Children hiding under the kitchen table for days at a time as bombs rain down on their neighborhood. Parents traveling hundreds of miles to find emergency care to save their children. In times of war and unrest, children are among the most vulnerable – their lives uprooted, their education interrupted, their families shattered. We’re hearing most about that today in Gaza. On Oct. 7, it was Israel. Before that – and still – in Ukraine, and in too many other parts of the world.

In Sudan, a catastrophic civil war continues to ravage the country more than six months after widespread fighting broke out. And again, it is children who bear the enormous brunt of displacement, disease, loss, and other traumas. In our roles with the Sudanese American Physicians Association (SAPA), we regularly coordinate with our organization’s health personnel responding to the crisis in Sudan. Our conversations with those on the ground are heartbreaking and harrowing.

The fighting between the Sudanese Armed Forces and the Rapid Support Forces has claimed at least 9,000 lives and displaced almost 6 million people. Clashes continue to rage across much of the country, and especially in the western region of Darfur and in and around the capital, Khartoum. Sudan faces the possibility of a lost generation unless the international community takes swift and drastic action.

Before the war, more than 500,000 Sudanese children were experiencing severe malnutrition; amid the conflict, those rates have soared. By August, 500 children had died of hunger, with Save the Children estimating that 1.5 million would soon fall into “crisis levels of hunger.” Overall, the United Nations estimates that more than 20 million people are experiencing acute food insecurity — though the reality of this hunger crisis may be even graver than reports indicate, as Sudan’s shaky infrastructure and the chaos of war have made accurate data collection all but impossible.

As residents’ ability to earn income has disappeared, the price of food has skyrocketed, often leaving families unable to access a single loaf of bread a day, according to our colleagues and friends on the ground. In camps for internally displaced people (IDPs), one meal a day is far from a given, despite the best efforts of aid groups.

Amid the turmoil, hospitals are overwhelmed, overcrowded, and understaffed, with patients often sleeping on floors. Vaccines have fallen off the priority list, leaving children more vulnerable than ever to disease, and the consequences have already proved fatal. Measles outbreaks have killed at least 1,200 children, and lack of immunization is certain to be contributing to high ongoing child mortality rates.

Faced with the daily challenge of survival, not a single child has attended school in Sudan in the last six months, leaving them susceptible to child labor and recruitment as child soldiers. And of course, the psychological trauma is immeasurable. Displacement, academic disruption, the loss of loved ones, and other horrors of war will have grave and lasting impacts on children’s psychological development, raising their risk of depression, anxiety, post-traumatic stress disorder, and other severe mental-health disorders.

So this war isn’t just a present humanitarian disaster but a threat to Sudan’s very future. Yet despite its calamitous toll, the international community has failed to meet the moment, donating just 26 percent of the U.N.’s total appeal. Each half-measure and moment of inaction exacerbates the suffering of the people of Sudan.

The international community has the opportunity to make a significant difference on the humanitarian front — but it will require urgent action.

Given the immediate threat of food insecurity, it’s critical to prioritize Sudan’s mounting hunger crisis, dismantling physical and logistical roadblocks that hinder the delivery of humanitarian assistance. The challenges include poor infrastructure, diversion by the warring parties, and the complexities of finding ways for local Sudanese groups to partner with multinational aid organizations.

The international community can help in other ways, too. International negotiations with both parties recently resumed in Saudi Arabia after months of a faltering diplomatic process. At the top of the agenda for the United States and regional powers must be continued pressure on the warring factions to allow a free flow of aid and to process more visa requests for international aid workers. Additional funding to IDP camps specifically would also bring much-needed assistance, allowing for the establishment of better sanitation infrastructure to stem the spread of disease and for additional housing and other facilities to ameliorate severe overcrowding.

Financial aid could remedy supply shortages, expand telehealth services, and supplement the kind of direct aid that SAPA has been providing to local health personnel and facilities to allow hospitals to stay afloat.

Six months into Sudan’s civil war, a generational crisis is unfolding, leaving the future of millions hanging in the balance. We call upon the international community to recognize the depth of this crisis and to act decisively. Sudan’s children cannot wait any longer.

IMAGE: Women and children gather in a building at a camp for Sudan’s internally displaced in al-Suwar, about 15 kilometres north of Wad Madani, on June 22, 2023. The fighting in Sudan between the regular army, led by Abdel Fattah al-Burhan, and the paramilitary Rapid Support Forces (RSF), headed by his former deputy Mohamed Hamdan Daglo, had by that point claimed more than 2,000 lives since war broke out on April 15. (Photo by -/AFP via Getty Images)