“It was tragic”: Women and health workers in Sudan describe fleeing El Fasher

NORTH DARFUR STATE, Sudan - "In El Fasher, I couldn't have any health check-ups because there were no hospitals left near us," said Zainab, 26, who was pregnant during describing a brutal siege that lasted 18 months in the capital of North Darfur State.

During the blockade, women and girls were subjected to relentless bombardment and escalating sexual violence while cut off from humanitarian aid. As health facilities came under repeated attack, medicines ran out, pregnant women delivered babies without any skilled assistance, and survivors of rape were left without medical care.

The crisis escalated in October 2025, as El Fasher fell to the Rapid Support Forces.

"We dug trenches to hide and sheltered inside them," said Rania, 22, who was pregnant at the time. "There was shelling every day."

More than 107,000 people - most of them women and children - escaped El Fasher however they could, most without transport, food or money. Rania and Zainab were among over thousands to flee to Al Affad, an overcrowded displacement site where healthcare and safety remain elusive.

Along the way, Rania collapsed from exhaustion and witnessed women giving birth by the roadside. "It was heartbreaking and frightening." When she reached Al Affad camp, she was rushed to a maternity hospital in nearby Al Dabbah and delivered her baby by Caesarean section.

Zainab had a similar welcome at the camp: "I was waiting to receive a tent, but I gave birth beforehand," she told UNFPA, the United Nations Population Fund, which is the UN's sexual and reproductive health agency.

Healthcare in crisis

Midwife Madina fled to Northern State from El Fasher and now works as part of a UNFPA-supported medical team at a clinic in Al Affad camp. © UNFPA Sudan/Sufian Abdulmouty

Health workers also described the terrors of the months-long siege. Midwife Madina Bashir was confined with 65 women inside a mosque in El Fasher for nearly a year. "For many days, we had no food or water. We survived by drinking rainwater and eating plants growing in the courtyard," she said.

"When the mosque was stormed, they took all the men away and forced the women out barefoot. Some of the women were pregnant - one gave birth on the road because we couldn't reach care in time."

Ikhlas Ahmed Abdallah Adam, a displaced obstetrician and mother of three, also described the conditions of the blockade: "Between my house and the Saudi Maternity Hospital [where I worked] there were more than 100 bombs a day. I would sleep overnight at the hospital, because if you tried to go back home you could be hit by a bomb. Many of my colleagues were killed that way."

She and her colleagues resorted to desperate measures. "We worked using cut-up bedsheets and mosquito nets - we did everything we could. We were performing procedures like amputations outside the operating room."

But their dedication was unwavering. "If a market or a neighbourhood gets hit, medical staff would have to donate blood because we didn't have any supplies… Meanwhile, the hospital itself is being hit."

Displaced but dedicated

Dr. Ikhlas is an obstetrician displaced from El Fasher, who is now working with a UNFPA medical team at Al Affad displacement camp, in Sudan's Northern State. © UNFPA Sudan

Today, both Ms. Bashir and Dr. Ikhlas are displaced, but they continue working. Both have joined UNFPA-supported medical teams in Al Affad.

Farha Ahmed encountered Dr. Ikhlas after spending a week fleeing El Fasher on foot, while pregnant and carrying her three-year-old daughter.

"We had no one with us. My children's father, my father and my brothers were all killed," she told UNFPA. "I was exhausted… When I arrived, I was sitting in the heat, under the sun, without supplies or anything to eat. Dr. Ikhlas found me and took me to Al Dabba Maternity Hospital."

Thanks to Dr. Ikhlas, Ms. Ahmed spent 11 days and gave birth at the hospital, which is supported by UNFPA. "She brought me everything I needed," said Ms. Ahmed. "She stayed with me throughout, and even after I was discharged she continued to follow up with me until she brought me here [to the clinic]."

Sustaining life-saving services

People arrive in Al Affad camp in Northern State fleeing violence in Tawila, in North Darfur State © UNFPA Sudan/Sufian Abdulmouty

UNFPA continues to work in Northern State by strengthening emergency obstetric care at Al Dabbah Maternity Hospital and operating a reproductive health clinic in Al Affad displacement camp. Roving midwife teams are also being deployed and training provided for community midwives and health providers on the clinical management of rape.

"The doctors displaced from El Fasher face many difficulties," said Dr. Ikhlas. "But we keep working and helping people. We do humanitarian work here."

While these interventions are preventing deaths and supporting survivors, without immediate, increased funding and access, women and girls will lose life-saving care when they need it most. After 1,000 days of war, nearly two thirds of the entire population is in dire need of humanitarian assistance.

UNFPA is appealing for $4.8 million to provide reproductive health and protection services in response to the crisis in El Fasher. As of the end of November, the appeal is just over a quarter funded.