WHO condemns killings of patients and civilians amid escalating violence in El Fasher, Sudan – World Health Organization (WHO)

Report on the Humanitarian Crisis in El Fasher and its Detrimental Impact on Sustainable Development Goals

A severe humanitarian crisis is unfolding in El Fasher, North Darfur, characterized by escalating violence, siege conditions, and attacks on healthcare infrastructure. These events represent a catastrophic failure to uphold international law and constitute a significant setback for multiple Sustainable Development Goals (SDGs), particularly those concerning health, peace, and basic human needs.

Direct Assault on SDG 3 (Good Health and Well-being) and SDG 16 (Peace, Justice and Strong Institutions)

Attacks on Healthcare Facilities and Personnel

The conflict has led to direct and repeated attacks on the healthcare system, fundamentally undermining SDG 3, which aims to ensure healthy lives and promote well-being for all. The sanctity of healthcare, a cornerstone of SDG 16 and International Humanitarian Law, has been violated through the following reported incidents:

• On 28 October, the killing of more than 460 patients and their companions at the Saudi Maternity Hospital.
• The abduction of six health workers, including four doctors, a nurse, and a pharmacist, on the same day.
• A series of attacks on the Saudi Maternity Hospital, the only partially functioning hospital in the city, resulting in the death of one nurse and injury to three others on 26 October.
• Since the conflict began, a total of 46 health workers have been killed and 48 injured in El Fasher, crippling the local health system’s capacity.

These actions directly contravene the targets of SDG 16 aimed at reducing all forms of violence and promoting the rule of law.

Compounding Crises and Reversal of Development Gains

Erosion of SDG 2 (Zero Hunger) and SDG 6 (Clean Water and Sanitation)

The siege has cut off the population from essential resources, leading to a public health emergency that reverses progress on fundamental SDGs.

1. Food Insecurity and Malnutrition: With humanitarian aid blocked since February, malnutrition is rising sharply, especially among children and pregnant women. This directly obstructs the achievement of SDG 2 (Zero Hunger) by creating acute food shortages and weakening population immunity.
2. Water Scarcity and Disease Outbreak: The lack of access to safe water has precipitated a rapid spread of cholera, a failure to meet the targets of SDG 6 (Clean Water and Sanitation). The disease surveillance and response systems are severely hampered.
   • El Fasher has reported 272 suspected cholera cases and 32 deaths, an alarming case fatality rate of nearly 12%.
   • Across the Darfur region, 18,468 cases and 662 deaths have been recorded.

Mass Displacement and Violation of SDG 1 (No Poverty) and SDG 10 (Reduced Inequalities)

The escalating violence has triggered significant population displacement, exacerbating poverty and inequality, in direct opposition to SDG 1 and SDG 10.

• Over 260,000 people remain trapped within El Fasher.
• Approximately 28,000 people have recently fled the city.
• An additional 100,000 are expected to be displaced, joining 575,000 already sheltering in surrounding areas.
• Displaced populations, including many women and unaccompanied children, face acute shortages of shelter, food, water, and protection, deepening their vulnerability.

Humanitarian Response and Call to Action for the Global Goals (SDG 17)

Coordinated Efforts Amidst Restrictions

In line with SDG 17 (Partnerships for the Goals), the World Health Organization (WHO) and its partners are attempting to mitigate the crisis despite severe access limitations. Key response actions include:

1. Mobilizing 20 metric tons of medicines and emergency kits, including supplies for cholera and malnutrition, for delivery to displaced populations.
2. Coordinating with partners at reception sites to stabilize patients and facilitate referrals.
3. Preparing rapid response teams to address urgent health needs in areas receiving displaced people.
4. Positioning aid trucks to join a UN convoy into El Fasher as soon as access is granted.

Urgent Imperatives for Sustainable Development

To prevent further loss of life and salvage progress toward the SDGs, the WHO issues an urgent call for the following actions:

• An immediate cessation of hostilities to protect human life, a prerequisite for all development (SDG 16).
• The protection of civilians, humanitarian workers, and healthcare infrastructure (SDG 3, SDG 16).
• Safe, rapid, and unimpeded humanitarian access to deliver lifesaving aid and restore basic services essential for achieving SDG 1, SDG 2, SDG 3, and SDG 6.

Analysis of the Article in Relation to Sustainable Development Goals

1. Which SDGs are addressed or connected to the issues highlighted in the article?

1. SDG 2: Zero Hunger

   • The article highlights a severe food crisis, stating that over 260,000 people are trapped “with almost no access to food” and that “malnutrition is rising sharply, especially among children and pregnant women.” This directly connects to the goal of ending hunger and all forms of malnutrition.

2. SDG 3: Good Health and Well-being

   • This is a central theme. The article details the collapse of the health system, attacks on hospitals, and the killing and abduction of health workers. It also describes a major public health crisis with a rapidly spreading cholera outbreak, evidenced by “272 suspected cases of cholera and 32 deaths” in El Fasher alone.

3. SDG 6: Clean Water and Sanitation

   • The article explicitly links the cholera outbreak to a lack of clean water, stating that the disease “continues to spread rapidly in El Fasher as people lack access to safe water.” This connects the crisis to the fundamental need for safe water and sanitation to prevent water-borne diseases.

4. SDG 16: Peace, Justice and Strong Institutions

   • The root cause of the crisis is conflict. The article describes “escalating violence,” “siege conditions,” and direct attacks on civilians and healthcare facilities, such as the killing of “more than 460 patients and their companions.” The call for an “immediate end to hostilities” and the “protection of civilians” directly relates to the goal of promoting peaceful societies and reducing violence.

5. SDG 17: Partnerships for the Goals

   • The article mentions the response efforts involving multiple actors. It notes that “WHO teams are working around the clock,” “WHO is coordinating with health partners,” and that WHO supplies were “handed over to partners at Abeche, Chad.” The call for “safe, rapid, and unimpeded humanitarian access” underscores the need for cooperation to deliver aid, which is a key aspect of this goal.

2. What specific targets under those SDGs can be identified based on the article’s content?

1. Targets under SDG 2 (Zero Hunger)

   • Target 2.1: By 2030, end hunger and ensure access by all people, in particular the poor and people in vulnerable situations, including infants, to safe, nutritious and sufficient food all year round. The article shows a complete failure to meet this target, as “more than 260 000 people remain trapped in El Fasher with almost no access to food.”
   • Target 2.2: By 2030, end all forms of malnutrition. The article directly references this target by stating that “malnutrition is rising sharply, especially among children and pregnant women.”

2. Targets under SDG 3 (Good Health and Well-being)

   • Target 3.3: By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases. The cholera outbreak, a water-borne disease, is a major issue, with the article noting its rapid spread across Darfur.
   • Target 3.d: Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks. The article indicates a regression on this target, as “Disease surveillance and response activities are reduced as a result of the deteriorating security situation.”

3. Targets under SDG 6 (Clean Water and Sanitation)

   • Target 6.1: By 2030, achieve universal and equitable access to safe and affordable drinking water for all. The article implies this target is not being met, as the cholera spread is attributed to people lacking “access to safe water.”

4. Targets under SDG 16 (Peace, Justice and Strong Institutions)

   • Target 16.1: Significantly reduce all forms of violence and related death rates everywhere. The article provides stark evidence of the failure to meet this target, citing “escalating violence,” the killing of “more than 460 patients,” and the fact that “46 health workers have been killed in El Fasher.”

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

1. Indicators for SDG 16 (Peace, Justice and Strong Institutions)

   • Indicator 16.1.2 (Conflict-related deaths): The article provides specific numbers that can be used as direct indicators of conflict-related deaths: “more than 460 patients and their companions were reportedly shot and killed,” and “46 health workers have been killed.” The number of injured health workers (48) is also a relevant metric.

2. Indicators for SDG 3 (Good Health and Well-being)

   • Indicator 3.3.2 (Incidence of water-borne diseases): The article provides data on the cholera outbreak: “272 suspected cases of cholera and 32 deaths” in El Fasher and “18,468 cases and 662 deaths” across Darfur.
   • Case Fatality Rate: An implied indicator for the severity of the health crisis and the collapse of the health system is the “alarming case fatality rate of nearly 12%” for cholera in El Fasher.
   • Attacks on Health Facilities/Workers: The number of attacks on health facilities (“Saudi Maternity Hospital… was attacked for the fourth time in a month”) and the number of health workers killed (46), injured (48), or abducted (6) are critical indicators of the breakdown of health security.

3. Indicators for SDG 2 (Zero Hunger)

   • Prevalence of Malnutrition (Qualitative): While no specific percentage is given, the statement that “malnutrition is rising sharply, especially among children and pregnant women” serves as a qualitative indicator of a worsening situation.

4. General Crisis Indicators

   • Number of Displaced Persons: The article provides figures on displacement which indicate the scale of the humanitarian crisis: “28,000 people to flee El Fasher Town in recent days,” with an expectation that “Over 100,000 more people are expected to move.”
   • Population in Need: The figure of “more than 260,000 people” trapped without access to basic necessities is a key indicator of the population requiring urgent humanitarian assistance.

4. Summary Table of SDGs, Targets, and Indicators

Source: who.int