Famine (IPC Phase 5) confirmed in part of Al Fasher, North Darfur

Famine (IPC Phase 5)¹ is currently ongoing in the Zamzam camp for internally displaced persons (IDPs) in the besieged locality of Al Fasher, North Darfur (Figure 1), based on reasonable evidence² that the Famine thresholds were passed in June. It is possible Famine (IPC Phase 5)³ is also ongoing in Abu Shouk and Al Salam IDP camps, but available evidence is limited and reduces the ability to confirm or deny this classification; at a minimum, many IDPs are experiencing starvation indicative of Catastrophe (IPC Phase 5). Approximately 400,000-600,000 IDPs are sheltering in these three camps, with the majority located in Zamzam. Famine (IPC Phase 5) is expected to continue in these areas through at least October and, in the absence of large-scale food assistance and an end to intense conflict, will possibly extend into the harvest and post-harvest seasons beyond October. FEWS NET also assesses there is a risk of Famine (IPC Phase 5) across the rest of Al Fasher – home to an additional estimated 800,000 people – if the siege ultimately prevents rural and urban households from migrating to safer areas in search of food and cash income for a prolonged period of time. An immediate and coordinated scale-up of multi-sectoral assistance, with unhindered humanitarian access to populations in need, is urgently required to mitigate the large-scale loss of life in Al Fasher’s IDP camps and prevent the acceleration of already high mortality levels in other areas of Al Fasher facing a risk of Famine (IPC Phase 5).

FEWS NET first issued an early warning of the risk of Famine (IPC Phase 5) in areas of Sudan in March 2024 and reiterated alarm for this risk in May 2024, emphasizing that Emergency (IPC Phase 4) and Catastrophe (IPC Phase 5) outcomes marked by high and rising levels of hunger, acute malnutrition, and mortality were already ongoing in multiple areas. Over 20 million people in Sudan need humanitarian food assistance to prevent hunger, acute malnutrition, and mortality. Since April 2023, the war between the Sudan Armed Forces (SAF) and the Rapid Support Forces (RSF) has heavily damaged agricultural production, trade flows, and market functionality, decimating household food and cash income sources. The RSF-led siege of Al Fasher has driven a further rapid and severe deterioration in the population’s access to food, including food assistance, since April 2024. The time required to gather and vet the evidence necessary to rigorously establish that the technical definition of Famine (IPC Phase 5) has been met – inclusive of a plausibility review by the Famine Review Committee – means a considerable loss of life has already occurred and is currently ongoing. Famine (IPC Phase 5) is only confirmed after many deaths occur and mortality rates reach extreme levels – in this case, as many as two months ago. This fact underscores that humanitarian and government actors should never wait for a confirmation of Famine (IPC Phase 5) before taking meaningful actions to save lives.

Since the onset of the RSF’s siege of Al Fasher in April, the escalation and intensification of conflict has caused destruction of essential infrastructure and massive displacement of civilians, cut off trade flows and humanitarian access, led to severe food shortages and steeply rising food prices, and aggravated already low access to water, sanitation, and health services. In late May and again in late June/early July, the RSF directly attacked Abu Shouk IDP camp in the north, while also carrying out attacks on public infrastructure such as hospitals, clinics, markets, and the town’s water reservoir in June. Analysis of thermal scarring done by Yale Humanitarian Research Lab (HRL) confirms targeted burning and razing of civilian dwellings, notably in southeastern areas of Al Fasher town heavily populated by minority groups. The International Organization for Migration estimates nearly 330,000 people were displaced between April and late June, primarily fleeing to other areas within Al Fasher or moving south to other localities in North Darfur or into other states in Greater Darfur. Additional reporting in June by Médecins Sans Frontières (MSF) and Yale HRL confirmed large-scale displacement out of the city, with MSF reporting many of the displaced stopping at Zamzam IDP camp. Located approximately 15 kilometers south of Al Fasher, the camp’s infrastructure has already been overwhelmed by the influx of IDPs during over 14 months of fighting. 

Due to the humanitarian access constraints imposed by the siege, collection of representative data on food consumption and livelihood change has not been possible; nevertheless, available evidence of food security conditions converge to support the conclusion that starvation is likely widespread and exceeds the threshold for Famine (IPC Phase 5) among IDPs in the main camps around Al Fasher. With very limited access to farmland, any food stocks that IDPs harvested from their own production in late 2023 were long ago depleted, leaving IDP households heavily dependent on markets and inconsistent access to food assistance. Under the siege, these sources of food have become increasingly inaccessible, as the weekly market in Zamzam is no longer functional, physical access to markets in Al Fasher town is severely limited by conflict, supplies in Al Fasher have become depleted, and available price data suggest sorghum and millet prices in Al Fasher town have surged 160-180 percent above the three-year average. At the same time, typically marginal sources of income to purchase food have rapidly declined under siege conditions, especially among recent IDPs who lost their livelihoods when fleeing conflict and protracted IDPs who were reliant on daily wage labor, petty trade, or other market-based activities. Furthermore, humanitarian food assistance deliveries have not occurred since April, as humanitarian partners are unable to securely access the area.

Prior to the siege, MSF collected representative acute malnutrition and mortality data in January 2024 in Zamzam IDP camp that indicated levels of acute malnutrition based on Middle Upper Arm Circumference (MUAC) were already above the MUAC threshold for Famine (IPC Phase 5) at 23.1 percent, while the non-trauma Crude Death Rate was near the Famine (IPC Phase 5) threshold at 1.9 deaths per 10,000 per day (95% CI: 1.5-2.4). Subsequent screenings conducted by MSF, the Sudan Ministry of Health, and partners suggested similar-to-higher levels of acute malnutrition. Based on the evidence of worsening starvation in Al Fasher, levels of acute malnutrition have likely risen further, while levels of non-trauma mortality have likely accelerated and surpassed the Famine (IPC Phase 5) threshold by June. Supporting evidence includes a recent Reuters investigative report, which analyzed satellite imagery of graves in and around Zamzam camp in North Darfur; Kalma and Kas IDP camps in South Darfur; and Nertiti and Hamidiya IDP camps in Central Darfur. The analysis suggested a disproportionate increase in graveyards adjacent to these camps specifically, with a 26 percent faster growth observed in Zamzam between mid-December 2023 and early May 2024 when compared to a similar period last year. According to interviews with community leaders (none interviewed in Zamzam), the leading causes of death in the camps were malnutrition and disease.

While Al Fasher is of greatest concern, the widespread impacts of conflict on agricultural production, trade, market functionality, humanitarian access, and water, sanitation, and health services are driving a risk of Famine (IPC Phase 5) across many other areas of Sudan. There is particular concern for IDP populations across Greater Darfur if conflict and humanitarian access denials from the SAF or RSF directly or indirectly prevent them from accessing remaining sources of food and cash income. The fluidity of conflict on the ground and the large gaps in available data on food consumption and acute malnutrition – in addition to more typical gaps in information on mortality – is leading to heightened uncertainty in the development of the “most likely” scenario; as such, it is possible FEWS NET’s assessment of the likelihood of Famine (IPC Phase 5) in these areas – particularly in other IDP camps in Greater Darfur – could shift rapidly depending on ground conditions and access to new information. In addition to the urgent need for a national ceasefire and an end to heavy conflict, bureaucratic impediments that limit the flow of assistance across conflict lines must be lifted to ensure humanitarian access to populations in need and prevent the spread of starvation. Humanitarian and government actors should act swiftly to mitigate further loss of life.