Sudan war

Sudan accuses Ethiopia of aiding RSF attacks, while Ethiopia claims Sudan backs Tigray rebels.

Ethiopia has ordered six Sudanese diplomats to leave the country within 48 hours and closed Sudan’s consulate in the border town of Asosa, according to Ethiopian and Sudanese officials.

The orders on Tuesday came as tensions between the countries rise, with Sudan accusing the Rapid Support Forces (RSF) paramilitary group of using Ethiopian territory to launch drone attacks on civilian infrastructure. Ethiopia claims Sudan backs rebels in its northern Tigray region.

On Sunday, ⁠Sudan lodged a complaint against Ethiopia with both the United Nations Security Council and the African Union’s Peace and Security Council, accusing Ethiopia of allowing the RSF to use its territory to launch deadly drone attacks against civilian infrastructure in Sudan.

“The Sudanese government remains committed to its right to defend its territory. Nevertheless, it is making ⁠every possible effort to avoid an open war with Ethiopia,” Amjad Farid, political and foreign affairs adviser for Sudan’s Transitional Sovereign Council, said.

A direct military confrontation with Addis Ababa would severely strain an already exhausted Sudanese military apparatus, which is still involved in intense battles with the RSF in the southeast of the country.

Sudan’s military has repeatedly accused Ethiopia of aiding the RSF, which it has been fighting in a civil war since April 2023. Addis Ababa denies it supports the RSF in Sudan’s civil war.

Meanwhile, Ethiopia has accused the Sudanese military of backing rebels linked to the Tigray People’s Liberation Front, a charge Khartoum denied.

Severing diplomatic ties

Ethiopia also accused Egypt and Eritrea of supporting the Tigrayan rebels who launched an offensive ⁠against government forces in September. All three countries have rejected the accusations.

The latest expulsions of Sudanese diplomats follow Ethiopia’s decision to expel 10 Eritrean diplomats and close its embassy in Eritrea on October 1. Eritrea responded by severing diplomatic ties.

Ethiopia also expelled an Egyptian diplomat last month. For Egypt, its dispute with Ethiopia over the Grand Ethiopian Renaissance Dam remains a major strategic concern that has long strained relations between the neighbours.

In a small house in Omdurman, Hassan Saber Jumaa, a senior administrator at the Zamzam displacement camp in Sudan, sat on a simple wooden chair. He scrolled through his phone, looking for any photograph he might have of Zamzam, which is near el-Fasher, the capital of North Darfur, and once sheltered hundreds of thousands.

He found nothing. Jumaa explained that his old phone was looted during last year’s attack by Sudan’s Rapid Support Forces on the camp. Pointing to the bare walls around him, Jumaa said that all he has left are his memories of the camp, and the people who once called it home.

Zamzam, established in 2004, was home to generations of people displaced by western Sudan’s Darfur war, which began in 2003 and continued for nearly two decades. Alongside Abu Shouk camp and al-Salam camp, Zamzam formed part of one of Darfur’s largest concentrations of displaced people.

Jumaa recalled a bustling community, with its market open every day, and children walking to school.

Zamzam memories

Zamzam continued as a refuge for civilians until Sudan’s current war, which began in 2023. The RSF, fighting the Sudanese Armed Forces and its allies, captured the camp in April 2025, after months of attacks. Famine had been confirmed in the camp in August 2024.

Mukhtar Musa, a survivor of the assault, watched the community he knew descend into starvation and violence. He said restrictions on the movement of goods had exhausted food supplies, leaving some residents with little choice but to eat animal feed and peanut shells.

Umm Kulthum Ali Saleh described the months before the final attack as the hardest of her life. The RSF siege on Zamzam stopped goods from entering. She searched for food every morning, and recalled seeing women cooking grass and mixing mud with flour to bake bread.

Saleh believes the blockade was not merely a military measure, but a deliberate way to weaken the camp’s residents in advance of the final offensive, and Zamzam’s fall.

Brutal military offensive

On April 11, the RSF launched a three-day assault using cars, camels, and horses, burning straw homes and health facilities.

A United Nations Human Rights Office report documented at least 1,013 civilians killed, including 319 who were summarily executed in homes, markets, schools, clinics, and mosques. The report documented other abuses, including rape, gang rape, sexual slavery, and other forms of sexual violence, particularly targeting the Zaghawa community.

Musa was a witness to some of those mass killings, and said he saw RSF fighters kill civilians while chanting religious slogans. He described seeing bodies scattered around the main market and near schools, and said fighters continued pursuing civilians along roads leading out of the camp.

Saleh also recalled seeing bodies littering the roads, with only chickens, donkeys, and sheep wandering among the abandoned buildings.

The attack forced tens of thousands to flee Zamzam, with many remaining in the el-Fasher area, and others fleeing south to Tawila and Dar al-Salam.

The violence continued to engulf el-Fasher and its surrounding displacement camps over the following months.

With Zamzam under its control, the RSF launched an attack on el-Fasher in August 2025, and soon captured the Abu Shouk camp.

The UN Human Rights Office said at least 40 displaced people were killed inside Abu Shouk, while 19 others were injured. The International Organization for Migration reported that at least 500 residents fled the camp that day.

The RSF captured el-Fasher itself on October 26, 2025. More than 6,000 people are believed to have been killed in the attack, in el-Fasher as well as on escape routes out of the city. The UN found that RSF fighters targeted civilians, including members of non-Arab communities, and committed acts amounting to war crimes.

The RSF has previously denied targeting civilians in Zamzam and el-Fasher, while acknowledging that some fighters committed abuses.

The survivors of Zamzam, al-Shouk, and el-Fasher focus on bearing witness to the tragedy they faced.

Jumaa said the destruction of Zamzam marked not the end of the violence, but the beginning of another wave of displacement.

For him, the camp survives in the memories of those who once lived there – even as they are now displaced elsewhere.

Musa, meanwhile, said he cannot forget the first days of the siege, and the bodies he saw on the streets.

“Whoever survives must tell the story of what happened,” Musa said.

Attacks the latest to disrupt electricity supplies; army reports new defections from paramilitary RSF.

Drone strikes are reported to have hit three electricity substations in eastern and northern Sudan, the latest attacks in a concentrated campaign.

The attacks on Monday, which caused widespread power outages across parts of the country, brought the number of strikes reported to target Sudan’s electricity network to 18 over the past week.

Sudan’s military government has claimed that Ethiopia is aiding the paramilitary Rapid Support Forces (RSF) – which it has been fighting since April 2023 – in carrying out the attacks.

Facilities in New Halfa and Aroma in eastern Kassala state were hit early on Monday, while the al-Ghazali substation in Sudan’s Northern State was also targeted, according to local media.

Videos circulating on social media appeared to show fires at the facilities, with civil defence teams trying to extinguish the fires. Al Jazeera was not able to immediately verify the footage and reports.

On Sunday, Sudan’s government said it had filed complaints against Ethiopia with the United Nations Security Council and the African Union’s Peace and Security Council, accusing Addis Ababa of involvement in the ongoing campaign of attacks on civilian infrastructure and power stations.

The Sudanese army also reported on Monday that a group of RSF members had defected by surrendering to its forces in Damazin, the capital of southeastern Blue Nile state.

The announcement follows a declaration, in video footage obtained exclusively by Al Jazeera, by senior RSF commander Siddiq Ander that he had defected.

In a statement, the army said that the development was the latest in increasing defections from the paramilitary group in Blue Nile state.

It added that the group’s commander had provided information concerning the management of military operations in Damazin, including “Ethiopian support” for the RSF.

Port Sudan, Sudan – Awad Haroun, 45, a visual artist and theatre director, fled his home in Al-Halfaya, Khartoum North, after war destroyed a life he had worked hard to build in the capital.

He moved to Port Sudan with his wife and son, leaving behind his home, artistic workspace and the tools he needed to work, shortly after fighting erupted between the Sudanese Armed Forces (SAF) and Rapid Support Forces (RSF) paramilitary in April 2023.

When he fled, he carried little: Two shirts, two pairs of trousers, two books and a few torn drawing papers, expecting to return soon. Instead, he has been forced to rebuild his life far from home.

He lost not only his home but also the tools and materials he relied on to work and make a living.

In Port Sudan, he looked to use his skills in sculpture, design and decoration for some money. He has since participated in theatrical performances at Wasel Festival, organised by Ahalina Cultural Group in partnership with UNESCO, and led traditional arts workshops with cultural groups.

Awad founded Ahalina cultural group in 2013 with a group of young people, using theatre, visual arts, music and puppetry to engage with young people and promote peace and social cohesion.

Drawing, storytelling, music and play have also given children opportunities to express themselves and connect with others.

“Losing my tools does not mean I have lost my skills, and losing my workspace does not mean I have lost my ability to create,” Awad told Al Jazeera.

Awad and other displaced artists found shelter at an old school in Port Sudan, where they helped clean and prepare the building for families forced from their homes.

“Now, concerns about the possibility of eviction have left us uncertain about where we will go next,” he said.

While art cannot replace a lost home or end the war, Awad believes it can preserve memories, bring communities together and offer children space to play and express themselves.

“From the ashes, we will rise” is the motto of Ahalina cultural group. This is more than a slogan for Awad; it is a reminder to keep creating, despite everything the war has taken from him.

The war has taken a heavy toll on Sudan’s cultural life, damaging heritage sites and disrupting the livelihoods of artists across the country.

In June 2026, UNESCO estimated that Sudan’s cultural sector faced a $30m funding gap. But behind this figure are deeply personal losses: Artists killed by the war or forced to leave behind studios, galleries, artworks and the tools they need to create.

In April 2024, UNESCO reported that the Artists and Writers Union in Port Sudan had provided shelter to more than 112 displaced artists and other cultural professionals.

The challenges remain significant, but cultural initiatives have continued. In April 2026, UNESCO said its initiatives in Port Sudan had benefitted more than 350 artists, women, girls and internally displaced cultural professionals, supporting efforts to sustain Sudan’s cultural life amid the conflict.

Asim Abdelaziz, 31, a musician and filmmaker, left El Obeid, the capital of North Kordofan state, amid escalating fighting and repeated drone attacks. He arrived in Port Sudan in November 2023, hoping to find safety and work.

Separated from his family, who are scattered between Omdurman and El Obeid, Asim lives alone in a shelter for displaced artists. The war has uprooted his life and disrupted his career, but he continues to use music to preserve Sudan’s cultural heritage and bring communities together.

In Port Sudan, he has worked with the local Artists and Writers Union, UNESCO and community organisations.  He has also collaborated with the Ministry of Culture and Information and other artists on music programmes to address social issues, including hate speech and racism.

Asim said the war has spurred hate speech and deepened divisions between Sudan’s different communities. He believes art can counter these differences by promoting diversity, mutual acceptance and peaceful coexistence.

“I have seen firsthand how hate speech affects people’s lives,” Asim told Al Jazeera. “Through music, I try to remind Sudanese people that we are all brothers and sisters, and that war does not represent who we are.”

Mokhalaya, a project he founded to document and archive traditional music and rhythms from across the country a year ago, is one avenue for this.

“I hope to take the project to international festivals, introducing audiences abroad to [showcase] Sudan’s rich musical traditions and cultural diversity,” he said.

Preserving heritage is not just about safeguarding the past, but also about keeping Sudan’s cultural identity alive during a war that has displaced communities and disrupted lives, he said.

Abdelqader Hashem, secretary of the Red Sea State Writers and Artists Union, told Al Jazeera the union has supported artists and their families who fled fighting in other parts of Sudan since the war began on April 15, 2023.

“We worked to establish a shelter for displaced artists in a school in Port Sudan and sought support from local and international organisations to provide for their basic needs,” he said.

Beyond providing shelter, the union has helped displaced artists take part in the city’s cultural activities, contributing to community awareness programmes that address important societal issues such as the dangers of drug use, a growing concern in Sudan.

“We have also implemented projects in partnership with UNESCO to train children in displacement camps in handicrafts, including concrete crafts,” Hashem said.

“Most of the displaced artists have since returned to their homes in Khartoum following the Sudanese army’s recapture of the capital.”

EXCLUSIVE

Siddiq Ander has accused RSF leader Hemedti of running the paramilitary group like a family business and suppressing dissent.

Senior commander Siddiq Ander says he has defected from Sudan‘s paramilitary Rapid Support Forces (RSF), according to exclusive video footage obtained by Al Jazeera.

The footage, published on Friday, shows Ander accusing relatives of RSF leader Mohamed Hamdan Dagalo, known as “Hemedti”, of tightly controlling the group’s finances, weapons, troop movements and military promotions.

Ander’s exit follows a string of high-profile defections this year, with some commanders leaving alongside hundreds of fighters.

“It has become clear to us beyond any doubt that we were serving a purely family-based project controlled by Hemedti’s relatives in every aspect, money, weapons, fighters’ movements and the granting of ranks,” Ander said.

“Anyone who speaks out and tells the whole truth faces expulsion, imprisonment or a hidden death.”

Hemedti’s brother, Abdul Rahim Hamdan Dagalo, serves as the RSF deputy commander.

Senior commanders break ranks

A wave of defections has seen several senior RSF commanders leave the group this year, including Lieutenant Colonel Mohammed Azraq al-Fanjari, who announced on October 8 that he was leaving, along with 300 officers and soldiers and 30 military vehicles.

Al-Fanjari also urged other fighters to abandon the RSF, expressing regret over the suffering caused by the war.

His announcement came after the September 25 defection of Al-Tayeb al-Wahidu, who joined the enemy Sudanese Armed Forces (SAF) with 50 fighters in Omdurman, across the Nile from the capital, Khartoum, according to The Sudan Tribune.

Al-Wahidu cited abuses within the RSF as his reason for leaving.

Earlier, in May, Brigadier Ali Rizqallah, known as Savannah, announced his departure.

Yet another senior commander, Major General al-Nour Ahmed Adam, known as al-Qubba, joined the SAF in April and was publicly welcomed by Sudanese leader and military chief Abdel Fattah al-Burhan.

Al-Qubba’s departure followed disagreements over military appointments within the RSF leadership, the Tribune reported.

Sudan’s war erupted in April 2023 after a power struggle between the army and the RSF, including disagreements over plans to integrate the paramilitary group into the regular military.

The conflict has since displaced about 13 million people and pushed parts of the country into famine.

The latest defections come as both sides increasingly use drones in attacks that have caused mounting civilian casualties.

On October 26, strikes hit a market and residential area in Nyala, an RSF-controlled city in South Darfur.

Emergency Lawyers, a Sudanese rights group, reported more than 100 deaths, although other medical organisations recorded lower figures.

The United Nations says drone strikes have become the leading cause of civilian deaths in Sudan’s war.

Khartoum, Sudan – Rasha Abdelaziz Musa works every day for seven hours selling tea. But by the time she finishes for the day at 10pm, she’s still unsure if she has enough to feed her four children.

Musa, 39, is doing her best, but her earnings are increasingly no longer enough to cover soaring food prices in the Sudanese capital.

Her husband, a member of the Sudanese military, has spent more than eight months on the front lines of the country’s war, in which the military has been fighting the paramilitary Rapid Support Forces since 2023. Musa has not heard from him for months, and he has sent no money.

In his absence, Musa has been left to provide for their children, who attend kindergarten, primary and secondary school.

Musa told Al Jazeera that feeding her family costs about 40,000 Sudanese pounds per day ($4 at the parallel-market exchange rate) before accounting for rent, household essentials and other expenses.

Some of the family staples are ful medames, a dish of stewed fava beans, or lentils. When lentils are too expensive, Musa serves taamiya, or falafel, sandwiches.

Prices regularly change, and Musa often ends the day in debt to the traders she gets her food from.

Large families struggle

Musa is not alone in struggling to cover her family’s daily expenses.

Ahmed Youssef, 61, supports a family of 12 through his work in a butcher’s shop and as an occasional intermediary in livestock sales. He can earn 90,000 to 140,000 pounds ($9 to $14) when a deal succeeds, but that income is irregular.

He told Al Jazeera that his household spends more than 100,000 Sudanese pounds ($10) daily and his income is no longer enough to support the family.

“One income is no longer enough to cover the family’s needs, and sometimes my older children have to work to help meet expenses,” Youssef told Al Jazeera.

Ali Fadil supports a family of 10. Without a permanent job, he goes to the market each morning to look for work. Some days, the 57-year-old earns enough to buy food, but on other days, he finds no work at all. And yet his daily expenses still reach about 70,000 pounds ($7), with rising prices adding to the financial pressure he faces.

“Sometimes I skip meals so I can pay for school fees or medical costs,” he said. “I also borrow money to meet other obligations.”

Food prices rise as Sudanese pound weakens

A survey of four local markets in the Khartoum State area by Al Jazeera last week found that prices for several essential foods had risen sharply within days, making it increasingly difficult for families to plan their spending.

A kilogramme (2.2.lb) of sugar cost about 10,000 pounds ($1), up from 9,000 pounds ($0.90) two days earlier. A litre (1 quart) of cooking oil rose to 25,000 pounds ($2.50) from 20,000 pounds ($2) while a loaf of bread costs 500 pounds ($0.05), compared with 300 pounds ($0.03) a week earlier.

Lentils cost about 10,000 pounds ($1) per kilogramme, up from 8,000 pounds ($0.80), and rice was priced at 13,000 pounds ($1.30) per kilogramme, up from 10,000 pounds ($1). Powdered milk reached 70,000 pounds ($7) per kilogramme, up from 60,000 ($6) two days earlier.

The Sudanese pound has also continued to weaken. According to exchange rates monitored by Al Jazeera, $1 was trading at 10,050 Sudanese pounds on the parallel market on Friday, compared with 9,500 the previous day.

Food inflation adds to pressure on households

Official figures offer further evidence of the rising cost of living, particularly in Khartoum and other urban areas.

According to Sudan’s Central Bureau of Statistics, prices across the country were 28 percent higher in September than a year earlier, up from 26 percent in August. Prices rose by 7.5 percent in September alone, more than double the increase recorded the previous month.

Food prices have risen even faster. Across Sudan, food and beverages cost nearly 37 percent more in September than a year earlier, up from an annual increase of about 21 percent in August. In September alone, food prices jumped by more than 17 percent.

The situation was particularly severe in Khartoum State, where prices were nearly 60 percent higher than a year earlier. Prices rose by more than 15 percent in September alone, following an increase of nearly 9 percent in August.

That sharp increase comes as the capital region struggles to recover from widespread destruction caused by the war. Although displaced residents have begun returning and businesses are gradually reopening since the military recaptured the state from the RSF last year, damaged infrastructure and rising transport costs continue to constrain the availability of goods.

The return of residents has also increased demand for essential supplies, further driving up prices. In September, fuel shortages hit the capital as consumption rose faster than supplies could be replenished.

Urban areas have generally been hit harder than rural communities. Food prices in towns and cities were 55 percent higher than a year earlier, up from about 40 percent in August. Overall, prices in urban areas rose by 40 percent over the past year, compared with about 21 percent in rural areas.

The war is the main driver of these increases, disrupting livelihoods and supply chains. According to the World Bank, Sudan’s economy shrank by an estimated 29 percent in 2023 and a further 14 percent in 2024 as the war devastated businesses, disrupted agricultural production and eliminated jobs.

The conflict has also forced millions of people from their homes with nearly 8.9 million people still internally displaced as of April, according to the International Organization for Migration.

War destroys livelihoods

Journalist and economic affairs specialist Khalid Teks said Sudan’s economic deterioration began long before the war. Falling oil production after South Sudan’s secession in 2011 worsened conditions as did the depreciation of the pound, cash shortages, international isolation, political conflict and corruption in the years preceding the removal of President Omar al-Bashir in 2019.

Teks said political instability during the power transition undermined Sudan’s economic performance, and deep reforms were not implemented before war broke out in 2023. The conflict devastated infrastructure and productive sectors, depleted savings and disrupted economic activity. The climate has also been a factor. Strong agricultural production in 2024 was followed by concern over limited rainfall this year and possible food shortages after the harvest begins in November.

Teks told Al Jazeera that families increasingly deplete their savings and sell their possessions to cover everyday expenses.

He also pointed to disruptions to remittance channels, which many Sudanese households rely on for financial support.

Teks called for easier humanitarian access, an end to the war, direct support for vulnerable households and low-interest loans for small businesses and craft enterprises.

“The government needs to provide direct support through dedicated funds and the Zakat Chamber, facilitate humanitarian organisations and offer affordable loans for small businesses and vocational activities,” Teks said. “This could help reopen markets and workshops and expand microfinance.

When Altayeb Alhadi was just six years old, his father died after a well collapsed in his village in White Nile state, south-central Sudan. Two months later, and his mother also died, leaving the five children in the family as orphans. As the eldest of the siblings, it was Altayeb’s responsibility to find work and help the family survive.

At 14, he travelled hundreds of kilometres from his home in Galli village to seek work in the north, where gold mines dot the landscape, so he could feed his siblings and keep them in school.

“We warned him about the dangers, but he was ambitious. Some relatives were already working in the area although they had found jobs in restaurants and other services rather than underground extraction,” Ayateb’s uncle Alhadi Hamid told Al Jazeera.

The boy initially worked in transport and other jobs, but when he heard lucrative stories from miners in the area, he began to search for gold in the surrounding mountains.

Altayeb died in an air strike attributed to the Egyptian military at a gold-mining site near Jabal Al-Aigdat in Sudan’s Red Sea region on October 10, which killed at least 72 miners, a few months after he began working at the site.

“It was less than 30 minutes since we separated, and he said he was going to the mine. We suddenly heard a loud sound of bombardment, and we ran. It was too chaotic with people running in all directions and many attacks taking place within a few minutes,” a fellow miner told Al Jazeera, speaking on condition of anonymity.

“We found Altayeb with his hand and leg [blown off] and a severe injury to his abdomen [which] was open. We tried to help him and took him to a safer place near a mountain. We were terrified. He died within hours. … We couldn’t believe how quickly things could happen.”

Altayeb worked alongside about 15 young men and children, using basic tools to extract gold from the rocks. The miners worked night and day, taking the material they gathered to nearby mills for processing.

Proceeds from any gold found were shared, but earnings depended on the amount of gold recovered and individual agreements. On productive days, the group could earn more than $100, the miner said.

“We used to dig for two to three weeks until we found a gram or less. If the gold percentage in the well wasn’t good, we would change locations. When we found a gram or less, we sold it and shared the profit, which was about $100,” Altayeb’s former colleague said.

For young people supporting relatives, even irregular earnings in these dangerous gold mines can seem preferable to unemployment.

Altayeb told his siblings 10 days before his death that he would soon return home, his sister Rogaia Alhadi told local media.

Friends told the family that Altayeb visited them at a restaurant near the mining site on the morning of the attack, his uncle said. They shared a cup of tea before heading towards the mine for the final time. Minutes later, the air strike hit the area.

Authorities in Egypt have accused Sudanese miners of crossing its border and reportedly linked some to gold smuggling, drugs and human trafficking. The Sudanese side did not respond to these allegations.

Since a civil war between Sudan’s military and the Rapid Support Forces paramilitary group broke out in 2023, the economy has tanked and forced thousands with no other source of income to find work in the artisanal gold mines of northern Sudan.

This can vary from independent prospecting to working in investor-owned pits for a share of the proceeds. Earnings depend on the amount of gold found, equipment and fuel costs, and profit percentages agreed with financiers.

Although some miners strike gold, they still face an array of dangers, ranging from collapsing shafts and unstable ground to air strikes. Limited medical care makes mining, particularly in remote areas, especially hazardous.

Living conditions are also extremely hard. Mohamed Awadalkarim, who was a miner in River Nile state for 10 years, said workers often shelter in makeshift huts made from burlap sacks and plastic sheeting. Their diet consists mainly of lentils and sorghum porridge.

But for families without reliable incomes, mining offers a possible source of immediate earnings. Miners may spend hours searching for gold and not find enough to cover their expenses. Others share proceeds with investors or equipment owners, leaving them with limited money left.

Artisanal and small-scale mining accounted for 53.71 tonnes, or about 83 per cent, of Sudan’s declared gold production in 2024, but this was just in areas under government control, according to research by the Chatham House think tank. About one million people were involved in artisanal mining across Sudan’s 18 states, generating $1bn annually for the country.

Artisanal mines, while generally viewed as being outside the main war-funding networks, have still been exposed to violence.

On June 16, several people were reportedly killed and injured in attacks on mining sites near the Egyptian border, according to local sources and miners.

The repeated air strikes near Sudan’s border with Egypt have raised concerns about civilian protection, territorial sovereignty and accountability.

Egyptian authorities have accused Sudanese prospectors of crossing the border to mine near a concession managed by an Egyptian company, but there is little independent evidence to back these claims.

Sudanese military leader Abdel Fattah al-Burhan reportedly ordered a fact-finding committee involving prosecutors, judicial representatives and security agencies to investigate the attack. Findings from an inquiry into a similar incident announced in June have not been made public.

Altayeb paid the highest price in this regional conflict and the hunt for gold, which provides huge profits for some and meagre incomes for many.

Altayeb’s siblings are now living with their extended family, including uncles, aunts and cousins. People who know them are trying to help his brothers and sisters and are carrying out community initiatives in Galli to keep his memory alive.

“We will raise the children and care for them as he would have wanted. He was young, caring and brave, and he will always be remembered,” Altayeb said.

Hasanat al-Rashid, 48, has lived with diabetes for 15 years, and the three-and-a-half-year civil war between Sudan’s military and the Rapid Support Forces paramilitary group has worsened her situation. Finding the treatment she needs has become a daily struggle.

When the war broke out in April 2023, she was forced to flee south from her home in Haj Yousif in Khartoum North to Umm Daw Ban in Khartoum State.

During her displacement, she went for days without medication and was forced to eat foods unsuitable for her condition, such as asida, a traditional Sudanese porridge.

She underwent operations on her foot twice when she developed complications of diabetes, including a severe infection.

She moved between hospitals in Gezira State south of Khartoum, seeking treatment in Rufaa, Wad Madani and Al-Hasahisa. When fighting spread to these areas in December 2023, she fled again, arriving in Port Sudan, a city on the Red Sea that was less affected by the war.

Her condition has worsened to the point that she now has to use insulin every day and with this comes added costs, something that forces diabetes sufferers in Sudan to choose between medicine and other essentials, such as food.

“The doses vary depending on whether my blood sugar is high or low,” she told Al Jazeera.

The war has pushed income levels in Sudan back to those last seen in the 1990s, according to the United Nations Development Programme. This means Hasanat and other diabetes sufferers are struggling to afford the medicine they need to treat the condition.

Hasanat’s doctor recommended she use an insulin pen, a device used to inject insulin under the skin. She would need one or two of the devices a month, but the cost at 70,000 Sudanese pounds ($8) is more than she can afford up front, so she opts for a vial of insulin.

This is cheaper at 17,000 Sudanese pounds ($1.80), but there is the additional cost of buying ice every day to keep the insulin cool. She spends 180,000 pounds ($20) a month on ice to preserve the medicine. But she is able to spread these costs out through the month, making the vials her only viable option even if the overall costs are higher than an insulin pen.

“It may last a month or less, but the challenge is that I don’t have a refrigerator, so I struggle to store the insulin properly,” she said.

She also needs painkillers and vitamins on a regular basis to manage complications caused by the diabetes.

The rising cost of treatment

Fatima Adam, 75, is among the patients at Port Sudan Hospital struggling to afford the medicines she needs to manage her hypertension and a thyroid condition.

She was admitted to the hospital with complications caused by high blood pressure, which has started to impact her heart. Too unwell to speak to Al Jazeera herself, her daughter, Aisha, described how the rising cost of treatment has affected her whole family.

Before the war, Fatima received medicine through the National Health Insurance Fund. She paid a quarter of the cost while the fund covered the rest. But when the war started and the economy collapsed, the medicines she needed were no longer covered by the scheme.

“My mother takes six different medicines because hypertension has affected her heart in addition to her thyroid medication. The war has made things harder because the prices of these medicines have gone up,” Aisha told Al Jazeera.

The responsibility for paying for Fatima’s treatment and supporting her and her daughter falls on her son, who works as a casual worker. With no fixed income, he goes to the market every day in search of work but sometimes returns home empty without any luck.

“Sometimes, when my brother finds work, we buy enough medicine to last a month. Other times, we have to buy smaller quantities and take the medicines intermittently,” Aisha said.

She bought a month’s supply of her mother’s medication a few days ago for 160,000 Sudanese pounds ($17.80), a substantial expense for a family whose income depends on day labour but essential to treating Fatima’s condition.

War damage

The war has caused an estimated $500m in losses to medicine stocks, infrastructure and transport fleets, dealing a major blow to Sudan’s pharmaceutical supply system, the National Medical Supplies Fund told Al Jazeera.

The National Medicines and Poisons Board estimated that only eight of the 30 pharmaceutical factories in Khartoum that shut down during the conflict have resumed operations despite the security situation in the capital recently improving.

This has increased Sudan’s reliance on imported medicines, but the subsequent depreciation of the Sudanese pound has driven up the costs of pharmaceutical procurement and production.

Hossam al-Naeem, who works as a pharmacist in Port Sudan, said customers with diabetes and hypertension require regular painkillers and vitamins to help their overall condition.

“I feel deeply saddened when I see the expressions on some patients’ faces as they ask about the prices of medicines and discover how much they have increased because of the depreciation of the Sudanese pound,” Hossam told Al Jazeera.

The currency’s collapse has created added challenges for pharmacists. Before the war, a dollar traded for roughly 600 Sudanese pounds. Now black-market currency traders are quoting rates of 9,300 pounds to the dollar, meaning higher costs for most goods in Sudan.

Sometimes Hossam incurs losses himself when he finds that the prices of drugs have risen sharply, and keeping essential medicines stocked is becoming difficult.

“I used to sell a strip of cold and flu tablets for 6,000 Sudanese pounds [70 cents]. But when I went to buy new stock, I found that the supplier’s price was also 6,000 pounds per strip. That means I made no profit, not even enough to cover the pharmacy’s operating costs,” he said.

The struggle to afford heart medication

Huda Mahmoud, 58, lives in el-Obeid, the capital of North Kordofan state in south-central Sudan, where drone attacks and other violence remain a problem while the military is making advances towards the city.

Huda has lived with heart problems for more than 12 years and described the impacts of the war as being physical, financial and emotional.

“I take five different medicines. There was a time when they weren’t available, and I suffered a lot. Sometimes, I had to ask people in Wad Madani, Sennar or Port Sudan to send them to me,” she told Al Jazeera. “The medicines were extremely expensive, costing me 300,000 Sudanese pounds [$33.30] a month.”

Taking medication has become a carefully managed routine with each pill tied to a specific time of day.

“I’ve become tied to my pills: this one before eating, that one afterwards. If I forget one, my heart starts beating very fast,” she added.

In March, Huda was forced to travel from el-Obeid to Omdurman. Following her strict treatment regimen has become increasingly difficult during repeated periods of upheaval.

She has now returned home to el-Obeid, where her regular medicine is priced at 151,000 Sudanese pounds ($16.80) a month, something she can barely afford.

Her greatest fear is running out of medicine or being unable to afford her next supply, which would put her at risk of a blood clot.

“I’m afraid of becoming incapacitated. I used to be responsible for the whole household, but now I need help. I feel like I’ve become a burden on my family,” she said.