Meet the Hongkonger grappling with the world’s worst humanitarian crisis
Hong Kong Free Press
The world’s largest war and humanitarian crisis has been unfolding in Sudan. Most United Nations aid agencies have pulled their staff out of the country due to the extreme danger they could face. But Beatrice Lau, from Hong Kong, remained on site as Médecins Sans Frontières’ (MSF) chief negotiator.
Her mission: to negotiate with the warring parties and ensure that the humanitarian organisation’s workers can safely access places where healthcare has all but collapsed. She makes sure staff can deliver urgent medical treatment and supplies to those most in need.
The civil war in Sudan – between the Sudanese military and the paramilitary Rapid Support Forces (RSF) – has raged for more than a year and a half. More than 10 million people – a fifth of the population – are estimated to have fled their homes and become internally displaced. The scale of internal displacement is now six times worse than in Gaza and almost three times worse than in Ukraine, according to U.N. statistics. Another two million people have fled to neighbouring countries, making it the largest and fastest growing humanitarian crisis in the world. MSF alone has treated nearly 12,000 people wounded in the war, as of June this year.
“Regardless of which party you are from, as long as you are wounded, you are sick, you have medical needs, we’ll provide it. When we are consistently doing so, we gain their trust.“
Beatrice Lau. MSF
Sudan was plagued by civil war for most of the second half of the 20th century, between the central government and forces in the south of the country. Ceasefires and negotiations over the years finally yielded a peace agreement in 2005. This gave way to a referendum in 2011, a vote which made South Sudan a country independent from the north. Just over a short decade later, the people of Sudan once again face mass killings perpetrated by both sides of the current warring parties. The healthcare system is in near total collapse.
From fundraiser to frontliner
After a brief career at a bank and an advertising agency, Lau joined MSF’s office in Hong Kong almost 20 years ago as head of fundraising. She began joining assignments abroad several years later, and rotated in operational roles or head of mission in countries including Niger, Tajikistan, Libya, and Belarus. She obtained a master’s degree in public international law between her years of travel, and has since taken up the role of legal adviser at MSF. This year, she landed in Sudan, where she stayed for four months until April.
To enable the MSF teams to deliver timely aid and medical care, Lau and her colleagues had to persuade the Sudanese military and its rival paramilitary groups to guarantee safe passage between checkpoints for MSF personnel, and grant them permits that are essentially visas, she said.
The warring parties each control slices of territory, making it difficult for anyone to “cross line” – to travel from one area of control to another.
Because travel permits for all cross-line movement are systematically rejected by the warring parties, Lau said, safe passage sometimes means a detour that adds almost 300 kilometres to the aid convoy’s mileage.
Due to the nature of the conflict and natural disasters, such as seasonal flooding, MSF would set up temporary bases and then move to another region in need.
“It’s not like you can drive around freely and travel from point A to point B. We need to apply for a travel permit each time, whether we’re transporting aid workers or supplies,” Lau said. Aid workers travelling to a destination must contact checkpoint commanders before arrival to ensure passage.
The extremely limited travel between conflict areas has not only made it difficult for workers to deliver aid and supplies. It also became a challenge to accurately assess the magnitude of a quickly developing humanitarian crisis.
In February, MSF in a report called attention to a malnutrition crisis at Zamzam Camp, in the North Darfur region bordering Chad and now home to 400,000 Sudanese fleeing violence. Widespread conflict has displaced farmers, disrupted agricultural production and logistics for food products. It is estimated that one child dies of malnutrition every two hours at the camp, according to MSF.
That might only be the tip of the iceberg in Sudan, Lau said. MSF workers know that other states such as Khartoum, home to the Sudanese capital of the same name, is also facing risk of famine.
MSF workers in the country were not able to travel to the area due to wartime travel restrictions, and cannot conduct an assessment according to an international classification system of the severity of food insecurity. From Phase 1 to Phase 5, proper classification determines whether aid agencies – including those with the UN – will divert staff and funding to help relieve an acute food crisis.
Gaining trust, strict neutrality
Lau is usually based in Port Sudan, on the other side of the country from Darfur. Part of her job involves urging the Sudanese government and RSF representatives to respect international humanitarian law and refrain from attacking medical personnel or hospitals.
Under international humanitarian law, even combatants are entitled to medical care. MSF’s mission is to deliver healthcare to people who need it the most, whether civilians or wounded soldiers.
“Regardless of which party you are from, as long as you are wounded, you are sick, you have medical needs, we’ll provide it. When we are consistently doing so, we gain their trust,” Lau said.
A principle of strict neutrality and impartiality have earned MSF respect from all fronts, although their staff have on occasions been intimidated, assaulted or detained because wounded fighters were not treated as quickly as fellow fighters wished.
“Sometimes they’d blame our colleagues because the injured person was sent to us too late and died,” Lau said. MSF representatives have to explain why they need to triage patients and treat them in order of priority. “All these are negotiations,” she said. Her job is to constantly remind warring groups of the principles that should govern even in wartime.
“Sometimes they’d also want to establish international recognition, to let people know that they’re not a non-state rebel group, and so they needed to demonstrate that they are capable of respecting international law just like a nation state does,” Lau said.
Other than negotiating with Sudanese officials and heads of paramilitary groups, Lau’s job as the MSF representative in Sudan is also to lobby UN officials to step up in the malnutrition crisis. Most UN workers and their contractors have left the country after it was deemed too dangerous.
MSF has stayed behind, but the crisis is far beyond its capacity. It can provide nutritional treatment to a child, but only for a few weeks. Longer term issues like food accessibility are typically handled by the UN’s World Food Program, while UNICEF would take charge of routine vaccination programmes in the country.
“MSF can’t do it all,” Lau said.
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