Thank you and good afternoon to you, Mr. Chair, and to all the members of this committee. Thank you for having me here today.
I represent Doctors without Borders/Médecins Sans Frontières, MSF, an international aid organization that provides medical care to people affected by armed conflict and humanitarian emergencies around the world. One of the worst of those emergencies right now is taking place in Sudan, where we operate in some of the areas worst hit by a brutal war characterized by atrocities against civilians and where many people cannot access the humanitarian assistance they urgently need.
I apologize in advance that my colleague, Michel-Olivier Lacharité, head of MSF's emergency operations for Sudan, was unable to join us by video link today as planned. I will present some of the information he was planning to share.
In recent days, we've seen the awful situation in Sudan take a further turn for the worse. El Fasher, the capital of North Darfur in Sudan, which was already facing an unprecedented humanitarian crisis after more than 500 days of siege, saw its situation deteriorate even more after the city was taken over by the Rapid Support Forces, the RSF, on the weekend of October 26.
MSF was operational in El Fasher until last year when attacks against our health activities forced us to evacuate. In April, we were again forced to evacuate from the nearby Zamzam camp for displaced civilians after it, too, was attacked. We are now based in the town of Tawila, 60 kilometres away from El Fasher, where we run a hospital with 200 beds and 500 staff.
We have been receiving there as patients many of the people who have managed to flee El Fasher, including over the past few days, who have been reporting to us what they have been witnessing directly. El Fasher is now the scene of mass atrocities, and although the pattern of the violence being committed is not new, it is rapidly intensifying and radicalizing. Civilians continue to be directly targeted. Children are not spared. Elderly people are not spared. Women are not spared. Non-Arab populations continue to be directly targeted. Civilian and medical infrastructure is also being targeted. Escaping from El Fasher is extremely difficult. Those attempting to flee are victims of extortion who must pay for their survival and who risk kidnapping, assault or worse.
At our hospital in Tawila, MSF has received more than 500 victims of gunshot wounds in the past week alone. We have received wounded people who had been left for dead and many cases of torture and bodily violence, approximately 20 per day. We also continue to see high numbers of cases of sexual violence, which has been a major characteristic of this war. Even before the recent developments in El Fasher, we had received 200 cases of sexual violence at our hospital in Tawila in September alone. These are not sporadic or isolated cases, but are consistent with the high and constant level of violence against civilians that we have observed for months. This has not changed over the past week, but has simply intensified. We estimate that there have been thousands of direct deaths in El Fasher and its outskirts in recent months, probably even more if one includes indirect deaths caused by the absence of care and those caused by famine.
The malnutrition situation is extremely severe. In several internally displaced person sites in the El Fasher area, nutritional assessments carried out in mid-March showed 38% global acute malnutrition among children under the age of five, of which 11% were severe acute malnutrition. That was more than seven months ago, after which the siege of El Fasher only intensified.
This extreme vulnerability is now further reinforced by increased direct violence. The risk of massive mortality remains extremely high. In Tawila, our teams receive not only children but also adult women and men whose levels of malnutrition are alarming. On October 27 in Tawila, all 70 of the children under the age of five received at our facilities were suffering from acute malnutrition. On October 28, 20% of adult men coming from El Fasher were also suffering from severe acute malnutrition.
What we are seeing right now in North Darfur following the takeover of El Fasher is not an anomaly. It is a scaled-up continuation of a system of targeted destruction of civilians as the dominant operational model of the RSF.
I want to take this moment to remind the members of this committee that civilians in conflict are meant to be protected under international humanitarian law, which forbids warring parties from deliberately targeting civilians or from attacking aid workers or preventing access to essentials such as food, water and medical care. I would also like to point out that we, as MSF, have already been calling on Canada to do more to stand up for international humanitarian law in conflict zones, most recently through a petition signed by tens of thousands of Canadians and delivered last month to the Prime Minister, asking his government to hold violators of IHL accountable.
Now more than ever, as we watch civilians—