London School of Hygiene & Tropical Medicine

Written by Maysoon Dahab, Assistant Professor at LSHTM

Since 15 April 2023, civil war in Sudan has created a rapidly escalating humanitarian emergency, with more than 30.4 million people requiring assistance. This is not a war between two parties: it is a war on the people of Sudan, where women and children are bearing the brunt of overlapping humanitarian crises rooted in both direct violence and collapse of infrastructure.

My colleagues and I recently published the first paper that pulls together verified reports, recorded figures and first-hand accounts from Sudan to piece together the breadth and depth of the conflict’s impact on women and children.

Our team of researchers from LSHTM, The Hospital for Sick Children (Toronto), the WHO, Ahfad University for Women and The Aga Khan University searched verified reports issued by the UN and its affiliated agencies to collate available evidence on the number of women and children killed or harmed in the ongoing conflict.

Direct targeting of women and children

We structured our research around the UN Security Council’s six types of grave violations against children in times of war. The data is limited because cases are often underreported, people may be reluctant to share information, and there’s a risk of duplication or bias, but the reports show that attacks on women and children are a key feature of this war:

1. Killing and maiming: 1,232 children killed and 1,751 maimed (1,833 boys, 975 girls, and 455 sex unknown).*
2. Abductions: 95 women and at least 50 children abducted.^a
3. Child recruitment and use: 199 boys and 35 girls recruited.^b
4. Attacks against schools: up to 19 million children are out of school.*
5. Attacks against hospitals: 623 attacks on the health-care system have occurred; 70–80% of hospitals were non-functioning.^c
6. Denial of humanitarian aid: 7.4 million women and 15.6 million children require humanitarian assistance, and 87 incidents have been reported of humanitarian aid being denied from entering affected areas.*

*from 15 April 2023 to present
^abetween 15 April 2023 and 30 April 2024
^bbetween 15 April 2023 and 31 December 2024
^cbetween 15 April 2023 and 8 July 2025

These figures are already disturbing, yet they are likely to be much higher, as the UN hasn’t yet verified any child deaths or maiming beyond 31 December 2024, and a study in Khartoum state has suggested that the UN figures reported so far are implausibly low.

First-hand accounts show a pattern of systematic brutality against civilians, where survivors and witnesses describe the maiming of young children and severe violence against women, including reports of militants forcibly severing umbilical cords and threatening infanticide.

“A war on the bodies of women and girls”

Verified reports show that at least 412 children and 400 women have faced sexual and gender-based violence (SGBV) since the beginning of the conflict, however the volume of first-hand accounts suggests that this is a vast underestimation. It appears likely that these numbers will far outstrip those seen even in other current conflicts.

Egregious accounts of human trafficking, forced marriage and sexual slavery have been associated with the abduction of women and girls. Many reports characterise the conflict as a “war on the bodies of women and girls”, which illustrates the widespread and systemic nature of sexual violence as a weapon of war.

Long-term health impacts of war

Children subjected to killing, maiming or recruitment into war are at heightened risk of both immediate physical injuries and lifelong disabilities, including amputations. These are breaches of international law that drive measurable, long-term adverse health outcomes.

The estimated 6.9 million women and girls at risk of SGBV are often affected by unwanted pregnancies, unsafe abortions and untreated sexually transmitted infections. Women and children also bear the brunt of the indirect impacts of war, such as the systemic collapse of curative and preventative healthcare services. For example, the lack of adequate essential services for women and children, such as nutrition, immunisation, screening and antenatal care services, is expected to increase maternal deaths, stillbirths and child mortality across the country, arguably for years to come.

The urgent need for international action

With every moment that we fail to act, the impacts on women and children’s health are being compounded. We call for the international community to urgently engage with Sudan to bring about an immediate ceasefire and coordinate efforts to ensure the rights and needs of all conflict-affected children are addressed. This should be accompanied by a high-level global summit to reassess and strengthen international mechanisms for protecting women and children in conflict settings in the future.

Read the full report in The Lancet Child & Adolescent Health.