NAIROBI — Humanitarian groups in Sudan are scrambling to deal with an emergency caused by more than 40,000 people who have crossed the border over the past three weeks to escape the Ethiopian government’s military campaign in its northern region of Tigray.
“No one was expecting to have to deal with a refugee emergency on this side of the country, so it kind of put everyone a bit off guard,” said Will Carter, country director for the Norwegian Refugee Council in Sudan.
Some are concerned the number of people could dramatically escalate following Ethiopian Prime Minister Abiy Ahmed’s warning Sunday that the military will launch an offensive in Tigray’s capital of Mekelle if the region’s forces don’t surrender within 72 hours.
With refugees landing in a part of Sudan with already scarce resources, aid groups are working to set up camps and services, preparing for what the United Nations estimates could be up to 200,000 refugees over the next six months.
“The area where the refugees are coming to and being hosted was already underprivileged,” said Massimo Diana, representative for the United Nations Population Fund in Sudan. “And then you are adding an additional 40,000 people in a short span of time.”
A challenging response
Setting up operations at the onset of the crisis was a challenge, Carter said. There were few humanitarian organizations already operating in this part of Sudan, and NRC said it had issues in getting access permits to relocate staff members.
“It was very rudimentary at the beginning and even until now. But it's about to sort of step up a gear,” he said, adding that the number of organizations involved in the response has increased, there is more of an interagency strategy, and more resources have been made available.
The Sudanese Red Crescent Society was one of the few organizations that was already active in the area and working with the United Nations Refugee Agency to provide services to long-term refugees already living in eastern Sudan.
People enter Sudan at two transit sites, where they are screened and registered. Following this, many are transferred to Um Rakuba — the only government-authorized camp — which is located about 69 kilometers (43 miles) from the border. Another area, called Village 8, is also receiving refugees.
Bottlenecks at the transit points are leading to congestion and long wait times, according to aid workers. Some refugees are also hesitant to leave the border for the camp for various reasons, including their ongoing search for separated loved ones.
At the camp, aid workers provide people with two meals a day, as well as a blanket, mat, and jerrycan for water, Carter said. At both the camp and the transit centers, people are sleeping out in the open or in large communal tents, raising concern over the safety of women and girls.
“Because of the speed in which these numbers were reached, this is not yet what you would call a refugee camp setting. This is not your traditional series of camps where each family has a tent and you're structured like a small neighborhood,” Diana said.
Though UNICEF and other partners have set up water points, there is still a limited number of showering facilities and toilets, leading to open defecation, Diana said.
The existing health capacities in the area are also lacking in terms of infrastructure and adequate numbers of trained health professionals, he said. Referral hospitals are a distance away from the camp and ill-equipped in providing surgeries and other areas.
People at the border are reportedly testing positive for a strain of malaria that is different from the one circulating in Sudan, which raises concern about this other strain spreading in the country, as well as questions over capacities for diagnosing and treating it. The nation already has an acute shortage of antimalarial drugs, said Heidi Diedrich, country director at Alight, formerly the American Refugee Committee, in Sudan.
“It was such a sudden displacement. … Within a few hours, you need to run for your lives … treading over dead bodies to get to a border crossing.”— Will Carter, country director in Sudan, Norwegian Refugee Council
People with HIV/AIDS also do not have medical care, and there are concerns about the spread of tuberculosis and COVID-19, she said. The country is currently seeing a second wave of the coronavirus pandemic, which is worse than the first.
Given the trauma of what people experienced as they left Ethiopia, there is a need for psychosocial support as well. But language barriers exist, and very few trained professionals are available.
Families are also separated. The Ethiopian government cut off internet and phone access in Tigray, meaning people are not in touch with loved ones, Carter said.
Many reportedly walked for days to reach the Sudanese border, according to the United Nations Office for the Coordination of Humanitarian Affairs. Almost half the arrivals are under 18 years old, and some are unaccompanied.
“You hear some pretty brutal stories from what people have endured. It was such a sudden displacement. This level of family separation is incredibly harsh,” Carter said. “Within a few hours, you need to run for your lives … treading over dead bodies to get to a border crossing.”
“As refugee emergencies go, it's a pretty bad one,” he added.
The influx of refugees comes at a time when Sudan is already struggling with the aftermath of unprecedented flooding this year that left over 875,000 people in need of humanitarian aid. Kassala state, which was heavily impacted by the floods, is now hosting refugees from Ethiopia.
“If not properly supported, Sudan could be overwhelmed by the added pressure on top of its own domestic challenges—which include poverty, hyperinflation, political instability, climate-related concerns, and an existing refugee population of around 1 million people,” according to a report from Refugees International.
Many NGOs are using seed funding for the initial months of this response, Diedrich said. But there is concern among aid groups about long-term funding if the situation becomes protracted.
UNHCR is expected to launch its response plan with a funding appeal in the coming days.
Update, Dec. 1, 2020: This piece has been updated to reflect that Heidi Diedrich is country director at Alight, formerly the American Refugee Committee.