Aid flows constrict and civilians in danger as Sudan descends into chaos

Humanitarian organizations severely cut back or halted work in Sudan as the fighting widened between Sudan’s two most powerful military groups.

The nation was unraveling after a week of fighting in which millions of civilians – many of them dependent on international organizations for food and basic services – were at a loss.

Starting on Tuesday, however, a 72-hour ceasefire was set to begin under a deal, brokered by the United States and Saudi Arabia, that U.S. Secretary of State Antony Blinken announced as a result of what he called intense negotiations for the past 48 hours.

The U.S. government will coordinate the creation of a committee to negotiate permanently ending the fighting and allowing aid to resume. "We will continue to work with the Sudanese parties and our partners toward the shared goal of a return to civilian government in Sudan," he said.

The World Health Organization warned on Tuesday that fighters' occupation of Sudan's National Public Health Laboratory in central Khartoum poses a great risk of chemical or biological contamination.

Trained laboratory technicians no longer have access to the laboratory, said Dr. Nima Saeed Abid, WHO's representative in Sudan, and with power cuts it can't properly manage the biological materials stored there for medical purposes. That creates a risk that the depleting stocks of blood bags will spoil, he said, and there are "very high" chemical and biorisk hazards due to lack of functioning generators.

“That is extremely, extremely dangerous because we have polio isolates in the lab. We have measles isolates in the lab. We have cholera isolates in the lab,” he said from Port Sudan. “There is a huge biological risk associated with the occupation of the central public health lab in Khartoum by one of the fighting parties.”

Patrick Youssef, the International Committee of the Red Cross' regional director in Africa, said the last few days were terrifying for civilians caught in the crossfire and the ICRC's top priority was to repair the water and power lines and get medical help so the hospitals can treat the wounded.

“We welcome the reports of a ceasefire and urge the international community to help find a durable political solution to end the bloodshed," Youssef said on Tuesday. "It’s clear that this ceasefire must be implemented up and down the chain of command and that it must hold for it to give a real respite to civilians suffering from the fighting.”

Four staff from the World Food Program and one from U.N. Migration were killed because of fighting, prompting a halt in their operations. Likewise, ICRC, U.N. Office for the Coordination of Humanitarian Affairs, Save the Children, and Norwegian Church Aid were all forced to scale back.

"A week since clashes started, hundreds of people have been killed, including five aid workers. This must stop," said OCHA chief Martin Griffiths, United Nations' undersecretary-general for humanitarian affairs and emergency relief coordinator.

An aid worker for Relief International also was killed because of the clashes, forcing that organization to put all its staff in Sudan "in hibernation" based on the U.N.'s advice, said its CEO, Craig Redmond.

The violence, which has killed hundreds of people and injured thousands more, must stop before it becomes an international catastrophe, U.N. Secretary-General António Guterres told a U.N. Security Council meeting on Monday in New York.

"It risks a catastrophic conflagration within Sudan that could engulf the whole region and beyond," he said. "We must all do everything within our power to pull Sudan back from the edge of the abyss."

Guterres said he was in constant contact with both sides and called on them to de-escalate tensions and return to the bargaining table.

"Let me be clear: the United Nations is not leaving Sudan," Guterres said. "I have authorized the temporary relocation both inside and outside Sudan of some United Nations personnel, and of families."

'This cannot go on'

The nation's infrastructure for water, electricity and other basic services was badly hit and looting of businesses and homes was widely reported. Hospitals shut down.

Sudan must grant "humanitarian pauses" and cease hostilities to let civilians and aid workers move to safety, replenish supplies and get food and water, said Abdou Dieng, U.N. humanitarian coordinator in Sudan.

"Many hospitals have had to close. And in those that are functioning, widespread blackouts and lack of electricity place patients at high risk. Several hospitals have run out of blood and other essential supplies," he said. "Assaults on hospitals, humanitarian staff and facilities must stop."

Fighting between rival generals – Gen. Abdel Fattah al-Burhan, commander of Sudan's armed forces, and Gen. Mohamed Hamdan Dagalo, head of the paramilitary Rapid Support Forces — caused widespread diplomatic evacuations.

Two years ago, the two generals collaborated on a military coup that ended Sudan's fledgling steps toward democracy in the wake of the 2019 protests that helped bring down leader Omar al-Bashir. Now they are competing to become Sudan’s next ruler.

As the fighting spread across the country, governments such as Britain, France, India, Germany and the United States evacuated diplomats and their families from Sudan's capital Khartoum, where 5.5 million people live. Most governments also began transporting to safety some tens of thousands of foreign citizens, but the U.S. did not evacuate 16,000 American citizens, including many dual nationals.

“For the last week the world has watched in horror at the appalling scenes of violence and bloodshed in Sudan. When battles rage in residential areas, it is civilians who pay the highest price," said ICRC President Mirjana Spoljaric.

Spoljaric said the suffering has been made worse by ICRC's inability to deliver aid to the people who need it most because of the lack of needed security guarantees.

"This cannot go on," she said. "We implore the parties to grant the ICRC immediate and unimpeded humanitarian access to assist Sudanese civilians in need. This is not optional – it is a legal obligation under international humanitarian law."

Thousands of Sudanese tried desperately to flee to neighboring Egypt or Chad. Sudan also borders Central African Republic, South Sudan, Ethiopia, Eritrea and the Red Sea. Tens of thousands of refugees were expected in neighboring countries.

“The people of Sudan are facing the possibility of an irreversible humanitarian disaster in the coming days," said Michelle Nunn, CARE's president and CEO. "With more than 11 million people across the country – prior to the current crisis – barely able to meet the minimum food requirements, the recent violence is exacerbating an already dire situation for civilians, especially women and girls."

This story has been updated with additional details.