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Mawada Mohamed, 17, cradles her 1-year-old sister, Aza Ismail, who is hospitalized in the MSF/Doctors Without Borders-run “inpatient therapeutic feeding center” at the hospital in El Geneina, the only referral hospital in all of West Darfur, Sudan.

Mawada Mohamed, 17, cradles her 1-year-old sister, Aza Ismail, who is hospitalized in the MSF/Doctors Without Borders-run “inpatient therapeutic feeding center” at the hospital in El Geneina, the only referral hospital in all of West Darfur, Sudan. (Diana Zeyneb Alhindawi/for The Washington Post)

EL GENEINA, West Darfur, Sudan — In Sudan’s post-apocalyptic cities, in the desert battlegrounds of Darfur and even in the war-ravaged farmlands of the south, families are beginning to starve.

It has been nearly a year since fighting broke out between the military, headed by Lt. Gen. Abdel Fattah al-Burhan, and the paramilitary Rapid Support Forces (RSF), headed by Gen. Mohamed Hamdan Dagalo, universally referred to Hemedti. The war plunged the nation of 49 million people into chaos, forcing more than 8 million from their homes.

The United Nations’ World Food Program says roots of the hunger problem are twofold: access and funding. Within Sudan, WFP trucks have been blocked, hijacked, attacked, looted and detained. Outside Sudan, makeshift camps are swollen with hungry and sick arrivals — but there’s no money to feed them. Most have fled into South Sudan and Chad. In Chad, a funding crisis meant only the newest arrivals had been receiving food. All food distribution in Chad — home to 1.1 million refugees — will cease entirely within a week, said Cindy McCain, executive director of WFP.

“This is a huge, looming problem, and they are very close to famine,” McCain told The Washington Post. “Kids are dying of starvation within Darfur and other parts of the country.”

A doctor at the mobile clinic examines 2-year-old Abdal Majib Abdullah, the youngest of Gisma Al Kher Hassan’s four children. Ten days before, Al Kher Hassan, 26, had returned to Sirba from Chad, where she had been a refugee for months. She is staying in an old primary school with hundreds of others.

A doctor at the mobile clinic examines 2-year-old Abdal Majib Abdullah, the youngest of Gisma Al Kher Hassan’s four children. Ten days before, Al Kher Hassan, 26, had returned to Sirba from Chad, where she had been a refugee for months. She is staying in an old primary school with hundreds of others. (Diana Zeyneb Alhindawi/for The Washington Post)

Men in El Geneina secure empty containers to a vehicle that will travel to Chad for the purchase of gasoline, which will then be sold at a premium in Darfur. No gas stations remain in service in El Geneina. They were all destroyed or looted in the conflict. Gas prices in West Darfur have nearly doubled since the start of the war.

Men in El Geneina secure empty containers to a vehicle that will travel to Chad for the purchase of gasoline, which will then be sold at a premium in Darfur. No gas stations remain in service in El Geneina. They were all destroyed or looted in the conflict. Gas prices in West Darfur have nearly doubled since the start of the war. (Diana Zeyneb Alhindawi/for The Washington Post)

A technician performs an ultrasound during a prenatal checkup at the Doctors Without Borders-run maternity ward at El Geneina Teaching Hospital.

A technician performs an ultrasound during a prenatal checkup at the Doctors Without Borders-run maternity ward at El Geneina Teaching Hospital. (Diana Zeyneb Alhindawi/for The Washington Post)

Getting permission from the government for food convoys can take up to three weeks, if granted at all, and the military won’t authorize opening key routes into the country. Aid workers also say there’s no clarity on engagement with the RSF, which has been declared a terrorist group by the military. During fighting, the RSF and its allies have repeatedly looted warehouses full of aid, although the paramilitary group is trying to encourage aid organizations to work in areas fully under its control. In other areas, no one is fully in control. Residents say some roads have become a patchwork of fiefdoms run by armed groups, each wanting to extract payments from passing traffic. Many gunmen survive off what they can extort and rob, including aid convoys.

If the situation continues, McCain said, Sudan “will be a bigger disaster than Gaza in terms of food.”

Many cities have been devastated by the fighting. Footage from the capital, Khartoum, shows buildings pockmarked with constellations of bullet holes. Markets, hospitals, warehouses full of food aid and factories have been looted and often burned. Schools have been bombed or are overflowing with displaced families seeking shelter. The RSF has taken four out of five regional capitals in Darfur and pushed into the southern farmlands, where the war has disrupted two harvests. Around the capital this month, the military has retaken the city of Omdurman, separated from Khartoum by the Nile.

The destruction has pushed inflation to 260 percent, and rents in the safer areas of the country have skyrocketed. Fuel is scarce — often smuggled over the border from Libya — and wildly expensive. Between 70 and 80 percent of health facilities have stopped functioning after hospitals were attacked and many doctors killed and kidnapped. More than 10,000 people have been infected with cholera, and about 15 million people cannot access any health care, the United Nations reports.

A woman waits to receive medication at a mobile clinic at a damaged hospital in Sirba. The French nonprofit Première Urgence Internationale runs the clinic, and most of its patients are sheltering at the hospital, nearby schools or other administrative buildings. It is the only health-care service in the Sirba locality and carries out over 100 consultations each day.

A woman waits to receive medication at a mobile clinic at a damaged hospital in Sirba. The French nonprofit Première Urgence Internationale runs the clinic, and most of its patients are sheltering at the hospital, nearby schools or other administrative buildings. It is the only health-care service in the Sirba locality and carries out over 100 consultations each day. (Diana Zeyneb Alhindawi/for The Washington Post)

A woman arranges her belongings in a damaged hospital building, another site in Sirba where displaced people are sheltering. Last year, the town was nearly destroyed or burned to the ground multiple times, and more than 144,000 people were impacted. Reports said the violence in Sirba targeted ethnic communities, particularly the Eringa tribe.

A woman arranges her belongings in a damaged hospital building, another site in Sirba where displaced people are sheltering. Last year, the town was nearly destroyed or burned to the ground multiple times, and more than 144,000 people were impacted. Reports said the violence in Sirba targeted ethnic communities, particularly the Eringa tribe. (Diana Zeyneb Alhindawi/for The Washington Post)

RSF soldiers ride a motorcycle on a main street in El Geneina past a destroyed tank that belonged to the Sudanese military.

RSF soldiers ride a motorcycle on a main street in El Geneina past a destroyed tank that belonged to the Sudanese military. (Diana Zeyneb Alhindawi/for The Washington Post)

In the town of Sirba in Darfur, Première Urgence Internationale has just opened the only clinic, in a partially destroyed hospital serving an area that was home to nearly 150,000 people before fighting broke out. Many of the rooms in the hospital are missing a roof or their walls are blackened by fire. Pieces of furniture and medical equipment lay scattered on the grounds as patients get passed prescriptions through a smashed window pane.

Conditions in Chad are already so bad that Gisma Al Kher Hassan returned to Sirba from the camps 10 days ago, seeking help for her youngest son, 2-year-old Abdal Majib Abdullah. He has been sick for nearly three weeks, but she has only millet porridge and water to give him. There’s a thriving market in Sirba, even though the town has been set aflame several times. The market stalls are spread out under blackened trees and flanked by destroyed homes, but few residents can afford to buy even a cup of rice from the bags resting on faded wooden boards.

“Fifteen days ago, I ran out of everything else to feed him,” the mother of four said. The attending doctor at the newly opened clinic said Abdal suffers from malnutrition caused by a lack of vitamin D and calcium.

The last time that WFP, the only major supplier of food aid in the region, was able to distribute food in Darfur was December. The military shut routes into Darfur from Chad in February, although two convoys of aid were permitted to cross this week.

Scheharazad Muhamed Ahmed, 25, holds her 15-month-old son, Eyaad Ahamday, as nurses administer a treatment at the Doctors Without Borders pediatric malnutrition ward at El Geneina Teaching Hospital. Eyaad, a sole surviving triplet who was born prematurely, suffers from anemia because Scheharazad, who is malnourished, cannot produce enough breastmilk to feed him.

Scheharazad Muhamed Ahmed, 25, holds her 15-month-old son, Eyaad Ahamday, as nurses administer a treatment at the Doctors Without Borders pediatric malnutrition ward at El Geneina Teaching Hospital. Eyaad, a sole surviving triplet who was born prematurely, suffers from anemia because Scheharazad, who is malnourished, cannot produce enough breastmilk to feed him. (Diana Zeyneb Alhindawi/for The Washington Post)

Ruins of the main mosque in El Geneina are dotted with bullet holes after clashes between the Sudanese military and the RSF overtook the city in 2023.

Ruins of the main mosque in El Geneina are dotted with bullet holes after clashes between the Sudanese military and the RSF overtook the city in 2023. (Diana Zeyneb Alhindawi/for The Washington Post)

Women prepare a meager meal in the yard of a former primary school in Sirba, a town about 15 miles north of El Geneina, the capital of West Darfur. The yard is one of numerous sites where thousands displaced by the war are staying.

Women prepare a meager meal in the yard of a former primary school in Sirba, a town about 15 miles north of El Geneina, the capital of West Darfur. The yard is one of numerous sites where thousands displaced by the war are staying. (Diana Zeyneb Alhindawi/for The Washington Post)

Around half of all Sudanese people need aid but only 5 percent of the United Nations’ $2.7 billion humanitarian appeal is funded. Medical charity Doctors Without Borders said last month that a child dies every two hours in the Zamzam camp for displaced people in North Darfur. That could skyrocket; the United Nations estimates that around 222,000 children could die of malnutrition in the coming months.

Those could be children like 15-month-old Eyaad Ahamday. His mother, Scheharazad Muhamed Ahmed, said she hasn’t heard from her husband, a soldier, since November. She cannot produce enough breastmilk to feed Eyaad and is trying to eke out a living selling plastic cups to feed her other three children. “Sometimes I don’t eat all day if I don’t sell enough,” she said at El Geneina Teaching Hospital, where Doctors Without Borders runs the malnutrition ward at the only referral hospital in West Darfur.

In Khartoum, many families rely on volunteer-run soup kitchens. But an internet shutdown has disrupted donations from abroad, and this week in the East Nile neighborhood of Bahri, the RSF arrested four members of emergency committees. The committees, which formed during the pro-democracy protests before the war, supervise the main soup kitchens.

Hafiz Haroun in Nairobi contributed to this report.

Children gather to start classes at the damaged Alkasim primary school in El Geneina. The school was the site of a camp for displaced people before it came under attack after the war broke out last April. In early January, 652 children resumed classes among the ruins. Because there are no school meals, classes end at noon, two hours earlier than they normally would.

Children gather to start classes at the damaged Alkasim primary school in El Geneina. The school was the site of a camp for displaced people before it came under attack after the war broke out last April. In early January, 652 children resumed classes among the ruins. Because there are no school meals, classes end at noon, two hours earlier than they normally would. (Diana Zeyneb Alhindawi/for The Washington Post)

People fetch water from a borehole in the yard of the old primary school.

People fetch water from a borehole in the yard of the old primary school. (Diana Zeyneb Alhindawi/for The Washington Post)

According to local authorities in Sirba, an estimated 6,000 people returned to town in the first three weeks of February. Humanitarian needs are exceedingly pressing as all public services, except for the market, have collapsed.

According to local authorities in Sirba, an estimated 6,000 people returned to town in the first three weeks of February. Humanitarian needs are exceedingly pressing as all public services, except for the market, have collapsed. (Diana Zeyneb Alhindawi/for The Washington Post)

Life is slowly resuming amid the ruins of Sirba. In the relative calm that ensued once the paramilitary Rapid Support Forces gained control of West Darfur, thousands returned to shelter in Sirba’s damaged central buildings, their homes and villages destroyed or looted.

Life is slowly resuming amid the ruins of Sirba. In the relative calm that ensued once the paramilitary Rapid Support Forces gained control of West Darfur, thousands returned to shelter in Sirba’s damaged central buildings, their homes and villages destroyed or looted. (Diana Zeyneb Alhindawi/for The Washington Post)

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