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.”
Advertisement
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.
Spreaker
This content is provided by Spreaker, which may be using cookies and other technologies.
To show you this content, we need your permission to use cookies.
You can use the buttons below to amend your preferences to enable Spreaker cookies or to allow those cookies just once.
You can change your settings at any time via the Privacy Options.
Unfortunately we have been unable to verify if you have consented to Spreaker cookies.
To view this content you can use the button below to allow Spreaker cookies for this session only.
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.”
A large-scale Russian attack through the night into Sunday injured at least 11 in Kyiv and killed three people in towns surrounding the capital.
There were attacks elsewhere as well, including drone strikes in Mykolaiv, where a residential building was hit.
Image: An apartment building destroyed after a Russian attack in Mykolaiv. Pic: State Emergency Service of Ukraine
‘Massive’ attack
In Kyiv, the city’s administration warned “the night will be difficult”, as people were urged to remain in shelters.
The city’s mayor Vitaliy Klitschko described it as a “massive” attack.
He said: “Explosions in the city. Air defence forces are working. The capital is under attack by enemy UAVs. Do not neglect your safety! Stay in shelters!”
It came after at least 15 people were injured in attacks the night prior.
Russia claimed it also faced a Ukrainian drone attack on Sunday, and that it intercepted and destroyed around 100 of them near Moscow and across Russia’s central and southern regions.
Image: A municipality worker cleans up after a Russian drone strike on Kyiv. Pic: Reuters
Russia ‘dragging out the war’
Meanwhile, Russia and Ukraine continued a prisoner exchange, marking a rare moment of cooperation in the war.
Amid the most recent attacks, Ukrainian President Volodymyr Zelenskyy repeated his calls for sanctions on Russia.
Russia “fills each day with horror and murder” and is “simply dragging out the war”, he said.
Image: A resident looks at an apartment building that was damaged in a Russian drone strike. Pic: Reuters
“All of this demands a response – a strong response from the United States, from Europe, and from everyone in the world who wants this war to end,” Mr Zelenskyy added.
Every day “gives new grounds for sanctions against Russia”, he said, and each day without pressure proves the “war will continue”.
Ukraine, meanwhile, is ready for “any form of diplomacy that delivers real results”.
Nine of a doctor’s 10 children have been killed in an Israeli missile strike on their home in Gaza, which also left her surviving son badly injured and her husband in a critical condition.
Warning: This article contains details of child deaths
Alaa Al Najjar, a paediatrician at Al Tahrir Clinic in the Nasser Medical Complex, was at work during the attack on her home, south of the city of Khan Younis in southern Gaza, on Friday.
Graphic footage shared by the Hamas-run Palestinian Civil Defence shows the bodies of at least seven small children being pulled from the rubble.
Rescuers can be seen battling fires and searching through a collapsed building, shouting out when they locate a body, before bringing the children out one by one and wrapping their remains in body bags.
In the footage, Dr Al Najjar’s husband, Hamdi Al Najjar, who is also a doctor, is put on to a stretcher and then carried to an ambulance.
The oldest of their children was only 12 years old, according to Dr Muneer Alboursh, the director general of Gaza’s health ministry, which is run by Hamas.
Image: Nine children were killed in the strike. Pic: Palestinian Civil Defence
“This is the reality our medical staff in Gaza endure. Words fall short in describing the pain,” he wrote in a social media post.
“In Gaza, it is not only healthcare workers who are targeted – Israel’s aggression goes further, wiping out entire families.”
Image: Pic: Palestinian Civil Defence
British doctors describe ‘horrific’ and ‘unimaginable’ attack
Two British doctors working at Nasser Hospital described the attack as “horrific” and “unimaginable” for Dr Al Najjar.
Speaking in a video diary on Friday night, Dr Graeme Groom said his last patient of the day was Dr Al Najjar’s 11-year-old son, who was badly injured and “seemed much younger as we lifted him on to the operating table”.
Image: Hamdi Al Najjar, Dr Al Najjar’s husband who is also a doctor, was taken to hospital. Pic: Palestinian Civil Defence
The strike “may or may not have been aimed at his father”, Dr Groom said, adding that the man had been left “very badly injured”.
Dr Victoria Rose said the family “lived opposite a petrol station, so I don’t know whether the bomb set off some massive fire”.
Image: Pic: Palestinian Civil Defence
‘No political or military connections’
Dr Groom added: “It is unimaginable for that poor woman, both of them are doctors here.
“The father was a physician at Nasser Hospital. He had no political and no military connections. He doesn’t seem to be prominent on social media, and yet his poor wife is the only uninjured one, who has the prospect of losing her husband.”
Please use Chrome browser for a more accessible video player
2:21
Nineteen of Gaza’s hospitals remain operational, all of them are overwhelmed with the number of patients and a lack of supplies
He said it was “a particularly sad day”, while Dr Rose added: “That is life in Gaza. That is the way it goes in Gaza.”
Sky News has approached the Israeli Defence Forces for comment.
Israel’s war against Hamas in Gaza began when the militant group stormed across the border into Israel on 7 October 2023, killing some 1,200 people, most of them civilians, and abducting 251 others.
Israel’s military response has flattened large areas of Gaza and killed more than 53,000 Palestinians, mostly women and children, according to Gaza’s Hamas-run health ministry, which does not differentiate between civilians and combatants in its count.
The head of the UN has said Israel has only authorised for Gaza what amounts to a “teaspoon” of aid after at least 60 people died in overnight airstrikes.
UN secretary general Antonio Guterres said on Friday the supplies approved so far “amounts to a teaspoon of aid when a flood of assistance is required,” adding “the needs are massive and the obstacles are staggering”.
He warned that more people will die unless there is “rapid, reliable, safe and sustained aid access”.
Image: A woman at the site of an Israeli strike in Jabalia, northern Gaza. Pic: Reuters
Please use Chrome browser for a more accessible video player
1:44
Gaza: ‘Loads of children with huge burns’
Israel says around 300 aid trucks have been allowed through since it lifted an 11-week blockade on Monday, but according to Mr Guterres, only about a third have been transported to warehouses within Gaza due to insecurity.
The IDF said 107 vehicles carrying flour, food, medical equipment and drugs were allowed through on Thursday.
Many of Gaza’s two million residents are at high risk of famine, experts have warned.
Meanwhile, at least 60 people have been killed by Israeli airstrikes across Gaza overnight.
More on Gaza
Related Topics:
Ten people died in the southern city of Khan Younis, and deaths were also reported in the central town of Deir al-Balah and the Jabaliya refugee camp in the north, according to the Nasser, Al-Aqsa and Al-Ahli hospitals where the bodies were brought.
Image: A body is carried out of rubble after an Israeli strike in Jabalia, northern Gaza. Pic: Reuters
Please use Chrome browser for a more accessible video player
3:08
‘Almost everyone depends on aid’ in Gaza
The latest strikes came a day after two Israeli embassy workers were killed in Washington.
The suspect, named as 31-year-old Elias Rodriguez from Chicago, Illinois, told police he “did it for Gaza”.
Israeli Prime Minister Benjamin Netanyahu accused Sir Keir Starmer, Emmanuel Macron and Mark Carney of fuelling antisemitism following the shootings.
Mr Netanyahu also accused Sir Keir, Mr Macron and Mr Carney of siding with “mass murderers, rapists, baby killers and kidnappers”.
Image: Palestinians search for casualties in Jabalia, northern Gaza. Pic: Reuters
But UK government minister Luke Pollard told Sky News on Friday morning he “doesn’t recognise” Mr Netanyahu’s accusation.
Earlier this week, Mr Netanyahu said he was recalling negotiators from the Qatari capital, Doha, after a week of ceasefire talks failed to bring results. A working team will remain.
The war in Gaza began when Hamas-led militants attacked southern Israel on 7 October 2023, killing some 1,200 people, mostly civilians, and kidnapping 251 others.
Follow The World
Listen to The World with Richard Engel and Yalda Hakim every Wednesday
The militants are still holding 58 captives, around a third of whom are believed to be alive, after most of the rest were returned in ceasefire agreements or other deals.
Israel’s offensive, which has destroyed large swaths of Gaza, has killed more than 53,000 Palestinians, mostly women and children, according to Gaza’s Hamas-run health ministry.