Since early 2003, the Darfur conflict has cost thousands of lives and forced millions to flee while government-backed militias have carried out a campaign of terror against civilians. When the government of Sudan and the southern Sudan People's Liberation Army (SPLA) signed a peace agreement in January 2005. Africa's longest-running civil war officially came to an end. But hope - as well as media attention - was short-lived. One year later, those most affected by the twenty-year conflict have yet to witness any real improvement in their abysmal living conditions. Recurrent medical emergencies, sporadic fighting, and a potential massive return of people to areas with little or no access to care means that many people will depend on humanitarian aid for some time to come.

MSF has been running projects in Darfur since early 2004 and today, with 123 international and 2,233 national staff working across the three provinces, it is one of their most significant operations in the world.

For MSF, the challenge is to continue to provide medical assistance to people with on-going major needs, to remain responsive in the event of new emergencies and, despite the insecurity, to provide high-quality assistance.

A malnourished child in an intensive care unit at an MSF primary health centre in Akeum, Bahr El Ghazal, Southern Sudan.

MSF medical teams in 26 locations in Darfur conduct medical consultations, treat victims of violence, care for severely and moderately malnourished children, improve water and sanitation conditions, and provide blanket feeding and other essential items for more than 700,000 displaced people in Darfur. MSF works in hospitals, health centres, and mobile clinics to bring basic health care to those who most need it. The near-total lack of infrastructure means that even basic health care is beyond the reach of most, leading to a heavy burden from vaccine-preventable diseases like measles and treatable endemic diseases like malaria and tuberculosis.

Since the beginning of its operations, MSF has born witness to the extent and the nature of the violence against people in Darfur and its impact on the health and nutritional status of the population.

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