On the second anniversary of the civil war in Sudan, the much-contested Darfur region remains inaccessible for sufficient humanitarian aid without a stable United Nations presence. The Rapid Support Forces, the paramilitary group fighting the government-run Sudanese Armed Forces, currently control Darfur, leaving the UN unable to operate humanitarian aid services there consistently.
To fill that gap, Médecins Sans Frontières (MSF) — which is present in four of the five Darfur states — is moving beyond traditional medical care by offering group cash-transfer programs. The Geneva-based group is leveraging its nimble funding model whose independence from government funding is paying off amid massive USAID cuts. Yet, MSF is sorely missing a steady UN presence in Darfur as the organization faces bureaucratic barriers from Sudan’s military-led government.
Lisa Searle, an Australian-born veteran MSF staff member working in the organization’s Dutch division, left a four-month stint in South Darfur state just over a week ago. She spoke to PassBlue by phone about MSF’s recently announced project to bring relief in new ways to the Darfur population. The plan is already providing immediate results.
MSF was able to re-enter South Darfur in January 2024, after fighting left the state largely inaccessible from April 2023 — the start of the current civil war — through October 2023. With the Rapid Support Forces (RSF) recently securing control of parts of the area, Nyala, the state’s capital, became a safer haven than the front lines elsewhere in Darfur.
“The government infrastructure, including schools and hospitals, has almost completely fallen apart,” Searle said, describing what she saw upon arrival in South Darfur. “So, these services are not being provided by the government anymore.”
She added that “the number of humanitarian actors who are there offering essential help is extremely limited.” That includes a minor presence by the UN.
Moreover, Searle said that “the UN are really struggling with the political situation, and the bureaucratic impediments [of working in Darfur] seem to be felt more strongly than with other organizations, because the UN operates differently than other international organizations.” This is particularly so as UN humanitarian-aid policy requires that it work with the government recognized as the UN member state. In this case, it is represented by the Sudanese Armed Forces, or SAF.
Searle, who has worked in hot spots around the world, says that while the UN is not completely absent from Darfur, “they’re certainly more absent than I’ve ever seen before working in conflict zones.”
“It’s kind of terrifying,” Searle added, “working in a place like this, where there is such minimal UN presence that’s palpable.” She described “flash visits” by the UN coming into certain parts of Darfur briefly.
According to Edmore Tondhlana, the acting officer heading the Office for the Coordination of Humanitarian Affairs (OCHA) in Sudan, there is a “standing agenda item” to establish a base for UN agencies in Darfur. For now, the SAF-led government in Khartoum is not allowing it, sometimes citing the potential for collateral damage when the army conducts airstrikes against the RSF.
“It would make more sense to be operational from inside Darfur,” Tondhlana said over WhatsApp, “but it is not necessarily required to have a base there.” He added that coordination is being done from Farchana, which is a short distance from a main Sudanese border crossing point, in neighboring western Chad.
Searle doesn’t think this effort is enough, citing the need for a robust on-the-ground coordination of humanitarian affairs in Darfur, even as a resource for aid organizations dealing with treacherous, costly border crossings, visa impediments and convoy logistics in a war.
Working without the UN present constantly, she added, “is much more difficult than working in a place where they are present.” In South Darfur, MSF Netherlands has 25 international staff and around 150 locally hired people.
Searle, a medical doctor who also does extensive project coordination work with MSF, spent her four-month stint in Nyala helping to build hospital and water infrastructure as well as surveying civilian groups with her team.
“We talk to the people, we ask the people what they need, and what we hear coming back from people every day is that they need food and they need water, and they need cash and livelihood,” she said.
These talks led MSF to consider possibilities they haven’t tried before, with the most notable departure being direct-cash grants. Such small handouts have been an overall feature of the war, which has consistently rendered international aid hard to deliver and resulted in increased funding being directed to a competent, brave network of Emergency Response Rooms and other community-based organizations.
Flexible response is a feature of MSF work, its advocates say, because it receives much of its budget from private donations, but the creativity behind the cash transfers is also driven by scarcity. “These are the kind of activities that are often done by other actors,” Searle said, “and in this case, those actors are not really there” — including the UN.
In the pilot program, 15 vetted groups received grants totaling $15,000 each through three payments. Of the 15 programs, seven are school-feeding projects; three are volunteer-run health posts; and two operate community kitchens for internally displaced people.
Searle said the effect has been significant. “For a relatively small amount of money spent, we have reached more than 10,000 beneficiaries through this program, and had a huge impact on people’s lives.”
But the efforts can never be enough in a region that is estimated by UNOCHA to be contending with 2.3 million needy people. Much of the help involves caring for people who have experienced gender-based violence and who require child-protection services.
MSF works in Darfur along with other international entities — including the International Medical Corps, World Vision, Mercy Corps and Alight — many of whom are being hurt by the USAID funding freeze, which was instigated soon after the Trump administration took office in late January.
“All of these other organizations are dependent on USAID funding,” Searle said, “and in South Darfur, we are already seeing some of these organizations shutting down activities, stopping support to clinics and stopping doing water trucking to displaced person camps — with no warning.”
Tondhlana of UNOCHA confirmed that US funding cuts are reducing the presence of some nongovernmental organizations who have been active in Sudan, but he said many groups are still getting support from European- and British-run aid services.
However, another organization active in Sudan, Alight, posted a Q&A on its website in March, confirming that the termination of 83 percent of USAID programs affected programs in the country, resulting “in the termination of lifesaving programs for refugees, malnourished children, and pregnant mothers.”
When contacted earlier this week for details on South Darfur specifically, Alight’s communications team responded that it was not “currently in a position to speak to the media.”
MSF’s traditional funding model benefits its work in South Darfur. “We don’t take any money from any governments,” Searle said, “as part of our core principles.” All its money comes from private donors, enabling MSF to allocate as it sees fit.
The reduced funding from the US worsens issues for organizations lacking a strong UN command center. And while humanitarian aid coordination is weak in Darfur, other UN bodies, like the International Office for Migration, are also missing. “With such limited presence,” Searle pointed out, “we don’t have the numbers.”
“We don’t know how many people there are,” she clarified. “We don’t have that demographic information about population movements and how many people are in each gathering point, or site for displaced people.” The war has driven millions of people to flee from their homes, compounding the disruptions created by previous conflicts.
At the beginning of April, Searle wrapped up the pilot cash program in Nyala and the next MSF team came in.
“For the next few months, we will just keep doing what we’re doing,” she said. “We will continue supporting two hospitals in Nyala and Ka [another major city in South Darfur]. We will continue all of our health care activities. Supporting women’s clinics and supporting primary health care centers.”
Detailing more of MSF’s work, Searle added: “We are also continuing to repair hand pumps, and trying to restore water supply to different parts of the city. Rehabilitating latrines, so that people can have a safe way to use the bathroom and to reduce the risk of outbreaks, like cholera.”
They also plan to continue with their work in cash transfers.
“These things are always determined by the presence and the activities of other actors,” she said. “Because if at some stage in the next few months, other actors come in and start scaling up, particularly in these areas, maybe we can focus our attention elsewhere.”
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Maria Luisa Gambale, a graduate of Harvard University, lives in New York City. In addition to writing, she produces film and media projects and is director of the 2011 film “Sarabah,” about the Senegalese rapper-activist Sister Fa. She has produced and directed video for National Geographic, ABC News, The New York Times and Fusion Network. Gambale’s work in all media can be viewed at www.veradonnafilms.com.
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