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East Darfur, Sudan — Hawa Adam did not expect a childhood illness to kill her son. Ali was two years old when he fell sick on February 25 in Labado, in Sudan’s East Darfur state. He died two days later.“I thought it was one of the ordinary childhood diseases,” the 37-year-old told Al Jazeera. “I never imagined I would lose my child to this epidemic.”Hawa attributes his death to the absence of basic medical care – no vaccination, no qualified doctors. “Most doctors”, she says, “left the area after the war broke out, forcing those with means to seek treatment abroad, in South Sudan or Uganda.”The Collapse of Routine Immunization in East DarfurA measles outbreak has struck several Labado districts since March, killing approximately 70 people and infecting about 1,000 others across 12 residential neighbourhoods, in a population of roughly 12,000, which includes displaced people who arrived during the war, according to Mohamed Abdel Aziz, 32, coordinator of the Labado crisis unit.Those numbers were disputed by East Darfur’s health director, Dr Jabir al-Nadeef, who confirmed to Al Jazeera that measles has struck four districts of the state, but only reported 300 cases and 26 deaths, figures that diverge substantially from those documented by the Labado emergency room.“Vaccines only arrived on April 11 from Chad via UNICEF [United Nations Children’s Fund ], after a prolonged period with no supply, and a vaccination campaign is scheduled to run from April 18 to 24 across the state,” he said.Measles is one of the world’s most contagious diseases, spread by contact with infected nasal or throat secretions or breathing in air that was breathed out by someone with measles, according to the World Health Organization (WHO). Outbreaks can result in severe complications and deaths, especially among young, malnourished children.Transmission: Contact with infected secretions or airborne particles.Current Coverage: Measles vaccination has fallen to 46 percent.Routine Immunization: First dose of diphtheria, tetanus, and pertussis dropped to 48 percent in 2024.Quantifying the Human Cost: Disputed Death Toll and Economic BarriersThe first measles cases in Darfur in the current outbreak were recorded in January, according to UNICEF. It is unfolding against the backdrop of a near-total collapse of public health infrastructure across Darfur, where war has gutted facilities, halted routine vaccination and driven out medical personnel.“We discovered the outbreak by accident,” Abdel Aziz, the coordinator, told Al Jazeera. The teams had been conducting home visits for a fire-prevention workshop when they saw the scale of the outbreak, with almost half of the homes visited having measles cases.In the al-Nil neighbourhood, Ismail Issa, 38, lost his two-year-old daughter Makarem on March 11. His brother Ahmed lost an 18-month-old son, Issa, on March 25. Then Hasan, the three-year-old son of Ismail’s sister Medeeha, died on March 23. All three families live in adjoining homes, and the infection passed between them.Abdel Aziz traced much of the death toll directly to a supply failure. Medicines ran out at the government health centre on February 23. Drugs remain available at private pharmacies, but most residents cannot afford them.Intravenous fluids: 8,000 Sudanese pounds ($20.50).Antibiotics: 10,000 to 15,000 pounds ($25.60 to 38.40).A Public Health Catastrophe UnfoldingAsmaa Jalaluddin, 28, lives in the Dar al-Naim West neighbourhood of Labado with her three children. Her three-year-old daughter, Mashaer Rajab al-Sheikh, fell ill on April 5 with fever, diarrhoea and persistent vomiting. She stopped eating and kept her eyes shut for four days.On April 8, Asmaa took her to the Labado health centre, where she was told her daughter had measles. With no medicines available, she was directed to travel to Shuairiya, 40 kilometres north. There, on April 10, Mashaer received fever reducers and vitamins and slowly began to open her eyes again. She was discharged two days later.Local doctors are now calling for intervention from international health organisations, noting that diseases that had been eliminated are returning.UNICEF spokesperson for Sudan, Eva Hinds, told Al Jazeera that “measles cases continue to be reported across Darfur, with insecurity, displacement, damaged health facilities, and prolonged disruption to routine immunisation all constraining the response.”UNICEF says that a measles-rubella vaccine catch-up campaign has been completed across all localities in Central Darfur and West Darfur, as well as parts of North and South Darfur, reaching approximately 2.1 million children aged nine to 14. Vaccination in remaining areas, including East Darfur, is scheduled for mid to end of April, aiming to reach close to 750,000 children across all nine of the state’s localities.The Long Road to RecoveryFor the families of Labado, the calendar offers little comfort. In the al-Nil neighbourhood, three siblings buried their children within days of one another over the Eid holiday. In Dar al-Naim West, a mother counts the days until her daughter’s 14-day isolation ends. In the Safaa neighbourhood, Hawa Adam has already buried hers.“They could have still been alive,” Hawa Adam said. “Those without money die in Darfur.”

The conflict in Sudan continues to intensify, with two drone strikes resulting in the deaths of at least 28 civilians. The strikes occurred in separate locations, with one hitting a market in Saraf Omra, North Darfur state, killing 22 people, including an infant, and injuring 17 others. Another strike targeted a truck carrying civilians on a highway in North Kordofan, approximately 500 miles east of Darfur, killing six people and wounding 10. The RSF was blamed for the attack, although it is unclear which side launched the drone. Sudan's civil war, which began on April 15, 2023, has led to over 11.6 million people being displaced out of a population of about 51 million. The conflict has resulted in tens of thousands to potentially over 400,000 deaths. The situation has been described as the world's worst humanitarian crisis, with large areas of the country at risk of famine. The UN has reported a significant increase in civilian deaths from drone strikes this year, particularly in the Kordofan region. Between January 1 and March 15, over 500 people were killed by drones. A recent drone strike on a hospital in East Darfur killed 64 people and wounded 89, according to the World Health Organization.