CAIRO – All roads around Sudan’s famine-stricken Zamzam camp in North Darfur are blocked and the security situation for aid workers on the ground has become “unbearable,” an international aid worker said.

Doctors Without Borders, also known by its French name Médecins Sans Frontières, or MSF, suspended all its activities in the camp because of safety concerns caused by intensified fighting between the Sudanese army and rival paramilitary group Rapid Support Forces, or RSF.

Marion Ramstein, MSF’s project coordinator for North Darfur, spoke with The Associated Press on Tuesday about the dire conditions in Zamzam Camp.

“It’s not even possible now to go from Zamzam to (the city of) El Fasher … all the roads around Zamzam are blocked because of the conflict,” she said.

Sudan plunged into a civil war in April 2023 when fighting erupted between the military and the RSF. The conflict has killed at least 20,000 people, forced more than 14 million people out of their homes and created famine in various parts of the country.

MSF said in a statement on Monday that being close to violence and facing challenges to send supplies and experienced staff left the charity with limited choice.

“So far, there is no more MSF activities since a couple of days now in Zamzam because the security was unbearable for our team. They’re not able to work anymore. They didn’t have enough capacity,” she said.

MSF said that two of its ambulances in December and January were shot at twice while carrying patients from the camp to El Fasher. Ramstein said that in one shooting, a woman who was accompanying her sister inside the ambulance was killed.

The international organization will come back to operate in Zamzam, but teams currently can’t work in a high-risk environment, Ramstein said.

“Unfortunately, MSF was kind of one of the few organizations still working in Zamzam, when we decided to suspend the activities — that was really a heartbreaking decision. We know that we left the population with no other support,” she said, referring to the difficulty of delivering food aid and necessary supplies in the area because of inaccessible roads.

A report by the Integrated Food Security Phase Classification, or IPC, found last year that Zamzam Camp and some parts of North Darfur are experiencing “the worst form of hunger” known as IPC Phase 5.

Ramstein said that MSF received a lot of cases of young children in the camp suffering from anemia. In September, MSF screened 29,300 children during a vaccination campaign in Zamzam and found that 34% of them suffer from acute malnutrition.

Zamzam camp hosts around 500,000 people and has seen displaced families arriving from the areas of Abu Zerega, Shagra, and Saluma. They have told MSF teams of abuses in villages and on roads in El Fasher that include killings, sexual violence, lootings and beatings.