Sudans

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.

At least 10 civilians were killed in West Kordofan and 5,500 displaced in Blue Nile as clashes widened on Tuesday.

Sudan’s military chief, Abdel Fattah al-Burhan, has promised to seize “every inch” of territory under the control of the paramilitary Rapid Support Forces (RSF), rejecting negotiations to end three and a half years of war.

Al-Burhan made the comments on Tuesday while addressing a gathering in Village 5, located in the northern Sudanese locality of Merowe, according to the Sudan News Agency.

He said the “military option” would continue until the RSF was removed from Sudan.

The Sudanese army and the RSF have been fighting since April 2023 after leaders of the groups fell out over plans to integrate the paramilitary force into Sudan’s army. The conflict has killed tens of thousands of people and displaced around 13 million, according to UN and international estimates.

Al-Burhan’s pledge to continue fighting came as 10 civilians were killed and several others were wounded in an attack by the RSF in Sudan’s West Kordofan state, according to a local charity group.

In a statement, the Dar Hamar Emergency Committee accused the RSF of multiple violations against civilians in Abu Ajal village in the southeastern countryside of En Nahud.

The RSF has been massing in West Kordofan as Sudan’s army advances towards the cities of En Nahud and Al Khuway after gains in neighbouring North Kordofan.

In Sudan’s Blue Nile state, more than 5,500 people were displaced from villages over three days amid deteriorating security, the International Organization for Migration (IOM) said on Tuesday.

Meanwhile, an envoy of US President Donald Trump said Sudanese parties must take the lead in talks to end the war.

In a post on X on Monday, Massad Boulos, the US senior adviser for Arab and African affairs, said peace could be achieved “through an inclusive Sudanese-owned and Sudanese-led national dialogue, transition toward a civilian-led government”.

The US State Department said last month that neither the Sudanese Armed Forces, the RSF, nor their respective leaders “represent legitimate, constitutional governance for Sudan”.

Fighting in Sudan’s Kordofan region has intensified since late 2025, turning it into one of the main battlegrounds in the war between the Sudanese Armed Forces (SAF) and the paramilitary Rapid Support Forces (RSF), now in its fourth year.

The vast region, which comprises North, West and South Kordofan states, lies where the two sides’ areas of control meet, between the army-held central region and the RSF-controlled Darfur in the West. In recent months, the SAF has pushed the RSF out of much of North Kordofan.

The battle is increasingly being fought from the air. Drone strikes on towns in North Kordofan are growing more frequent and deadly, and civilian infrastructure has been hit across the region.

Since the war began in April 2023, one in five recorded attacks in Sudan has taken place in Kordofan.

Al Jazeera maps where the fighting is concentrated in Kordofan and across Sudan, and the displacement that has followed.

Who controls what on the ground?

Sudan is broadly divided between the two sides. The SAF controls the capital, Khartoum, and most of the north, east and centre, while the RSF controls the west, including almost all of Darfur and parts of Kordofan. Smaller armed groups, including the RSF-allied Sudan People’s Liberation Movement-North (SPLM-N), hold pockets of territory in the south.

The army has the upper hand in the north, the RSF in the west, and South Kordofan remains contested.

Where have most attacks occurred?

According to an Al Jazeera analysis of data from the Armed Conflict Location and Event Data (ACLED), an independent conflict monitor, there were 14,648 recorded attacks between the start of the war on April 15, 2023, and September 19, 2026.

The four most affected states include:

• Khartoum: The capital region has seen the most, with 5,719 attacks, or 39 percent of the total, almost three times as many as North Darfur, the second-highest
• North Darfur has witnessed 1,999 attacks (13.7 percent)
• Gezira state has seen 1,435 attacks (9.8 percent)
• Kordofan emerged as a major centre for fighting. North, South and West Kordofan together recorded 2,876 attacks, or about 19.7 percent of all recorded attacks, putting the region behind only Khartoum when considered collectively.

Who has carried out the most attacks?

The SAF is associated with the largest share of recorded attacks between April 15, 2023 and September 19, 2026, accounting for just over half (52 percent), compared with just over a third (34.7 percent) for the RSF and 13.3 percent for other actors.

The balance of attacks has shifted over time. The SAF was associated with more recorded attacks than the RSF in the first year and a half of the war, before the RSF overtook it in number of attacks from late 2024 to mid-2025.

Since August 2025, the two sides’ monthly attack counts have been closer, with the SAF generally recording slightly more, even as the overall number of attacks has fallen sharply.

Where have attacks in Kordofan occurred?

After the fall of el-Fasher, the last major Darfur city held by the army and its allies, in October 2025, attention shifted to Kordofan. The region sits between RSF-held Darfur and the army-held centre, north and east, forming a corridor between the two sides’ heartlands.

Kordofan’s three states recorded 2,717 attacks: North Kordofan had 1,205 (44 percent), South Kordofan 789 and West Kordofan 723. Adding Abyei, a disputed oil-rich area on the Sudan-South Sudan border that was historically part of Kordofan, brings the total to 2,878.

The concentration of attacks differs from state to state. In North Kordofan, Sheikan locality alone accounted for 497 attacks, or 41 percent of the state’s total. Sheikan is home to the state capital, el-Obeid, a commercial and administrative hub linking central Sudan with the west. Taking the city would open a route east towards Khartoum for the RSF.

On September 9, a drone strike on a college in el-Obeid tore the roof off the building and killed a security guard, the college’s dean, Abdel Aziz al-Sheikh, told Reuters.

“As you can see, the entire faculty is destroyed and we feel that our dreams are destroyed, ⁠our future is destroyed,” Omnia Aboul Gassim, a student who had sat her exams at the el-Obeid college just one day before the attack, told Reuters.

In South Kordofan, Dilling locality was the main hotspot, with 242 attacks (31 percent), followed by Kadugli with 107 (14 percent) and Al Quoz with 94 (12 percent).

Attacks in West Kordofan were spread more evenly across localities. Babnusa recorded the most, with 142, followed by En Nuhud (119), Al Khiwai (112) and Abu Zabad (111).

ACLED has recorded at least 12,314 reported fatalities in Kordofan since April 2023.

The SAF was associated with 1,323 attacks (46 percent) across all three states in Kordofan, compared with 920 (32 percent) for the RSF and 633 (22 percent) for other actors.

How many people are displaced?

About 8.6 million people remain internally displaced across Sudan, according to the latest United Nations figures, down from a peak of 11.6 million in January 2025 as millions returned home to areas retaken by the army. New displacement continues in Kordofan, Darfur and Blue Nile.

Darfur hosts the largest concentrations of internally displaced people (IDPs), particularly South and North Darfur.

Returns have steadily increased since 2025, reaching about 5.1 million by August 2026. Khartoum has seen a major return of displaced people, with about 2.7 million returnees.

Despite the decline, millions remain displaced more than three years into the war. The International Organization for Migration (IOM) says the number of people newly displaced in Kordofan since fighting escalated in October 2025 has risen 65 percent in four months, from more than 132,000 in February to at least 219,000 by late June.

The agency has warned that el-Obeid, which shelters about 500,000 people, including more than 83,000 displaced, faces a looming threat of a full-scale invasion.

“The warning signs are impossible to ignore,” said IOM Director General Amy Pope earlier this month. “Across Sudan, families are fleeing violence, losing access to water, electricity and healthcare, and now facing the added burden of destructive floods.”