A woman turns up at the entrance of the tented cholera quarantine ward in Kassala Teaching Hospital. She has a small baby in her arms.
“Does your baby have cholera?” an anxious health worker asks. The woman says no. “Then move away from here,” he yells.
These are extreme conditions that require a stern tone. Sudan‘s eastern states, areas of relative safety in a country torn apart by war, are facing a battle of their own. A fight to combat the spread of life-threatening illness like cholera – soaring in unsanitary conditions aggravated by heavy rains, mass displacement and crumbling infrastructure.
Inside the ward, health workers move quickly to triage incoming patients. Most of them are too weak to walk or talk.
One man collapses as he tries to walk from one room to the next. He is put in a wheelchair and moved to a room a few steps from where he fell. As soon as his helpers release him, he drops down onto a hard bed. There is no strength to sit up without support.
“This is the first time the state experiences something like this. At least in recent years, there has not been a cholera outbreak like this,” Dr Ali Adam, Kassala Minister of Health, tell us in the quarantine ward.
He has granted us rare access to the facility despite the dire conditions around us.
“There is extreme pressure on the state’s services. Kassala is home to three million people – a number that has nearly doubled.”
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Despite the despairing state of the people being treated behind him, those who can make it to this ward are the fortunate ones. With rehydration therapy and monitoring, they are very likely to survive.
The latest figures from Sudan’s Federal Ministry of Health show that cholera cases are surging. On the 26 September, 15,557 cases had been reported since late July. By yesterday that had jumped to 24,116 reported cases – a 55% increase in just two-and-a-half weeks.
Cholera-related deaths in the same reporting window are also on the rise. 681 people have died – a 34% increase from 507 deaths.
Experts and frontline responders told us these figures are still likely to be a gross underestimate.
Sudan’s cholera outbreak is a growing, grim reality – fuelled by armed violence and the ongoing displacement of people to densely populated safe zones.
The country is currently experiencing the world’s worst internal displacement crisis.
“The main issue in cholera is overpopulation,” says Chiara Lodi, MSF Spain’s Sudan country director. “The movement from one state to another impacts the health system because it cannot absorb and impacts the infrastructure – the city or the village – because they do not have enough space for everyone and they are not built to have so many people.”
Movement of critical supplies and humanitarian support has also been hampered by state bureaucracy in the wartime terrain.
“If we need to intervene in 24 hours as we normally do, it is impossible because we need to follow certain procedures,” says Chiara.
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As the chaos of this conflict continues to unfold, the millions of vulnerable people impacted by the spread of deadly diseases are falling through the cracks.
“In this kind of setting everyone is focussed and worried about a certain kind of patient and then we forget that actually the population that is most impacted by what is happening is not the people that are getting blast injuries,” Chiara adds.
“It is children, mothers and elderly who have to escape and find themselves without anything in a place that is not built to cope with them and a health system that is heading to collapse.”
The Rohingya refugees didn’t escape danger though.
Right now, violence is at its worst levels in the camps since 2017 and Rohingya people face a particularly cruel new threat – they’re being forced back to fight for the same Myanmar military accused of trying to wipe out their people.
Image: A child at the refugee camp in Cox’s Bazar
Militant groups are recruiting Rohingya men in the camps, some at gunpoint, and taking them back to Myanmar to fight for a force that’s losing ground.
More on Rohingyas
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Jaker is just 19.
We’ve changed his name to protect his identity.
He says he was abducted at gunpoint last year by a group of nine men in Cox’s.
They tied his hands with rope he says and took him to the border where he was taken by boat with three other men to fight for the Myanmar military.
“It was heartbreaking,” he told me. “They targeted poor children. The children of wealthy families only avoided it by paying money.”
And he says the impact has been deadly.
“Many of our Rohingya boys, who were taken by force from the camps, were killed in battle.”
Image: Jaker speaks to Sky’s Cordelia Lynch
Image: An aerial view of the refugee camp in Cox’s Bazar
The situation in Cox’s is desperate.
People are disillusioned by poverty, violence and the plight of their own people and the civil war they ran from is getting worse.
In Rakhine, just across the border, there’s been a big shift in dynamics.
The Arakan Army (AA), an ethnic armed group has all but taken control of the state from the ruling military junta.
Both the military and the AA are accused of committing atrocities against Rohingya Muslims.
And whilst some Rohingya claim they’re being forced into the fray – dragged back to Myanmar from Bangladesh, others are willing to go.
US President Donald Trump has told Gazans to hand over Israeli hostages or “you are dead”.
The threat, made over social media, came hours after the White House confirmed that US officials had broken with tradition to hold direct talks with Hamas.
The US has previously avoided direct contact with the group owing to Washington’s longstanding position not to negotiate with terrorists – with Hamas having been designated as a terrorist group in the US since 1997.
In a press conference on Wednesday, White House press secretary Ms Keavitt said there had been “ongoing talks and discussions” between the US officials and Hamas.
Image: File pic: AP
But she would not be drawn on the substance of the talks – taking place in Doha, Qatar – between US officials and Hamas, but said Israel had been consulted.
Ms Leavitt continued: “Dialogue and talking to people around the world to do what’s in the best interest of the American people, is something that the president has proven is what he believes is a good faith, effort to do what’s right for the American people.”
There are “American lives at stake,” she added.
Adam Boehler, Mr Trump’s pick to be special envoy for hostage affairs, participated in the direct talks with Hamas.
A spokesperson for Benjamin Netanyahu’s office said Israel had “expressed to the United States its position regarding direct talks with Hamas”.
Hours later, Mr Trump warned Hamas to hand over Israeli hostages or “it’s over for you” – adding: “This is your last warning”.
Image: Hamas militants on the day of a hostage handover in Gaza in February. Pic: Reuters
On his Truth Social platform, Mr Trump wrote: “Release all of the hostages now, not later, and immediately return all of the dead bodies of the people you murdered or it is over for you.
“Only sick and twisted people keep bodies and you are sick and twisted. I am sending Israel everything it needs to finish the job, not a single Hamas member will be safe if you don’t do as I say.”
Mr Trump met with freed Israeli hostages on Wednesday, something he referenced in his social media post, before adding: “This is your last warning. For the leadership of Hamas, now is the time to leave Gaza, while you still have a chance.
“Also, to the people of Gaza, a beautiful future awaits, but not if you hold hostages. If you do, you are dead. Make a smart decision. Release the hostages now, or there will be hell to pay later.”
Israel estimates about 24 living hostages, including American citizen Edan Alexander, and the bodies of at least 35 others, are still believed to be in Gaza.
Image: Donald Trump with Benjamin Netanyahu in February. Pic: Reuters
The US has a long-held policy of not negotiating with terrorists – which it is breaking with these talks as Hamas has been designated a foreign terrorist organisation by the US government’s National Counterterrorism Center since 1997.
The discussions come as a fragile Israel-Hamas ceasefire continues to hold, but its future is uncertain.
Image: Palestinians amid the rubble in the southern Gaza strip. Pic: Reuters
Mr Trump has signalled he has no intention of pushing the Israeli prime minister away from a return to combat if Hamas does not agree to terms of a new ceasefire proposal – which, Israel says, has been drafted by US Middle East envoy Steve Witkoff.
The new plan would require Hamas to release half its remaining hostages – the group’s main bargaining chip – in exchange for a ceasefire extension and a promise to negotiate a lasting truce.
Donald Trump has admitted his tariffs on major trading partners will cause “a little disturbance” – as China said it was “ready” for “any type of war” with the US.
The US president made his comments in an address to Congress, hours after the levies on imports came into effect.
Producers in Mexico and Canada have been hit with a 25% tax on items they export to the US, while a 20% tariff has been applied to Chinese imports.
Image: Donald Trump and Chinese President Xi Jinping. The US president has admitted his tariffs will cause ‘a little disturbance’ – as China responds. Pic: Reuters/AP
Stock markets, which Mr Trump is said to pay close attention to, slid on the tariffs news.
Exporters in the affected countries as well as businesses in the US and economists have raised concerns about the potential price-raising impact of the tariffs.
Making imports more expensive will likely make goods more expensive and could push prices up across the board.
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6:35
Trump’s Congress speech unwrapped
Concern over threat to interest rates
A cycle of high inflation could lead to interest rates being higher for longer in the US, the world’s largest economy, which could dampen economic activity.
A slowed US economy would have global consequences but even without a hit to the States, there are fears of a global trade war – in which countries add their own trade barriers in the form of tariffs.
The Chinese embassy in the US posted on X: “If war is what the US wants, be it a tariff war, a trade war or any other type of war, we’re ready to fight till the end.”
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Speaking to Sky News presenter Yalda Hakim the US former deputy national security advisor Matt Pottinger said Chinese president Xi Jinping was turning the Chinese economy “into a wartime economy”
“He’s preparing his economy for war so that it can withstand the shocks of war,” he said on The World with Richard Engel and Yalda Hakim podcast
“That means he’s willing to undergo massive inefficiencies in the economy. He’s willing to stockpile food that otherwise would flow easily and more cheaply in from foreign vessels.”
“He’s stockpiling copper and all kinds of inputs into the economy. He is making sure that the private sector is wholly aligned with his broad goals, which are about increasing the Chinese Communist Party’s control over the economy and creating a bigger, better defence industrial base,” Mr Pottinger said.
“He’s preparing for war.”
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Canada’s prime minister Justin Trudeau said his country was launching its own WTO challenge and described the US tariffs as a “dumb thing to do”.
He also warned the move by the Trump administration would impact American workplaces and add to inflation in the US.
Addressing the American public, he said: “We don’t want this… but your government has chosen to do this to you.”
Canada has announced the imposition of 25% tariffs on US imports worth C$30bn (£16.3bn).
But US commerce secretary Howard Lutnick struck a different note on tariffs and on Monday said the president will “probably” announce a compromise with Canada and Mexico as early as Wednesday.