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A REUTERS INVESTIGATION


AS FAMINE LOOMS IN SUDAN, THE HUNGRY EAT SOIL AND LEAVES



By By MAGGIE MICHAEL. Visuals by EL TAYEB SIDDIG

Filed April 30, 2024, 11 a.m. GMT


Mawaheb, a 9-month-old girl, has her arm measured as a test for malnutrition in
the North Darfur camp of Zamzam earlier this month. Photo by Zakariya Ali

Mawaheb, a 9-month-old girl, has her arm measured as a test for malnutrition in
the North Darfur camp of Zamzam earlier this month. Photo by Zakariya Ali


A Reuters Special ReportAs famine looms in Sudan, the hungry eat soil and leaves




Nearly five million people are close to famine as the country’s civil war passes
the one-year mark. Aid officials say the warring parties – the army and the
Rapid Support Forces – are looting aid or blocking it from reaching areas where
starvation is taking hold. But ‘the world’s largest hunger crisis’ is drawing
little global attention.




By MAGGIE MICHAEL

Visuals by EL TAYEB SIDDIG

Filed: April 30, 2024, 11 a.m. GMT

OMDURMAN, Sudan

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 says his wife and children are so hungry that they are eating
soil in the North Darfur refugee camp of Al Lait. Photo by Wilson Ngor Akol

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 can’t 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 had “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.


Fresh graves in the Zamzam displaced persons camp where Doctors Without Borders
estimates that a child is dying on average every two hours. Photo by Salih
Abdel-Karim

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 recognized
hunger monitor. The IPC also estimates that of this group, nearly five million
people are one step 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.

The Clingendael report has drawn three possible scenarios for Sudan. The most
optimistic one projected that 6% of the population will face famine. In the
worst case, 40% 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.




Hunger’s widening reach

Regions across Sudan face increasingly dire food shortages, hunger monitors warn



Source: Famine Early Warning Systems Network (FEWS NET); Natural Earth.
Definition of famine: “Households have an extreme lack of food and/or other
basic needs even after full employment of coping strategies. Starvation, death,
destitution, and extremely critical acute malnutrition levels are evident. (For
Famine Classification, area needs to have extreme critical levels of acute
malnutrition and mortality.)”



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 organization
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.”

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
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 galvanize 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% because of the war.

In middle class neighborhoods 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.


Lina Mohammed Hassan said her family resorted to boiling mango leaves and eating
them when food supplies ran out. REUTERS/El Tayeb Siddig

For Lina Mohammed Hassan and her family, starvation set in slowly.

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

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.





A group of children roasts peanuts last month at a displaced persons camp in
Port Sudan where children with bloated stomachs from malnutrition walk around.
REUTERS/Maggie Michael




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 neighborhood 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.”


A street in the city of Omdurman damaged in the year-long civil war. Residents
in the city have found themselves besieged in their homes, trapped between the
RSF and the army. REUTERS/El Tayeb Siddig

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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’d 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 jewelry 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 neighbor 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.”


 


Residents in Omdurman, one of three cities that make up the capital Khartoum,
line up to receive food in March. The war has decimated the economy, with almost
half of the population unemployed, according to the International Monetary Fund.
REUTERS/El Tayeb Siddig

Even those who have escaped the fighting to the army-controlled area of Omdurman
say they have little to eat, because they’re 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.

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 isn’t. “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.

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


Fatma Saleh, a pharmacist who fled her home, said she cried the first time she
had to stand in a food line. REUTERS/El Tayeb Siddig

Looting the ‘food of the people’

Chaos in Sudan’s breadbasket regions is ravaging the national food supply. A
March report by the UN’s Food and Agriculture Organization (FAO) showed Sudan
had a 46% 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.


Motawakel Belal says that when people ran out of food in his besieged
neighborhood, some became so desperate they ate cats. REUTERS/El Tayeb Siddig

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, didn’t 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 smoldering remains of the Samil factory in Khartoum, which manufactured
therapeutic food for children with malnutrition. Handout via Reuters




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 last year, 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. Samil used to produce 60% of this therapeutic food for children in
Sudan, according to UNICEF, the UN children’s agency.

“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, 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% of people who need it,
according to a survey conducted late last year by Humanitarian Outcomes, a group
that advises aid agencies and donor governments.





Justin Brady, the Sudan head of the UN’s office for coordination of humanitarian
affairs, says it can take weeks for an aid truck to reach its destination.
REUTERS/El Tayeb Siddig




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 appeals for agencies to deliver aid to areas under its control, army chief
Burhan said in February: “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.”


Boxes containing aid are stockpiled in a warehouse run by Sudan’s Humanitarian
Aid Commission in Port Sudan in May last year. REUTERS/Ibrahim Mohammed Ishak

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 organization to open a
cholera treatment center 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 center 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.





Geoffrey Babughirana, health and nutrition manager at World Vision, said it took
his organization four months to complete the bureaucratic steps required by the
authorities for the opening of a cholera treatment center in El Gezira.
REUTERS/El Tayeb Siddig




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 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.”


General Mohamed Hamdan Dagalo, the head of the Rapid Support Forces, speaks at a
press conference in Khartoum in February last year. Humanitarian officials say
that RSF forces have looted major aid hubs in places like El Gezira.
REUTERS/Mohamed Nureldin Abdallah

Military chief General Abdel Fattah al-Burhan salutes as he listens to the
national anthem in Port Sudan last August. Aid agency officials say the
military-led government has put in place bureaucratic measures that hold up the
delivery of humanitarian assistance. REUTERS/Ibrahim Mohammed Ishak

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.

> “We will likely see a famine that we haven’t seen in decades.”
> 
> Anette Hoffmann, author of a report on the food emergency in Sudan

Children who’ve been eating soil have been vomiting and getting diarrhea,
multiple residents told Reuters.

Before the war, the camp’s residents worked on farms and were paid in harvested
crops, getting 20% 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 spiraling costs of fertilizers and insecticides and a
lack of financing, cut back on the areas they planted, depriving farm laborers
of their jobs.

Today, 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 don’t eat, residents said.

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, after a year without food assistance, eight aid trucks from the
WFP arrived in the area carrying cereals, oil and flour.

It isn’t enough. Malnutrition and disease are killing people, residents said.





Achek Kuol Ngor (second from right) said her twins died less than two weeks
after they were born. “Sick and hungry,” she said, when asked how they perished.
Photo by Wilson Ngor Akol




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 last year.
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 late last year. When his son David, 17,
started vomiting and developed a fever, Majok put him in a cart and traveled
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.

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.


People sleeping at a displaced persons center in Omdurman in March. REUTERS/El
Tayeb Siddig

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 percent 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 placed in the
red zone: severe acute malnourishment, at risk of death.




reuters investigates

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Starving in Sudan

By Maggie Michael

Photography and Video by El Tayeb Siddig

Additional reporting: Ryan McNeill

Graphics: Vijdan Mohammad Kawoosa

Photo editing: Edgar Su

Art direction: Catherine Tai

Edited by Peter Hirschberg

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Garang Achien Akok says his wife and children are so hungry that they are eating
soil in the North Darfur refugee camp of Al Lait. Photo by Wilson Ngor Akol1 /
14

Fresh graves in the Zamzam displaced persons camp where Doctors Without Borders
estimates that a child is dying on average every two hours. Photo by Salih
Abdel-Karim2 / 14

A group of children roasts peanuts last month at a displaced persons camp in
Port Sudan where children with bloated stomachs from malnutrition walk around.
REUTERS/Maggie Michael3 / 14

A street in the city of Omdurman damaged in the year-long civil war. Residents
in the city have found themselves besieged in their homes, trapped between the
RSF and the army. REUTERS/El Tayeb Siddig4 / 14

 5 / 14

6 / 14

The smoldering remains of the Samil factory in Khartoum, which manufactured
therapeutic food for children with malnutrition. Handout via Reuters7 / 14

Justin Brady, the Sudan head of the UN’s office for coordination of humanitarian
affairs, says it can take weeks for an aid truck to reach its destination.
REUTERS/El Tayeb Siddig8 / 14

Boxes containing aid are stockpiled in a warehouse run by Sudan’s Humanitarian
Aid Commission in Port Sudan in May last year. REUTERS/Ibrahim Mohammed Ishak9 /
14

Geoffrey Babughirana, health and nutrition manager at World Vision, said it took
his organization four months to complete the bureaucratic steps required by the
authorities for the opening of a cholera treatment center in El Gezira.
REUTERS/El Tayeb Siddig10 / 14

General Mohamed Hamdan Dagalo, the head of the Rapid Support Forces, speaks at a
press conference in Khartoum in February last year. Humanitarian officials say
that RSF forces have looted major aid hubs in places like El Gezira.
REUTERS/Mohamed Nureldin Abdallah11 / 14

Military chief General Abdel Fattah al-Burhan salutes as he listens to the
national anthem in Port Sudan last August. Aid agency officials say the
military-led government has put in place bureaucratic measures that hold up the
delivery of humanitarian assistance. REUTERS/Ibrahim Mohammed Ishak12 / 14

Achek Kuol Ngor (second from right) said her twins died less than two weeks
after they were born. “Sick and hungry,” she said, when asked how they perished.
Photo by Wilson Ngor Akol13 / 14

People sleeping at a displaced persons center in Omdurman in March. REUTERS/El
Tayeb Siddig14 / 14