There is no medicine for my son
In the Blue Nile state of Sudan, a war that once burned at a distance has arrived at the doorstep of communities that believed themselves peripheral to the conflict. Since early 2025, fighting between the Sudanese army, the Rapid Support Forces, and allied rebel factions has made this border region a strategic prize — and in the process, displaced tens of thousands of people into camps where survival itself has become the daily labor. The suffering of families like Awatif Awad's, rationing a single meal while a sick child goes untreated, is not incidental to this war but its most honest measure.
- Blue Nile has shifted from a forgotten borderland to the war's newest center of gravity, with over 450 killed in just three months as rival forces compete for control of territory that could determine the fate of central Sudan.
- More than 30,000 people have flooded into already overwhelmed displacement camps near Damazin, arriving with injuries, malnourished children, and nothing but what they could carry across days of walking through unfamiliar terrain.
- Al-Karama 3 and similar sites offer plastic sheeting for shelter, one meal a day, and a single motorized rickshaw as the only link to a hospital — while community emergency rooms that filled the gap were abruptly shut down last month.
- The rainy season is arriving now, threatening to flood the makeshift camps and collapse what little protection displaced families have, even as UN coordinators warn that funding gaps and access restrictions are preventing aid from keeping pace with need.
- Accusations that Ethiopia and the UAE have conducted drone strikes in Blue Nile from Ethiopian territory — denied by both countries — raise the specter of regional escalation that analysts warn would devastate the most vulnerable first.
Awatif Awad fled Kurmuk in late March when paramilitary fighters arrived in force. She walked three days through unfamiliar terrain with her five children, carrying what she could. When she reached Damazin, the state capital, she found a camp already overwhelmed. Her five-year-old has malaria. There is no medicine.
Blue Nile state was, until recently, a peripheral concern in Sudan's three-year war. That changed early this year when the Sudanese army, the Rapid Support Forces, and the rebel SPLM-N began fighting for control of the region in earnest. At least 450 people were killed between January and March — the deadliest stretch since 2023. Analysts describe the shift plainly: Blue Nile borders the recently recaptured Sennar state, and whoever holds it may determine who controls central Sudan.
The camps around Damazin were not built for this. Al-Karama 3 was originally designed to house returning refugees from earlier conflicts. Since January, it and nearby sites have absorbed around 30,000 newly displaced people, with over 150,000 displaced across the state since April 2023. Shelters are plastic sheeting and straw. There is no clinic. A single battered rickshaw connects the camp to the city hospital. Mahasin Abdelhamid, 33, shares a large tent with dozens of families and fears what happens when the rains come — the flooding, she said, will leave nothing standing.
Local volunteers describe severe shortages across every category: food, shelter, healthcare. Displaced people arrive injured with nowhere to be treated. A recent UN assessment flagged worsening overcrowding, poor sanitation, and rising risks of gender-based violence. Aid agencies, local authorities say, cannot keep pace — the numbers grow faster than assessments can track. Community-run emergency rooms that had been filling the gap were ordered shut last month without explanation.
The fighting shows no sign of stopping. Sudan has accused Ethiopia and the UAE of conducting drone strikes in Blue Nile from Ethiopian territory since March; both deny it. If the conflict widens, analysts warn that health systems, maternity care, and education — already near collapse — will not survive. Awad's son still has malaria. There is still no medicine.
Awatif Awad sits in a sprawling camp in Sudan's Blue Nile state, watching her five children and rationing what little food arrives. One meal a day. Her five-year-old son has malaria. There is no medicine. She is 38 years old and has been fighting to keep them alive in a place that, until recently, was nowhere near the war.
Blue Nile has become something different now. For years it was a peripheral concern, a border region where various armed groups operated but the main fighting happened elsewhere. Then, early this year, the conflict shifted. The Sudanese army and a paramilitary force called the Rapid Support Forces, along with a rebel group called the Sudan People's Liberation Movement-North, began fighting for control of the state in earnest. Between January and March, at least 450 people were killed there—the deadliest three-month stretch since 2023. A senior analyst at the Armed Conflict Location and Event Data project described it plainly: Blue Nile had moved from the margins to the center of the war. Control of the state matters strategically. It borders Sennar, which the army recaptured last year, and whoever holds Blue Nile could determine who controls central Sudan.
Awad fled Kurmuk, a town near the Ethiopian border, in late March when paramilitary fighters arrived in force. She gathered what she could carry and walked for three days with her children across terrain she did not know, moving through darkness, simply walking. When she reached Damazin, the state capital, she found a camp already overwhelmed. Al-Karama 3 was originally built to house refugees returning from earlier conflicts in South Sudan and Ethiopia. Since January, it and other displacement sites in the area have absorbed around 30,000 people fleeing violence across Blue Nile. Kurmuk alone saw over 11,000 civilians leave in a matter of weeks.
The camps are improvised and fragile. Shelters are made from plastic sheeting, straw, and scraps. There is no clinic. Reaching the city hospital depends on whether a battered motorized rickshaw—the camp's only transport—is available. Local volunteers have posted photographs of women queuing with their children for meager rations of food and water. A 33-year-old woman named Mahasin Abdelhamid, who also fled Kurmuk, shares a large tent with dozens of families. She is afraid of the rains. When the rainy season begins this month, she said, the place will flood and the tents will not protect anyone.
Local officials say more than 150,000 people have been displaced across Blue Nile since April 2023, with around 100,000 sheltering in Damazin alone. A volunteer assisting displaced families, who asked not to be named for security reasons, described the conditions plainly: severe shortages of food, shelter, and healthcare. Some displaced people arrive injured, but there are no clinics to treat them. A recent UN assessment warned that conditions were worsening due to overcrowding, poor shelter, sanitation, and rising risks of gender-based violence. The UN humanitarian coordinator said funding gaps, insecurity, and access constraints were crippling aid efforts. Local authorities told AFP that aid agencies cannot keep pace—they assess needs based on one number, but when they return the next day, the figures have increased. Community-run emergency rooms that provided food, basic healthcare, and coordination were ordered shut last month without explanation.
Meanwhile, the fighting continues. Sudan has accused Ethiopia and the United Arab Emirates of launching drone attacks on several states, including Blue Nile, from Ethiopian territory since March. Both countries have denied the accusations. If the conflict escalates further, analysts warn that vulnerable groups will suffer most. Health and maternity care might collapse entirely. Children are already out of school, and continued escalation will only deepen that loss. Awad's son still has malaria. There is still no medicine.
Notable Quotes
Blue Nile has shifted from a peripheral front to a central battleground— Jalale Getachew Birru, Armed Conflict Location and Event Data project
We are scared of the rains. When the rainy season starts this month, this place will flood and the tents won't protect us— Mahasin Abdelhamid, displaced woman in Al-Karama 3 Camp
The Hearth Conversation Another angle on the story
Why did Blue Nile suddenly become the center of the war? It seems like it was quiet before.
The paramilitary forces and their allies needed to control it. It's a resource-rich border region between Ethiopia and South Sudan—it's a supply corridor. Once the army lost ground in Darfur, the fighting moved east, and Blue Nile became strategically crucial for whoever wants to control central Sudan.
So these camps—Al-Karama 3 and the others—they weren't built for this. They were built for something else.
Exactly. They were built to house refugees who had fled earlier conflicts and then returned home. Now they're holding 30,000 people who arrived in a matter of months, and the infrastructure was never meant for that. One meal a day. No clinics. Shelters made from plastic and straw.
The rainy season is starting this month. What happens then?
The tents will flood. People are already afraid. There's no drainage, no solid structures. It's going to be worse—disease, water contamination, more sickness on top of malaria and malnutrition.
You mentioned that community-run emergency rooms were shut down. Who ordered that?
Local authorities. No explanation was given. A human rights monitor documented it, but when AFP asked the authorities for comment, they didn't respond. It's another layer of collapse—people had somewhere to go for basic help, and now they don't.
Is there any sign the fighting will stop?
No. And there's a risk it could expand. Sudan is accusing Ethiopia and the UAE of launching drone attacks from Ethiopian territory. If that's true, or if it escalates, the whole region could be drawn in. The analyst I mentioned said if that happens, health care might collapse entirely, and children will stay out of school indefinitely.