Acting humanitarian chief Joyce Msuya told the U.N. Security Council that famine has already struck Zamzam camp, about 15 kilometers (10 miles) from North Darfur’s embattled capital of El Fasher. She said a large-scale humanitarian operation is “a matter of life and death.”

Sudan plunged into conflict in mid-April 2023, when long-simmering tensions between its military and paramilitary leaders broke out in the capital Khartoum and spread to other regions including Darfur. The U.N. says over 14,000 people have been killed and 33,000 injured.

Msuya urged the council to demand that the warring government and paramilitary Rapid Support Force refrain from targeting civilians, hospitals, schools and other civilian infrastructure, and allow unimpeded delivery of humanitarian aid through all border crossings and across conflict lines.

She also called on the U.N.’s 193 member nations to pressure the parties “to agree to a humanitarian pause to save lives, give civilians respite and allow us to deliver assistance.”

Two decades ago, Darfur became synonymous with genocide and war crimes, particularly by the notorious Janjaweed Arab militias, against populations that identify as Central or East African. Up to 300,000 people were killed and 2.7 million were driven from their homes.

That legacy appears to have returned, with the International Criminal Court’s prosecutor, Karim Khan, saying in January there are grounds to believe both sides may be committing war crimes, crimes against humanity, or genocide in Darfur.

Msuya said “the world should not abide in El Fasher the atrocities we witnessed in West Darfur.”

In June, the Security Council adopted a resolution calling for “an immediate halt to the fighting and for de-escalation in and around El Fasher.”

Regrettably, Msuya said, both sides ignored the call, and fighting escalated in the past week with “constant and heavy” shelling and bombing.

“Civilians, especially women and children, have been hit (and) civilian sites and infrastructure — including hospitals and internally displaced persons’ camps — have been hit,” she said. “Of the three main hospitals in El Fasher, only one is functioning, although only partially following an attack that caused extensive damage in August.”

In August, international experts confirmed there is famine in Zamzam camp, which houses around 500,000 displaced people.

Msuya said close to 1.7 million people in North Darfur face “acute food insecurity,” adding that 13 other localities in Sudan have been identified as at risk of famine.

In February, Doctors Without Borders reported that a child was dying every two hours in Zamzam camp, she said. The latest screening by the medical aid organization and the Ministry of Health between Sept. 1 and 5 indicates the situation is getting worse.

“About 34% of the children are malnourished, including 10% who are severely malnourished,” Msuya said.

Aid deliveries have been impeded by fighting and flooding, but Msuya said that as floodwaters subside in the coming weeks, the U.N. will be able to start moving food and other assistance to El Fasher and other areas at risk of famine.

The acting undersecretary-general for humanitarian affairs stressed that to address “the atrocious humanitarian situation,” there are two keys: a de-escalation in fighting and a willingness by both sides to facilitate access to those in need.

“Be in no doubt: Without safe and predictable access and a steady supply of food and humanitarian supplies, we will see a dramatic spike in mortality — including children — in Zamzam and in other areas around El Fasher,” she said.

“The same goes for the situation across Sudan,” Msuya said, especially the capital Khartoum and neighboring Sennar and Jazeera states in southeast Sudan, which continue to be devastated “by relentless violence.”