Children were married as young as 11 or starved to death. Families survived by drinking water from the stream or eating weeds.

This is the grim reality of life in Sudan, local aid workers say, as the country marks the first anniversary of its descent into a bloody civil war in April 2023.

According to the International Rescue Committee, at least 14,700 people have been killed in violence as the Sudanese armed forces and paramilitary Rapid Support Forces (RSF) fight for control of the country (although aid agencies believe the death toll is likely an underestimate).

Food and water are scarce, and one in seven children in Sudan is under the age of five Is considered to be Severe malnutrition.

Conflicts also arose The world’s largest displacement crisis20,000 people are forced to flee their homes every day.

Mohammed Qazilbash, head of Plan International’s humanitarian response team in Sudan, said the deepening crisis has led some parents to marry off their young daughters because they believe they cannot provide for them.

“Girls as young as 11 and 12 are often married to men three to four times their age,” he said.

Breastfeeding mothers struggle to produce milk due to their own lack of nutrients, while families “eat weeds and wild things because food supplies are in short supply”, Mr Kazirbash said.

Aid workers believe the situation will get worse.

“My concern is that if famine does rear its ugly head, survival sex will become a reality as well,” he said. “People can’t cope. They’ve lost their dignity and can’t struggle. Sudanese people don’t die from gunshot wounds, they die from lack of shelter and disease. People are dying from 17th-century diseases in the 21st century.”

Civilians drink water from streams to survive

Dr Arif Noor, Save the Children’s country director for Sudan, said that due to severe food shortages, many people are eating only one meal a day and “eating what they can”.

“In Khartoum, there was a young woman who had two children and was pregnant. They couldn’t leave their house because of the fighting and she didn’t have water for three days,” he said.

World Food Program data shows food prices in Sudan are 73% higher than last year and 350% higher than the five-year average.

“Even in areas where we don’t see intense conflict but there are large numbers of internally displaced people [internally displaced people] Upon arrival, the demand for food increased. With so much violence, it’s not easy for traders to get things in and out. It’s basically a seller’s market and people are forced to pay whatever price they put in,” Dr Noor said.

These shortages have resulted in children starving to death. Some 700,000 children suffer from severe acute malnutrition, according to Save the Children, which warns that without urgent intervention, 220,000 children and 7,000 mothers will die in the coming months.

Widespread violence means many people are unable to go out to collect supplies, leading to fears people are starving at home.

many people interviewed I Some said they survived on just water for days, while others said local traders came to residential areas and threw bags of sorghum, a nutrient-rich grain, at them.

Clean water is scarce. Dr Noor’s team went without running water for days and was forced to use donkey carts to transport water to a hospital in North Kordofan state.

Mohamed Elmi Shirwa, Islamic Relief’s Sudan program manager, said some civilians depended on drinking from streams and rivers to survive.

“We’re struggling to get food. It’s extremely challenging,” he said. “People eat whatever they can get their hands on; usually sorghum or locally produced vegetables. That’s for those who can afford it. For those who can’t afford it, we can’t say how they survive. Nutrition The situation, especially in Darfur, is deteriorating rapidly.”

Doctors forced to ration care

Dr. Noor said the violence had caused Sudan’s health care system to “almost collapse”, with 80% of Sudan’s hospitals halted operations and the remaining hospitals “barely functioning”.

Severe shortages of medical supplies and a constant loss of health care professionals have resulted in unpredictable staffing levels, leading to doctors making impossible choices in rationing care.

“We have to make difficult decisions across the country to focus our activities,” said Jean Stowell, Médecins Sans Frontières’ head of mission in Sudan. “What is the most life-saving care? Are you focusing on the mother or the war casualty?”

“Just today we had a surgeon get sick and they were the only surgeons available that day. If you had an emergency during this time, what do you do? Usually you have backup or supplies that can be rotated in.”

“At the end of last year we were operating in four hospitals around Khartoum, but today we have consolidated our resources into one hospital. We can see the huge need that we cannot meet, and we know that if we had better access With permission, we can provide more services.”

“This is the end of the world”

According to the agency, at least 8.2 million people have had to flee their homes as violence rages. united nations humanitarian responseAbout 6.5 million people remain in Sudan, while the rest cross into neighboring countries such as Chad and South Sudan.

Some people who remain in Sudan are living in the remains of damaged homes or abandoned buildings, while others are living in overcrowded public buildings, according to local aid workers.

Mr. Kazirbash said the residential area of ​​one school, which could accommodate 1,000 boys, now houses 8,000 people, including women and children. One colleague had to move his family seven times in 12 months.

“This is beyond imagination. This is the end of the world. We see this in movies and this is real life for the people of Sudan,” he said.

“Many of the people forced to flee their homes had well-paying jobs and comfortable lives. They were forced to live in a hotel with hundreds of strangers, sharing toilets, and without any of the food they were accustomed to. The emotional and psychological toll this took It’s immeasurable.”

Two months after the war began, I As civilians fleeing violence head to the border between South Sudan and Sudan, they find babies dead at checkpoints after being exhausted from leaving a war zone.

Survivors have revealed gruesome details of life in the war zone, with many experiencing unspeakable levels of violence.

I They also visited snake-infested refugee camps where Sudanese civilians must live, where robbery is rampant and disease spreads. One day, a five-month-old baby died inside the camp and another baby was born in a nearby tent.

Sudan ‘pushed to the brink’

Fighting between the Sudanese army and the RSF continues to occur on a daily basis as they battle for control of the country.

Gunfights broke out in residential streets, and sexual violence is believed to be widespread.

Foreign state actors have been accused of fomenting conflict. I It was revealed last year that the Russian Wagner mercenary group operates in Sudan and has been actively involved in fighting in the country.

“The intense conflict continues. It has not stopped at all. This conflict is mainly concentrated in and around densely populated areas, which unfortunately means that civilians – especially women and children – bear the brunt,” Nuno Dr. Er said.

“This is a nightmare that has no end. Sudan was in a humanitarian crisis before this, and it has been going on for decades. But now it has been pushed to the edge. Every day we hear that some communities are Horrible things happen. There is too little respect for basic rights.”

But despite the scale of the crisis, Sudan’s humanitarian response has received only 6% of the funding it needs, according to the United Nations.

Mr Kazilbash said “words cannot express how inadequate the response has been”.

“I don’t think this is a forgotten emergency; this is a neglected emergency. Forgetting is accidental, neglect is intentional,” he said.

“I don’t know where humans have gone. It’s not that people don’t know it, but they are willing to ignore it. That’s what worries me. The aftershocks will be felt beyond Sudan.”

Celebrities including Bill Nighy, Alan Cumming and Paloma Faith signed one An open letter to British Foreign Secretary Lord Cameron This week called on the British government to “put meaningful pressure on the warring parties and their sponsors to stop the war”.

Singer Annie Lennox, founder of feminist NGO The Circle and one of the signatories of the letter, told us I Women and girls “bear the brunt of conflicts”.

“Disgusting sexual and gender-based violence, using the bodies of women and girls as weapons of war, is an abhorrent travesty perpetrated by all parties,” she said. “We heard first-hand from our partners helping refugees fleeing war, women who face hopelessness upon arriving in displacement camps. Families need food, shelter, adequate protection and trauma-healing support to help them Dealing with your own experiences.”

Ms Lennox added: “We cannot stand idly by and watch this disaster befall our sisters and innocent families across the globe. For too long this horrific war has been all but forgotten and Sudanese women and children need immediate Take action, which is why I and many colleagues from the creative industries have signed a letter to UK Foreign Secretary David Cameron urging more action to be taken immediately to end the war.”