The number of war deaths in Sudan is likely much higher than recorded, researchers say

CAIRO/OMDURMAN, Sudan: More than 61,000 people are estimated to have been killed in Khartoum state during the first fourteen months of Sudan’s war. Evidence suggests the toll from the devastating conflict is significantly higher than previously recorded, according to a new report from researchers in Britain and Sudan.

The estimate includes about 26,000 people who suffered violent deaths, a higher figure than the figure currently used by the United Nations for the entire country.

The preprint study from the Sudan Research Group at the London School of Hygiene and Tropical Medicine, released ahead of peer review on Wednesday, suggested that hunger and disease are increasingly becoming the leading causes of death reported across Sudan.

Estimated deaths from all causes in Khartoum state were 50 percent higher than the national average before the conflict between the army and paramilitary Rapid Support Forces broke out in April 2023, researchers said.

The UN says the conflict has driven 11 million people from their homes and created the world’s worst hunger crisis. Nearly 25 million people – half of Sudan’s population – need aid as famine has struck at least one displaced persons camp.

But counting the dead has been a challenge.

Even in peacetime, many deaths in Sudan go unrecorded, researchers say. As the fighting intensified, people were cut off from places of death, including hospitals, morgues and cemeteries. Repeated disruptions to internet services and telecommunications left millions of people unable to connect with the outside world.

The study “tried to capture that invisibility” using a sampling technique known as “capture-recapture,” said lead author Maysoon Dahab, an infectious disease epidemiologist and co-director of the Sudan Research Group.

Originally designed for ecological research, the technique has been used in published studies to estimate the number of people killed during pro-democracy protests in Sudan in 2019 and the COVID-19 pandemic, when it was not possible to conduct complete counts , she said. .

Using data from at least two independent sources, researchers look for individuals who appear on multiple lists. The less overlap there is between the lists, the greater the chance that deaths will go unrecorded, information that can be used to estimate the full number of deaths.

In this case, investigators compiled three lists of the dead.

One was based on a public survey distributed via social media platforms between November 2023 and June 2024. The second used community activists and other “study ambassadors” to privately distribute the survey within their networks. And the third is composed of obituaries posted on social media, a common practice in the cities of Khartoum, Omdurman and Bahri, which together form the larger capital.

“Our findings suggest that deaths have gone largely unnoticed,” the researchers wrote.

COUNTED TOLLS

The deaths on the three lists accounted for just 5 percent of the estimated total for Khartoum state and 7 percent of the deaths attributed to “intentional injuries.” The findings suggest other war-affected parts of the country could have experienced similar or worse tolls, the study said.

The researchers noted that their estimate of violent deaths in Khartoum state exceeded the 20,178 killings recorded nationwide during the same period by the Armed Conflict Location & Event Data project (ACLED), a US-based crisis monitoring group.

ACLED’s data, which is based on reports from news organizations, human rights groups and local authorities, among others, has been cited by UN officials and other humanitarian workers.

Dahab said researchers did not have enough data to estimate death rates in other parts of the country or to determine how many total deaths could be linked to the war.

The study also points to other limitations. The methodology used assumes that, for example, every death has an equal chance of appearing in the data. However, well-known individuals and those who have suffered a violent death are more likely to be reported, the researchers said.

Paul Spiegel, head of the Center for Humanitarian Health at the John Hopkins Bloomberg School of Public Health and not involved in the study, said there were problems with all three data sources that could skew the estimates. But he said the researchers had incorporated such limitations into their methodology and analysis.

“While it is difficult to know how the various biases in this capture-recapture methodology could affect the overall numbers, it is a new and important effort to estimate the number of deaths and draw attention to this horrific war in Sudan ” he said.

An official from the Sudanese American Physicians Association, an organization that provides free health care across the country, said the findings appeared credible.

“The number could even be higher,” the program manager, Abdulazim Awadalla, told Reuters, saying weakened immunity from malnutrition made people more susceptible to infections.

“Simple diseases kill people,” he said.

The study was funded by the US Centers for Disease Control and Prevention and the UK Foreign, Commonwealth and Development Office.

“WE BURIED HIM HERE”

Among the many victims of the war was Khalid Sanhouri, a musician whose death in Omdurman’s Mulazmeen neighborhood was announced on social media in July last year.

A neighbor, Mohammed Omar, told Reuters that friends and relatives were unable to get medical care for Sanhouri after he fell ill due to the intensity of the fighting at the time.

“There were no hospitals or pharmacies where we could get medicine, not even markets to buy food,” Omar said.

They couldn’t even reach the nearest cemetery.

“So we buried him here,” Omar said, pointing to a grave just behind the bullet-riddled wall surrounding the musician’s home.

Since last year, hundreds of graves have turned up next to houses in greater Khartoum, residents say. As the army has returned to some neighborhoods, they have started moving the bodies to Omdurman’s main cemetery.

As many as 50 funerals take place there a day, funeral director Abdin Khidir told Reuters. The cemetery has been expanded to include an adjacent football field.

Still, the bodies keep coming, Khidir said.

The warring sides have blamed the growing toll.

Army spokesman Brigadier General Nabil Abdallah referred questions about the investigation’s estimates to the Health Ministry, but said: “The main cause of all this suffering is the terrorist Rapid Support militia (RSF), which from the first moment has not hesitated to kill civilians to attack. ”

The Health Ministry said in a statement to Reuters that it had observed far fewer deaths than the survey estimates. The number of war-related deaths stands at 5,565, the report said.

The RSF did not dispute the investigation’s estimates and blamed the deaths in the capital on “deliberate airstrikes on populated areas, in addition to artillery shelling and drone strikes.”

“It is known that the military is the only one that has such weapons,” the army said in a statement to Reuters.

The war broke out from a power struggle between the Sudanese armed forces and the RSF, ahead of a planned transition to civilian rule. The RSF quickly took over most of the capital and has now spread to at least half the country, although the army has regained control of some neighborhoods in Omdurman and Bahri in recent months.

Both sides have committed abuses that could amount to war crimes, including attacking civilians, a UN fact-finding mission said in September. The war has also led to ethnically driven violence in the western region of Darfur, much of which has been blamed on the RSF.

However, the new report highlighted the significant and likely growing toll taken by the war’s indirect consequences, including hunger, disease and the collapse of the health care system.

Sick patients lined the corridors of al-Shuhada Hospital in Bahri, where a spike in cases of malnutrition and diseases such as malaria, cholera and dengue have been observed.

Fresh fruit, vegetables and meat were difficult to come by until the arrival of the army opened supply routes, said hospital manager Hadeel Malek.

“As we all know, malnutrition generally leads to weak immunity,” she said. “This is one factor… that has led to many deaths, especially among pregnant women and children.”

Both sides deny that aid and commercial deliveries are being hampered.