The head of the U.N. children’s program, UNICEF, said Thursday that 16 million children in Sudan are suffering horribly from the country’s civil war, with many facing daily threats of violence, starvation, disease and sexual assault.

"The fighting is happening right at their doorsteps, around their homes, their schools and hospitals, and across many of Sudan’s cities, towns, and villages,” Catherine Russell, UNICEF’s executive director, told a meeting of the U.N. Security Council.

She said children under the age of five are particularly at risk, with more than 1.3 million living in five famine hotspots in the country, and another 3 million at risk of diseases including cholera, malaria and dengue due to the failing health system. At least 16.5 million young people are out of school.

Russell said there were 221 cases of rape against children reported in nine of Sudan’s 18 states last year. She said two-thirds were girls.

"In 16 of the recorded cases, the children were under the age of five. Four were babies under the age of one,” she said.

While she demanded an end to the hostilities, she said it would not erase the pain those children have endured.

"The trauma these children experience and the deep scars it leaves behind do not end with the signing of a ceasefire or a peace agreement,” she said. “They will need ongoing care and support to heal and rebuild their lives.”

The head of Doctors Without Borders (MSF) told the council that his teams in Sudan have also seen evidence of sexual violence, having treated 385 survivors last year.

“The vast majority — including some younger than five — had been raped, often by armed men,” said Secretary General Christopher Lockyear. “Nearly half were assaulted while working in the fields. Women and girls are not merely unprotected, they are being brutally targeted.”

The children are caught up in a power struggle between two rival generals that began in the capital, Khartoum, in April 2023, but has since spread to large parts of the country, including the Darfur region. The paramilitary Rapid Support Forces has been fighting the Sudanese Armed Forces, and the United Nations says both sides have committed grave human rights abuses.

The head of MSF told the council that he was in Sudan six weeks ago and witnessed a scene of “utter carnage” at one of their partner hospitals in Omdurman, near the capital.

“I witnessed the lives of men, women, and children being torn apart in front of me,” Lockyear said.

He told the 15-nation Security Council that their repeated calls on the parties to end the war have gone unanswered.

“While statements are made in this chamber, civilians remain unseen, unprotected, bombed, besieged, raped, displaced, deprived of food, of medical care, of dignity,” Lockyear said.

He later told reporters that the situation in Sudan “is so catastrophic for millions of people, it should be something that is on all of our consciences on a daily basis.”

The UNICEF director said the agency needs a billion dollars this year to provide critical support to 8.7 million children in Sudan, including nutrition, water and sanitation, protection, health, and education. She and Lockyear both urged the council to press the warring parties to remove obstacles to the delivery of aid.