Both a lack of access to food and health facilities will ultimately lead to death for many, warned the Norwegian Refugee Council.

More than 40 percent of Sudan’s population is facing acute hunger, according ⁠⁠to a report by a global hunger monitor, the three-year civil war having created one of the world’s worst humanitarian crises.

Nearly 19.5 million Sudanese people are facing such dire circumstances, the United Nations-backed Integrated Food Security Phase Classification (IPC) said on Thursday.

Sudan’s three-year civil war, between the Sudanese armed forces (SAF) and its rival Rapid Support Forces (RSF) paramilitary group, which has killed hundreds of thousands of people and displaced millions in the country, has also begot tremendous levels of hunger and famine.

The IPC report stated that 14 areas in ‌‌the country’s North Darfur, South Darfur, and South Kordofan states remain at risk of famine, where 135,000 people face “catastrophic” levels of hunger.

Those areas include the cities of el-Fasher and Kadugli, judged last year to be experiencing famine largely as a result of sieges by the RSF.

But in October, the RSF completed their takeover of el-Fasher, largely emptying the city, while this year the army broke the siege of Kadugli.

As a result of the hunger crisis, families have been forced into “very negative coping mechanisms”, said Grace Oongee, from the Norwegian Refugee Council.

“We’ve had reports of families who’ve been forced to eat leaves, who’ve been forced to eat animal feed, even reports of families breaking into slaughterhouses that have been closed down just to get the skin of the animals to be able to eat and to survive,” Oonge told Al Jazeera, speaking from the city of Port Sudan.

Both a lack of access to food and health facilities will ultimately lead to death for many, she warned.

Some of the figures from the IPC report and others, she added, may not be a true representation of what is actually happening on the ground due to restrictions on access.

“Ongoing hostilities – especially around major supply routes, ⁠⁠such as El Obeid in North Kordofan – and the possibility of renewed siege-like conditions continue to heighten risks,” the IPC said in a statement.

Some ⁠⁠825,000 children are expected to suffer from severe acute malnutrition as ⁠⁠insecurity, access restrictions, and budget cuts have made aid deliveries to many parts of the country difficult, the global monitor also said.

Last year, the IPC’s report estimate was slightly higher, stating that 21.2 million people faced acute hunger, compared with this report’s 19.5 million.

‘An invisible crisis’

Drone warfare has seemed to replace ground ⁠⁠campaigns as the leading mode of warfare in Sudan.

Fighting rages on ⁠⁠in the Kordofan region, as well as Blue Nile state, with drones killing at least 880 civilians since January, according to the UN’s human rights office.

Drones have also targeted civilian infrastructure, including markets, hospitals, and power stations.

Sudan’s rainy season, which begins around July and coincides with the leaner planting season, is expected to also worsen conditions.

Parts of North Darfur hosting those fleeing from el-Fasher are also at risk of famine, including Tina, Um Baru, and Kernoi, which have seen drone attacks, as well as fighting, as the RSF consolidates ‌‌its ‌‌control of the area.

The US-Israel war on Iran also threatens to worsen the situation, raising food, fuel, and fertiliser prices and making a successful harvest later this year less likely.

“I think Sudan is becoming an invisible crisis, and which is why we need to continue echoing the message and continue sharing the horrors of the current situation on the ground – it’s more than just the numbers,” said Oonge.