 1,500 people have been reached through awareness sessions held in Halfa Aj Jadeedah , Reifi Khashm Elgirba, and Reifi Nahr Atbra, particularly at the Alistad, Village 6 Arab, Egyptian School, and Dimyat gathering sites. These sessions have focused on raising awareness about GBV prevention, response mechanisms, and available support services. At least 22 women and girls have received individualized psychosocial support (PSS) to address trauma and mental health needs, while group psychosocial sessions with 200 participants have provided safe spaces for sharing experiences and developing coping strategies.