There is no medicine for my son
In Sudan's Blue Nile state, a war that has already consumed years and countless lives has found a new center of gravity, pulling tens of thousands of civilians into displacement camps where survival itself has become the daily labor. The region's strategic position — bordering Ethiopia and South Sudan, adjacent to the army's hard-won gains in Khartoum — has made it a prize worth terrible violence, with at least 450 killed in the first quarter of 2024 alone. Families like Awatif Awad's, who walked three days through darkness to reach safety, now find themselves in camps that were never built for this scale of suffering, waiting for medicine that does not come and food that arrives once a day. What unfolds in Blue Nile may well determine not only Sudan's future, but the stability of an entire region.
- Blue Nile has transformed almost overnight from a secondary front into the war's most consequential battleground, with paramilitary forces and rebel groups fracturing control of a state that borders two nations and anchors central Sudan's power balance.
- More than 30,000 people have flooded into makeshift camps around Damazin since January, overwhelming shelters built from plastic sheeting and straw, with a single motorized rickshaw standing between the sick and the nearest hospital.
- Children are dying from untreated malaria and malnutrition while community emergency rooms that once provided basic care have been shut down without explanation, leaving aid agencies unable to keep pace with needs that multiply faster than they can be counted.
- Sudan has accused Ethiopia and the UAE of conducting drone strikes from Ethiopian territory, a charge both deny, but one that signals the very real risk of a regional war igniting around an already catastrophic humanitarian collapse.
- The rainy season is arriving, and the camps will flood — a deadline that no ceasefire, no aid convoy, and no diplomatic statement has yet moved fast enough to meet.
Awatif Awad is 38 years old, sitting in a camp in Sudan's Blue Nile state with five children and one meal a day. Her youngest has malaria. There is no medicine. She fled Kurmuk in late March, walking three days through darkness after paramilitary fighters descended on the town near the Ethiopian border. More than 11,000 others fled Kurmuk in the weeks that followed.
By early 2024, Sudan's long and devastating war had shifted east. The Rapid Support Forces, having overrun the army's last stronghold in Darfur, pushed into Blue Nile alongside the rebel SPLM-N. The state — resource-rich, wedged between Ethiopia and South Sudan, and strategically adjacent to the army's recaptured territory around Khartoum — became a central battleground almost overnight. At least 450 people were killed there between January and March, the deadliest quarter since the conflict began. Analysts noted that control of Blue Nile could determine who ultimately controls central Sudan.
When Awad reached Damazin, the state capital, she found Al-Karama 3 camp already overwhelmed. Originally built to house returning refugees from earlier regional conflicts, it and nearby sites had absorbed roughly 30,000 people since January. Local officials estimated more than 150,000 displaced across the entire state since April 2023. Shelters are improvised from plastic sheeting and straw. There is no clinic. A woman named Mahasin Abdelhamid, sharing a large tent with dozens of families, said she feared the coming rains would flood everything.
The UN warned of worsening overcrowding, poor sanitation, and rising gender-based violence, while funding gaps and access constraints crippled aid efforts. Community-run emergency rooms that had provided food and basic care were shut down last month without explanation. Meanwhile, Sudan accused Ethiopia and the UAE of launching drone strikes on Blue Nile from Ethiopian territory — a charge both governments denied, but one that raised the specter of regional escalation. Analysts warned that a wider conflict could cause the health system to collapse entirely.
Awad's son still had malaria. The medicine still had not come. And the war was still moving.
Awatif Awad sits in a sprawling camp in Sudan's Blue Nile state, watching her five children and rationing what little food arrives. One meal a day is all the camp provides. Her five-year-old son has malaria. There is no medicine for him. She is 38 years old, and she is trying to keep her family alive in a place that was never meant to hold this many people.
Three months into 2024, Sudan's war shifted geography. The fighting that had consumed the capital and the western regions moved east, into Blue Nile—a resource-rich border state wedged between Ethiopia and South Sudan. The paramilitary Rapid Support Forces, who had overrun the army's last stronghold in Darfur, pushed deeper into territory the Sudanese military was trying to hold. They came alongside the Sudan People's Liberation Movement-North, a rebel group with deep roots in the region. Control of Blue Nile became fragmented, divided between rival camps. Between January and March, at least 450 people were killed there—the deadliest quarter since 2023. A senior analyst at the Armed Conflict Location and Event Data project called it a transformation: Blue Nile had shifted from a peripheral front to a central battleground. The state's location mattered strategically. It bordered Sennar, which the army had retaken in a counteroffensive that also restored their grip on Khartoum. Whoever controlled Blue Nile could determine who controlled central Sudan.
Awad fled Kurmuk, a town near the Ethiopian border, in late March. Paramilitary fighters were descending in force. She gathered what she could carry and took her children by foot across unfamiliar terrain for three days. The nights were pitch black. They kept walking. Over 11,000 civilians fled Kurmuk in the weeks that followed, according to UN figures. When Awad reached Damazin, the state capital, she found a camp already buckling under weight. Al-Karama 3 had originally been built to house refugees returning from earlier conflicts in South Sudan and Ethiopia. Since January, it and other displacement sites in and around Damazin had absorbed roughly 30,000 people fleeing violence across Blue Nile. Local officials reported that more than 150,000 had been displaced across the entire state since April 2023, with around 100,000 sheltering in Damazin alone.
The camps are improvised and fragile. Shelters are patched together from plastic sheeting, straw, and scraps. There is no clinic nearby. Reaching the city hospital depends on the availability of a battered motorized rickshaw—the camp's only form of transport. Photographs shared by local volunteers show women gathering their children close as they queue for meager food rations and water. A 33-year-old woman named Mahasin Abdelhamid, who also fled Kurmuk and now shares a large tent with dozens of families, spoke of fear. When the rainy season began that month, she said, the place would flood and the tents would not protect them. A volunteer assisting displaced families described the reality plainly: people were suffering severe shortages of food, shelter, and healthcare. Some arrived injured, but there were no clinics to treat them.
The UN warned that conditions were worsening due to overcrowding, poor shelter and sanitation, and rising risks of gender-based violence. The humanitarian coordinator for the UN said funding gaps, insecurity, and access constraints were crippling aid efforts. Local authorities said aid agencies could not keep pace. They assessed needs based on a certain number, but when they returned the next day, the figures had increased. Community-run emergency rooms that had provided food, basic healthcare, and coordination were ordered shut last month without explanation, according to a local human rights monitor. Authorities did not respond to requests for comment.
Meanwhile, the fighting showed no sign of easing. Sudan accused Ethiopia and the United Arab Emirates of launching drone attacks since March on several states, including Blue Nile, from Ethiopian territory—a development that risked drawing the wider region into conflict. The UAE repeatedly denied accusations that it armed the RSF. Ethiopia denied hosting RSF or UAE forces. If the conflict escalated, analysts warned, vulnerable groups would be greatly affected. Health and maternity care might completely collapse. The conflict had already kept children out of school. Continued escalation would only deepen that damage. Awad's son still had malaria. There was still no medicine for him. And the war was still moving.
Citações Notáveis
Blue Nile has shifted from a peripheral front to a central battleground— Jalale Getachew Birru, Armed Conflict Location and Event Data project
We are scared of the rains. This place will flood and the tents won't protect us— Mahasin Abdelhamid, displaced from Kurmuk
A Conversa do Hearth Outra perspectiva sobre a história
Why does Blue Nile matter so much that both sides are willing to fight for it now?
It's not just geography—it's a corridor. The state borders Ethiopia and South Sudan, and it's resource-rich. More importantly, it sits between Sennar, which the army holds, and the western regions. Whoever controls it can cut supply lines or secure them. It determines who controls central Sudan.
Awatif Awad walked for three days with five children. What does that journey actually mean in the context of this war?
It means the fighting was close enough and violent enough that staying meant death. She couldn't wait for safety to come to her. She had to move through darkness with children, not knowing if she'd find shelter at the end. That's not a choice—that's desperation.
The camps were built for returning refugees, not for 30,000 new arrivals. What happens when infrastructure breaks like that?
Everything fails at once. One meal a day because there's no supply chain. No clinics because there's no space or staff. Plastic sheeting for shelter when the rains come. A single motorized rickshaw for a camp of thousands. The system wasn't designed for this scale, and it's collapsing under the weight.
Why were the community emergency rooms shut down?
The source doesn't say. No explanation was given. But it happened last month, and it removed the only local coordination and basic care that was happening. It's a gap no one is filling.
If Ethiopia and the UAE are involved with drone strikes, does this become a regional war?
That's the fear. Right now it's Sudan's internal conflict, but if external powers are actively striking from across borders, the boundaries blur. And if it escalates, the people in those camps—already at the edge—have nowhere left to go.
What does Awad's son represent in all of this?
He's the concrete cost. Not a statistic—a five-year-old with malaria and no medicine. He represents what happens when a war moves into a place unprepared to absorb it, when systems collapse faster than anyone can rebuild them.