More than 1 million Sudanese have fled their homes in Darfur in the past 16 months in efforts to escape violent attacks by militias, reportedly backed by the Khartoum government, deployed to quell rebel uprisings in the region. Now, according to estimates from the United States Agency for International Development, 1.2 million internally displaced people are living in makeshift camps that dot the region and another 200,000 have fled to neighboring Chad.
The group estimates that in addition to the 30,000 people who have died so far, another 300,000 could lose their lives due to the worsening health crisis.
While some help has begun flowing into the area -- targeted for camps and nearby cities overflowing with newly arrived refugees -- aid agencies have reported worsening medical and sanitary conditions within the camps.
Aid workers are most troubled by recent disease outbreaks, overcrowding, food shortages and inadequate shelter in many of the camps where makeshift structures have been built from sticks and only few people have plastic sheeting.
"The scale of this crisis is almost unimaginable," said Adrian McIntyre, a relief coordinator for the U.K.-based aid agency Oxfam. Speaking to the Online NewsHour from El Fasher, the capital of North Darfur, McIntyre said the crisis has become worse as people arrive daily in camps in North, South and West Darfur.
"We're talking about more than a million people that have been displaced in a region roughly the size of France," McIntyre said. "Many of these people are living in some of the worst conditions I've ever seen in the world."
Of the 130-odd camps in the region -- the larger ones each home to some 50,000 to 60,000 refugees -- only some have received aid. Camps in the more remote rural areas have yet to be identified or helped.
In Kalma camp in South Darfur, where the site of human excrement festering in pools in the 110-degree temperatures is common -- agencies are working to provide clean water and sanitation as well as food and health care.
Oxfam recently flew a shipment of sanitation supplies into the regional capital of Nyala where they were unloaded and trucked to various camps to be made into temporary toilet facilities. The agency hopes the improved sanitation will help stop the spread of disease.
"Clean water and proper sanitation are incredibly important," McIntyre said. "It's primarily important because of health. Without it people get sick, children get diarrhea. A child who's already weakened from malnutrition can die from a case of diarrhea."
In New York, Michael Neuman, a program officer for Medecins Sans Frontieres, agreed that the majority of the deaths his group has seen in recent weeks have been due to diarrhea and malnutrition.
MSF has more than 150 foreign workers in the region as well as about 2,000 Sudanese staff who have set up mobile health units and food distribution centers in areas with the highest numbers of malnourished children.
The rainy season, Neuman said, could bring another major health problem: malaria. Aid officials also worry about a possible cholera outbreak and just last week, officials from the World Health Organization said they had successfully stopped the spread of an Ebola virus outbreak.
In addition, aid workers are helping women and girls raped by members of the militia.
"We still see rape cases, cases of sexual violence," Neuman said. "Women will go out to collect wood or to collect water and are attacked by militias on the way."
The problems are so widespread Neuman said it could be several months before his group and other aid agencies are able to decrease their emergency efforts.
"Before the population is able to go back home -- if the security situation allowed it -- it would take at least a year before the population can put in place some coping mechanisms that would allow them to sustain themselves," he said.
Even if security can be restored, returning home could pose a problem. According to McIntyre, this year's planting season, on which many of the displaced farmers count for food, has been missed, a problem that could carry food shortages into next year.
The response to the crisis has been slow; by the time many agencies first entered the area in late 2003/early 2004, some 500,000 Sudanese already had fled their homes. Now, agencies such as Oxfam and MSF, joined by the World Health Organization, the Red Cross, Medair, USAID and the World Food Program all have emergency response programs in the area and are responding to the need with medicine, food and water.
Last week, the United Nation's World Food Program, the largest food relief presence in the region, began air dropping supplies into areas made inaccessible by violence and the rains that have just arrived. Sudan's rainy season runs from July through September and makes many of the roads in the underdeveloped region impassible.
In Washington last week, President Bush signed a bill allocating $95 million in aid to Sudan. The United Nations, which has appealed for $350 million in aid, reached an agreement with the Sudanese government to disarm the militias responsible for the ongoing attacks, Reuters reported.
The Sudanese government, blamed by many for creating and exacerbating the crisis, has agreed to lift travel restrictions on aid workers that initially hampered relief efforts, and to remove the requirement for payment of custom's duties on relief supplies entering the country.
"At the moment the delivery of humanitarian aid is not being obstructed by the government," McIntyre said.
Still, on Thursday, Secretary of State Colin Powell called on the Sudanese government to do more.
"Violence and atrocities on a wide scale continue to be committed against the civilian population in Darfur," he told the Wall Street Journal. "The Sudanese government has not, however, taken decisive steps to end the violence."
Sudan's government, headed by Pres. Omar al-Bashir, has been accused of arming the militias and unleashing them in villages believed to house rebels. The rebels rose up against the government, calling for more political autonomy and better infrastructure such as schools, hospitals and roads in the Darfur region.
A recent U.N. resolution promised sanctions against the government unless steps to disarm the militia were carried out.
In Khartoum, thousands of protesters have taken to the streets, accusing the United States of planning an Iraq-style invasion of their country.