Two days after the war erupted in Khartoum on April 15, 2023, we, the established Emergency Response Room (ERR) in southern Khartoum –the grassroot and community base groups/initiatives and community forms of mutual aid groups established before war to response to the crisis and pandemics– successfully reached the nearest hospital in our area. It subsequently became our central gathering point for the emergency response room to provide services. We assessed the feasibility of delivering services within the hospital, examined functioning departments and available medications, and evaluated accessible food resources to secure provisions for the neighborhoods. From the very outset of the conflict, emergency response was shaped by simultaneous shortages of food, medicine, and functioning health infrastructure—conditions that would quickly translate into preventable deaths.
As ERRs accountable to our communities through an internal system designed to provide services and focus on enhanced community engagement, we operate as a group of volunteers. The number of women and girls volunteering at the grassroots level significantly exceeds that of male volunteers. As women, we were unable to provide services requiring field presence in the early days, such as transporting injured individuals, money transfer, and data collection, due to the constant fear of being raped, abducted, and threatened. Gendered insecurity restricted women’s mobility at precisely the moment when access to food, medicine, and emergency care was most urgent.
At that time, there was no women’s office or identified resources dedicated to women’s needs, as everyone remained in shock and had not yet fully processed that war had actually commenced. Approximately two weeks after the war began in the capital, two women arrived at the hospital, both in active labor. However, no gynecologists, obstetricians, or midwives were present at the facility. After extensive networking and searching, we located a midwife in a nearby neighborhood who performed the deliveries. Tragically, one woman lost her infant, while the other experienced severe complications from the delivery. These deaths and injuries were not the result of medical complexity, but of war-driven deprivation: the absence of skilled birth attendants, medical supplies, and safe facilities.
This incident highlighted the critical importance of providing women’s services and establishing a dedicated women’s office to address these needs, with a portion of available funds allocated accordingly. We established the women’s office as part of the ERR hierarchy to address the needs of women and children. We networked with approximately five midwives to facilitate access to pregnant women and assist with deliveries. Additionally, we created connections between girls and women across different neighborhoods to identify women in need and link them with available or nearby midwives. Beyond these efforts, numerous challenges persisted, including continuous bombing, security issues — leaving one’s home meant a risk of rape, abduction, and killing — the departure of medical personnel, and medication shortages. The targeting and collapse of health systems combined with fear of sexual violence systematically cut women off from life-saving care during pregnancy, childbirth, and post-partum periods. A small clandestine clinic was established in each neighborhood with assigned medical personnel and teams, secretly providing services to beneficiary groups. Social network connections at the community level were utilized to protect survivors and victims. Some challenges were addressed through these channels and solutions. The scarcity of medications was managed by contacting pharmacies and establishing small medication distribution points staffed by pharmacists.
Rape cases committed by the Rapid Support Forces (RSF) began to emerge after the main hospital sectors became operational, which included first aid services, dialysis, and delivery units. The documentation of rape cases and provision of care services were conducted covertly due to death threats issued by RSF soldiers to victims, survivors, aid volunteers, or anyone who discussed cases of rape perpetrated by the RSF. No rape protocols were implemented. We only provided emergency contraceptive pills and referred victims and survivors to safer states. Proper medical assistance and psychosocial support was available in places where the war had not yet erupted at that time, including Al Jazeera, Northern states, Eastern states, and some areas in Kordofan and Darfur states. Victims and survivors selected states where they had extended family members or relatives. Travel time posed a significant challenge; for example, the journey from Khartoum to South Kordofan during wartime typically required one to two weeks by bus or car. During this journey, survivors/victims passed through active war zones, encountering looting groups, and navigating checkpoints controlled by RSF and Sudanese Armed Forces (SAF) soldiers, where individuals were required to undergo inspections and pay crossing fees.
These delays turned rape into a series of escalating reproductive harms. A victim or survivor might exceed the optimal timeframe for proper intervention to prevent pregnancy or health complications. Another major challenge was that people’s relocation funds were typically exhausted upon arrival at the destination state, exposing victims and survivors to economic hardship, including an inability to afford daily necessities such as food, water, and shelter. Sexual violence thus directly translates into food insecurity, homelessness, and heightened risk of deprivation and starvation.
One month later, cases of rape perpetrated by RSF soldiers, other looting groups, and civilians in different neighborhoods had been documented by aid workers at the hospital. RSF soldiers soon discovered that rape cases were being documented at the hospital and that medical services for victims and survivors were being provided there. The RSF fighters stormed the hospital, firing weapons, attacking medical staff and volunteers (firing guns near their food, abduction, death threats), and arresting volunteers. These attacks on functioning medical facilities and medical personnel highlight how the destruction of healthcare and the silencing of sexual violence documentation were integral to a broader strategy of civilian deprivation and control. Consequently, we adapted by utilizing the neighborhood mechanisms and linkages previously created to provide services and refer victims and survivors for proper medical and psychological support for rape and sexual violence.
We also established communal soup kitchens to provide meals to people of all age groups. The majority of staff members were women who prepared meals, and it was primarily women who gathered to collect food for themselves and their families. These kitchens became critical starvation-response mechanisms in neighborhoods where food systems had collapsed. Over time, these women developed strong relationships with one another and began using the kitchen space to converse and share their diverse experiences. We were able to document several cases of rape and domestic violence among women and girls, utilizing the kitchen as a safe space for women to share experiences of violence and receive psychosocial support activities. Hunger relief spaces thus became entry points for identifying and responding to gender-based violence produced and intensified by food scarcity and the war.
Subsequently, dedicated safe spaces for women and girls emerged in response to the challenge of providing psychosocial support to the community and addressing the urgent need for activities to divert attention from the war, such as coffee gatherings and henna learning sessions. These spaces also fostered social connections between different races and tribes within the community, as our community comprised people from various regions of Sudan, as well as refugees from other countries, including South Sudan, DRC, Eritrea, and Ethiopia. Services to the community were provided equitably among all constituent groups.
We encountered stigma as a significant barrier to reaching and providing services to SGBV victims and survivors in the community. In one case, a young girl, approximately 16 years old, was reported to us by a friend, and we began documenting her case. However, when her family discovered this, they removed her and disappeared from the area. We never learned what happened to her. Stigma, fear, and starvation intersected here: families facing extreme deprivation often prioritized survival and secrecy over access to care, leaving survivors isolated and unprotected. Additionally, our capacity levels at that time were inadequate to address the volume of reported cases and to overcome the stigma prevalent among community members. The funds dedicated to our activities covered only “dignity kits, some delivery assistance in terms of cash for operations, a few safe spaces, and limited referral cases,” as noted by a female volunteer in the Khartoum ERR.
Our interventions operated within a limited context; nevertheless, the impact extended far beyond the interventions themselves. Through the safe spaces for women, girls, and boys, a range of impacts materialized as services were provided among different community components. These impacts included social cohesion and acceptance of others within the community. They also contributed to the social protection system for volunteers and aid workers. In the neighborhoods where we operated, citizens protected volunteers from violence perpetrated by various armed groups and protected one another.
Grassroots groups—including women’s offices, women-led initiatives, and groups operating across different regions of Sudan—have witnessed women and girls subjected to various forms of SGBV, including assault, harassment, and rape. These groups focus on addressing the needs of women and children, particularly during the crisis. They also provide essential services for girls and boys, including psychosocial support and early healthcare interventions, as well as gender-based violence and conflict related sexual violence response services. In contexts where hospitals were destroyed, medical workers killed or displaced, and humanitarian access blocked, grassroots women’s groups became one of the few remaining lines of defense against food insecurity, starvation, untreated injuries, and reproductive harm.
Grassroots women’s groups demonstrated remarkable creativity in finding solutions to continue providing services to survivors and victims. Most health facilities were either damaged or under the control of armed groups, making service provision to women, girls, and male victims of violence and sexual violence a considerable challenge. For instance, rather than accessing health facilities controlled by military personnel, alternative approaches were developed.
Out of love for our country and people, we have remained steadfast since day one of the war. Despite all challenges, we have made significant contributions at the aid delivery level, in community engagement, and in coordination mechanisms. In a war where starvation, sexual violence, and medical deprivation are used together as tools of control, women’s emergency response efforts are not ancillary—they are life-sustaining. Undertaking initiatives without our engagement and contribution results in a lack of sustainability, failure to reach the grassroots community, and the loss of the majority of volunteers and individuals willing to serve their communities. We will continue our work regardless of the difficulties we encounter or the risks to which we expose ourselves.
Source: Women Volunteer – Khartoum ERR (2023 – 2024)
