Three years after Sudan’s civil war erupted on April 15, 2023, the country has become the epicentre of what humanitarian agencies describe as the world’s largest and most neglected crisis, with even the most basic measure of its human toll—an accurate death count—still unknown. According to reporting originally published by El País and analysed here by Finanacil Times, the war between the Sudanese army and the paramilitary Rapid Support Forces (RSF) has devastated nearly every region of the country, leaving behind a humanitarian disaster defined as much by invisibility as by scale.
The absence of reliable figures on fatalities has itself become a symbol of collapse. Aid workers and humanitarian leaders say the inability to estimate the number of dead reflects the breakdown of state institutions, health systems, and international monitoring mechanisms. Javid Abdelmoneim, president of Médecins Sans Frontières (MSF), has described the situation as evidence of “how completely the system has disintegrated,” adding that Sudan’s neglect by the global community is reflected in the fact that even its death toll cannot be properly recorded. In most conflicts, statistics help frame the scale of tragedy; in Sudan, even that anchor has vanished.
The war began in the capital, Khartoum, but quickly spread across the country, transforming into a nationwide conflict marked by shifting frontlines and expanding territorial control by both sides. Only a few regions in the north and east have remained relatively less affected. Elsewhere, the fighting has become entrenched and increasingly complex, involving drones, irregular warfare, and external influence. Human rights organisations have documented widespread atrocities, including ethnic cleansing, sexual violence, executions, torture, arbitrary detention, and looting. In one of the most alarming assessments, a United Nations mission accused the RSF of committing genocidal acts during its capture of El Fasher in North Darfur, describing it as one of the worst massacres in recent history.
Beyond direct violence, Sudan is experiencing a humanitarian collapse that is driving mortality through hunger, disease, and the breakdown of basic services. The United Nations estimates that around 34 million people—roughly 60% of the population—now require humanitarian assistance, the highest figure anywhere in the world. Denise Brown, the UN’s humanitarian coordinator in Sudan, has described the situation as “a brutal war with brutal consequences for people,” underscoring the scale of civilian suffering across the country.
Sudan is also the world’s largest displacement crisis. Although approximately 3.8 million people have returned to their homes in recent months, about nine million remain internally displaced, while another 4.5 million have fled abroad, mainly to Egypt, South Sudan, and Chad. Entire communities have been uprooted, and many of those attempting to return find their towns and cities in ruins, with destroyed housing, damaged infrastructure, and no functioning public services.
The collapse of Sudan’s health system has been one of the most devastating consequences of the war. Hospitals have been repeatedly attacked, looted, or occupied, and medical staff have faced violence, detention, and intimidation. According to the World Health Organization (WHO), there have been more than 200 attacks on health facilities since the war began, and Sudan accounted for 82% of all deaths in such incidents globally in 2025. Only around 37% of the country’s health centres remain operational, leaving vast areas without access to basic care.
This breakdown has created what health experts describe as a “perfect storm” for epidemics. Outbreaks of cholera, measles, hepatitis E, and dengue fever have become frequent and overlapping, fuelled by overcrowding, lack of clean water, and deteriorating sanitation systems. With millions of people living in displacement camps or informal shelters, preventable diseases have become a leading cause of death, further obscuring the true human toll of the war.
At the same time, hunger has been systematically weaponised. Both sides in the conflict have been accused of restricting food access, contributing to catastrophic levels of food insecurity. Recent UN-backed assessments warn that more than four million children and pregnant or breastfeeding women are expected to suffer acute malnutrition in 2026, including hundreds of thousands in life-threatening condition. Famine has already been declared in multiple regions, including displacement camps and key urban centres, marking one of the most severe food crises in decades.
Education has also collapsed. More than half of Sudan’s schools are closed, and many have been converted into shelters for displaced families. As a result, around 13 million children are out of school, representing more than three-quarters of all school-aged children in the country. For an entire generation, the war is not only a source of immediate suffering but also a long-term rupture in access to education and opportunity.
Despite recent localized returns of displaced populations, conditions in many home areas remain extremely fragile. Infrastructure damage is widespread, and essential services such as electricity, water, and healthcare are either absent or severely limited. In many cases, returns are driven less by safety and more by desperation in displacement camps where food, shelter, and aid are increasingly scarce.
In recent months, both the army and the RSF have escalated their use of drones and targeted attacks on infrastructure, including power stations and refineries. These strikes have caused widespread blackouts and disruptions to essential services, deepening the humanitarian crisis. Meanwhile, humanitarian access has become increasingly restricted, with both sides accused of obstructing aid deliveries through bureaucratic barriers, security threats, and administrative interference.
Aid workers have warned that some of these restrictions appear deliberately designed to limit assistance in enemy-controlled territories, effectively turning bureaucracy into a weapon of war. More than 130 humanitarian workers have been killed since the conflict began, most of them Sudanese nationals, highlighting the extreme risks faced by those attempting to deliver aid.
In response to the crisis, local volunteer networks have emerged as essential lifelines. Emergency response units have organised food kitchens, delivered water, supported health centres, and helped civilians escape conflict zones. However, these groups also face increasing pressure and restrictions, particularly in areas where state or military authorities seek to control humanitarian distribution.
International response efforts have been widely criticised as inadequate. The United Nations’ humanitarian appeal for Sudan in 2026 remains severely underfunded, having received only a fraction of the required resources. Despite widespread acknowledgment of the crisis, financial support from the international community has failed to match the scale of need, deepening frustration among aid officials.
As Denise Brown has noted, the tragedy in Sudan is not a lack of awareness but a failure of action. The world recognises the severity of the crisis, yet that recognition has not translated into sufficient funding, protection, or political pressure. Three years into a war that has erased cities, displaced millions, and overwhelmed entire systems, Sudan remains trapped in a cycle of violence and neglect—defined as much by what the world does not see as by what it does.
