The Silent Humanitarian Crisis: Long-Term Developmental Impacts of Childhood Malnutrition in Sudan

Sudanese refugees and ethnic South Sudanese families who have fled from the war in Sudan gather after crossing the border while waiting to be registered by the authorities at the Joda Border Crossing Point, near Renk, on February 14, 2024.  Photo by Luis Tato.

***

In the heart of the largest ongoing humanitarian crisis, Sudan stands as a poignant emblem of neglect and suffering. Ravaged by decades of conflict, political instability, and economic turmoil, the Sudanese people endure unimaginable hardships on a daily basis. Amidst the chaos and strife, a silent but devastating crisis unfolds: the pervasive specter of childhood malnutrition. It is within this context of deprivation and despair that the intergenerational cycle of childhood malnutrition thrives, perpetuating a silent crisis with far-reaching developmental implications. A sustained commitment to addressing childhood malnutrition is imperative for Sudan’s long-term development agenda, and holds broader implications for global humanitarian studies and efforts toward sustainable development.

Understanding the complexities of a crisis begins with understanding the complexities of the state it breaks out in—and Sudan is nowhere short of complex. The history of Sudan is a tapestry woven with threads of socio-political upheaval, colonization, and internal conflict—all boiling down to deep-rooted issues of separation within the country. 

This division in Sudan started before it was even its own country. Colonial rule, primarily by Egypt and Britain, sowed division between the north and south, leading to the First Sudanese Civil War in 1955. Southern Sudanese, marginalized during colonialism, sought self-governance, sparking conflict over cultural and religious differences. The war claimed half a million lives and displaced hundreds of thousands. The Addis Ababa Agreement of 1972 temporarily eased tensions, but they reignited in 1983 when Sudan’s president at the time, Gaafar Nimeiry, imposed Sharia Law on the nation. The result was the Second Sudanese Civil War, which would only come to an end with the Comprehensive Peace Agreement in 2005. This agreement paved the way for South Sudan’s independence in 2011, yet political challenges persisted. During the war, a general named Omar al-Bashir executed a coup over the existing government and appointed himself head of state. His reign was characterized by widespread violence and a heavy military presence that caused extensive protests among Sudan’s population, culminating in another coup that saw the very military groups al-Bashir built up overthrowing him in 2019. 

After the ousting of al-Bashir, control of Sudan fell into the hands of Mohammed Hamdan Dagalo, known to Sudan as Hemeti, and Abdel Fattah al-Burhan. However, Hemeti, as the leader of the Rapid Support Forces (RSF), and al-Burhan, as the leader of the Sudanese Armed Forces (SAR), were complicit in illegal arms deals and the violent crackdown on protests during al-Bashir’s reign. For good reason, the people of Sudan viewed Hemeti and al-Burhan with skepticism and distrust, and ultimately continued the protests prevalent during al-Bashir’s rule. With their newfound power, the two men have had ongoing disagreements over merging the RSF and SAR, further exacerbating tensions within Sudan and resulting in further violence, civilian deaths, and unparalleled human rights abuses.

The crisis Sudan now faces at the hands of al-Burhan and Hemeti is undoubtedly one of the most intense humanitarian crises happening in the world today. Nearly 25 million people, more than half of the nation’s population, require life-saving aid. Moreover, this crisis is not confined to a single region; rather, it is inescapable and permeates every corner of the country. The pervasive violence and poverty have forced millions to flee their homes, resulting in 6.5 million internally displaced persons (IDPs), a significant proportion of whom are girls and pregnant women. Amidst the immense violence, the crisis has manifested in other ways as well. A primary example is the immense food insecurity that plagues 42% of Sudan’s population, a consequence of poor harvests, restricted access to farmland, and disrupted supply chains. As a result, food prices have soared far beyond affordable levels, pushing millions into hunger. Particularly alarming is the plight of children, with nearly four million under the age of five suffering from malnutrition, thus posing significant risks to their health and development. 

Unfortunately, children in Sudan are also being forced to face a myriad of challenges beyond hunger. Approximately 14 million children urgently need lifesaving assistance, including access to clean water and essential vaccines. However, many lack these necessities, leaving them vulnerable to diseases and preventable illnesses. Furthermore, around 19 million children—nearly 33% of Sudan’s youth population—are out of school, denying them vital education and opportunities. These children face conditions of poverty and neglect, and are also being sought out and recruited as child soldiers. Such a phenomenon only further perpetuates cycles of violence and exploitation. Compounding these issues, though, is the collapse of Sudan’s healthcare infrastructure, with 70% of facilities in conflict zones destroyed or closed as a result of multiple attacks and occupations. This has left an estimated 11 million people, most notably children, in urgent need of medical care. The fact that these people are unable to access said care further underscores the magnitude of Sudan’s humanitarian catastrophe under the leadership of Hemeti and al-Burhan.

The intergenerational cycle of childhood malnutrition is a complex phenomenon with profound implications for various aspects of development. At its core, malnutrition severely impacts cognitive development, impeding brain development and compromising learning abilities, which in turn affects academic achievement. Furthermore, malnutrition manifests physically, leading to growth stunts and muscle wasting. In combination with malnutrition, these physical manifestations can contribute to long-term health issues such as impaired immune function, increased susceptibility to chronic diseases, as well as reduced physical stamina and productivity in adulthood. Children who suffer from malnutrition may also exhibit symptoms of depression, anxiety, and social withdrawal, impacting their overall well-being and ability to form healthy relationships. Moreover, the intergenerational transmission of malnutrition perpetuates the cycle from one generation to the next, as malnourished mothers are more likely to give birth to underweight babies. As Erin Boyd, Nutrition Advisor at USAID’s Bureau for Humanitarian Assistance, aptly states, “The long-term effects of malnutrition are devastating. I have seen whole communities where children can’t play, learn, or grow because of malnutrition, and sadly the preventable cycle continues into adulthood. The missed educational opportunities and long-term health issues that result from child malnutrition are felt for generations.” 

What Boyd describes is exactly what Sudan is and will continue to face for decades: a relentless cycle of childhood malnutrition that not only stifles immediate development, but also perpetuates long-term socioeconomic disparities, emphasizing the critical need for multifaceted interventions to break this cycle and provide a healthier future for generations to come. 

It is clear, since Sudan has been plagued by humanitarian crises and suffering for decades upon decades, that the humanitarian response in Sudan has undeniably failed. International aid and humanitarian efforts, though well-intentioned, have struggled to keep pace with the overwhelming scale of Sudan’s needs. Limited resources, logistical hurdles, and bureaucratic red tape have contributed to these struggles. Local and international organizations, while possessing expertise, have grappled with navigating the volatile security landscape and accessing conflict-affected regions, leading to inefficiencies and gaps in assistance delivery. Furthermore, the failure to craft political treaties tailored to Sudan’s needs and desires, such as not removing Hementi and al-Burhan from power, have perpetuated instability and discord. 

Why have these failures occurred? While some of the reasons for this are quite clear, there are more reasons that are less obvious and arguably far more detrimental. Firstly, ongoing war and violence have rendered it unsafe and exceedingly challenging to provide life-saving interventions. Armed groups frequently target aid workers and infrastructure, impeding access to vulnerable populations and hindering the delivery of essential assistance. Political instability further exacerbates the situation, as Sudan’s complex history and deep-seated divisions make implementing solutions exceptionally difficult. Achieving lasting peace becomes almost impossible when ideological divisions remain entrenched, fueled by historical grievances and power struggles. 

However, there is one more reason that explains these failures on a much deeper level that, at first glance, goes unnoticed—but has arguably done the most in hindering effective humanitarian response: people simply do not care enough about Sudan. 

Despite being one of the largest ongoing crises, Sudan garners scant media coverage and struggles to captivate global consciousness, perpetuating a cycle of indifference and neglect. The cause of this neglect can be simplified to two main issues. First is the simple fact that the world’s attention span is notoriously short-term, and unfortunately, the crisis in Sudan has been ongoing for far too long to maintain sustained global interest. Take, for instance, the situation in Ukraine. Following the 2022 full-scale invasion, news outlets and social media platforms were flooded with support for Ukrainians, leading individuals worldwide to urge their leaders to intervene and end the crisis. However, as time passed, media coverage dwindled, and public discourse shifted to other issues. While the humanitarian crisis in Ukraine is still very much ongoing, it has largely faded from the forefront of global attention. 

Though any country being able to maintain its grasp on the world’s attention is a difficult task, it is a task made significantly harder for Sudan due to the fact that it is an African country. Humanitarian crises affecting states home to predominantly people of color tend to receive significantly less media attention, funding, and sympathy from the general public compared to crises affecting predominantly white states. 

Ukraine is once again a poignant example of this. The humanitarian system and the world alike were much quicker to act in providing aid to solve the Ukraine crisis, a conflict between two predominantly white states, and with less hesitation than it has with providing aid to solve the Palestine crisis, a conflict between one predominantly white state (Israel) and one predominantly non-white state (Palestine). The international community rallied behind Ukraine, offering financial assistance, military aid, and diplomatic support, demonstrating its swift willingness to intervene in conflicts affecting white populations. In contrast, the response to the ongoing crisis in Palestine has been marred by hesitancy and geopolitical complexities. Despite the significant humanitarian needs and widespread suffering in Palestine, which should arguably take priority, the response has been tepid and politicized, reflecting a systemic bias that prioritizes the needs and narratives of white communities over those of people of color. The disparity in attention and support underscores the racial biases that shape global perceptions and responses to humanitarian crises that hinder effective humanitarian response in regions like Sudan. 

The intergenerational cycle of malnutrition, perpetuated by systemic failures and compounded by entrenched socio-political complexities, casts a long shadow over Sudan’s developmental trajectory. Despite the best efforts of international aid and humanitarian organizations, challenges such as limited resources, logistical hurdles, and systemic biases have hindered effective response. Urgent action is needed to address childhood malnutrition in Sudan, including long-term monitoring, investment in education and social protection, and efforts to promote peace and stability. A sustained commitment to addressing childhood malnutrition is not only imperative for Sudan’s long-term development agenda, but also for advancing global efforts toward a more just, equitable, and resilient world.