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On July 6, volunteers distribute medicine to people displaced by conflict at a makeshift emergency clinic set up in a former school in eastern Sudan.

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On a recent June morning in the Red Sea city of Port Sudan, Tedla Damte, UNICEF Sudan’s health chief, woke up energised and thinking about his plans for the day: a visit to a UNICEF school for displaced children and meetings with Sudan’s health minister.

The veteran humanitarian has been trying to tackle Sudan’s massive health crisis since the civil war began in April 2023. It’s a challenge Damte faces most days. But on that day in June, he received a text message from Darfur, on the other side of the country, where fighting has escalated in recent months.

It was from a colleague who informed Damte that the Saudi hospital there had been attacked and damaged. “And it was really heartbreaking when I heard that in the attack we also lost one of the most experienced pharmacists who gave his life on the front lines helping the people of Sudan,” Damte said.

The attack was one of several attacks on hospitals in Sudan since early June. Armed groups have attacked hospitals, health facilities and staff since a power struggle between the Sudanese armed forces and the paramilitary Rapid Support Forces escalated into civil war. Both sides are accused of committing war crimes against civilians and against medical facilities and staff.

Damte and representatives of other global aid organizations warn that these increasing attacks could soon lead to many loss of life due to a lack of medical care.

According to UNICEF, at least 77 hospitals in Sudan have been attacked since the war began. Aid groups say Sudan has become the world’s largest humanitarian crisis due to intense fighting that has displaced more than seven million people. The attacks have made it difficult for health workers to respond and provide vital medical care to millions of people.

When the Darfur maternity hospital was attacked, most of the staff had fled, so it’s not known how many of them — or their patients — were injured. And in early June, Doctors Without Borders told NPR that the only remaining hospital — the Southern Hospital — in the besieged town of El Fashir in North Darfur was raided and looted by armed groups — authorities could not confirm exactly who was responsible — forcing staff there to flee as well, leaving patients behind.

“But it’s not just the attacks on hospitals and facilities, but also the lack of fuel and medical staff. In areas like Darfur, over 70 percent of health facilities are literally unable to provide services right now,” said Damte. According to UN estimates, more than 10 million people lived in Darfur before the war began.

Most of Sudan’s medical supplies and equipment, such as blood banks and public health laboratories, are located in the capital Khartoum, a frontline of the conflict, and are inaccessible. Damte said most of the 250,000 health workers working there in Sudan’s health ministry have fled the country, making the situation even more difficult for those who remained behind.

“In addition, health workers in many places have no access to facilities for fear of their own safety and without any guarantee of protection and have not been paid for months,” he said.

The need for medical care is enormous in Sudan. The World Health Organization reported in June that more than 25 million Sudanese are suffering from acute food shortages. There have also been several disease outbreaks, including cholera, measles, malaria and dengue fever.

UNICEF’s Damte recalls a woman he met a few weeks ago near the Sudan-Egypt border, where more than a million displaced people were camping. Many slept homeless on the desert floor while scorpions crawled around. The woman was expecting twins and was rushed to the nearest hospital when she went into labor.

“And when they got to the hospital, the baby had died because there weren’t enough newborn supplies and they had to be resuscitated,” Damte said.

Of the more than seven million internally displaced people in Sudan, only two percent have access to medical care, says Shashwat Saraf, the International Rescue Committee’s regional emergency director for East Africa.

This has prompted the IRC and other aid agencies, including the World Health Organization, to take a new approach to improve access to people in need: setting up mobile clinics wherever they are available, such as schools, buildings or even in the shade of trees.

“A large part of our health programs are carried out in the form of mobile health teams. This makes us more flexible and adaptable and allows us to reach people on the move over a larger area,” says Saraf.

But many populated areas – such as Khartoum, Al Jazeera and Darfur – remain difficult to access and dangerous for medical workers, and it is also difficult to send aid there. Aid groups say immediate international assistance and funding are needed to end the fighting and prevent further catastrophic loss of life.