The United Nations warns that the conflict in Sudan has caused one of the world's largest human displacements.

It began about 10 months ago, when the Sudanese military and a powerful paramilitary group began fighting each other for political control.

Last week, the U.N. pleaded for more aid to the region. It said the fighting had displaced more than 10 million people — many of them fleeing to neighboring countries. It's also left 18 million people facing acute food insecurity.

James Elder is a spokesperson for UNICEF — the U.N. agency that provides humanitarian aid to children — and has just returned from a trip to the border of Sudan and Chad. He spoke to NPR's Sacha Pfeiffer about what he saw.

And a warning: Some of what is discussed may be difficult to read.

This interview has been lightly edited for length and clarity.

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Interview highlights

Sacha Pfeiffer: Could you describe what you saw, your strongest visual memories of being there?

James Elder: I think probably the strongest is just the eeriness of when you walk around communities, it could be a rural area or a neighborhood like a middle-class neighborhood, and it's empty. It's just absolutely silent. You can only hear the crunching of glass under your feet. And you look and its buildings are pockmarked, clothes and things, everything's been burned and looted and there is no one. There's no one. This is the largest displacement of children on the planet, it's mind boggling.

And then just this exhaustion of people that you see, whether it was in Chad, where the refugees have gone, or whether it's those in Darfur who are still terrified because they've had homes looted and burned. There is just that look amongst people that they're battered, they're exhausted, and they're still terrified because war is very much still raging in Sudan.

Pfeiffer: Despite that emptiness, were you able to talk with some people? And if so, what did they tell you?

Elder: Yeah, I spoke to a lot of people. I was in Chad, where you've had a lot of refugees come in, and I was in Darfur, where the war continues.

People speak to a couple of things. They speak to the horrendous violations, what we call "grave violations." The sexual abuse, seeing children killed, seeing rape of sisters or of mothers — this horrible level of kind of human suffering.

As a woman said to me, "If they couldn't steal it, they burned it." You know, I heard stories of someone's brother having sand stuffed so far down his throat into his esophagus. Deliberate attempts just to terrify and torture people.

So the stories are endless, as are the stories of those people who walk for days and days with badly malnourished children, desperately seeking help. They're repeated time and again.

Pfeiffer: Your work focuses specifically on children. What are the unique or particular challenges that kids are facing in this?

Elder: Nutrition has to be a huge one. You're talking about hundreds and hundreds and hundreds of thousands of children with a type of malnutrition that is the most dangerous, the most likely to kill someone. Because the health system's been shattered, that's something UNICEF is desperately trying to sustain.

We get "therapeutic food" – it's basically "magic" peanut paste — to children, we try and get that across the country. That's difficult as well because aid is blocked in areas.

But nutrition is a big one, and when you have a health system in tatters and when you have millions of people not actually accessing safe water and these relentless attacks on people, you have this vicious cycle of nutrition and water and disease, and that's what will kill children.

Pfeiffer: All these people fleeing are obviously going to other places. You mentioned Chad as an example. Where else are people going?

Elder: Chad is taking the most refugees, for sure. South Sudan has taken a large number. I have spent a lot of time in South Sudan, it is a very difficult place to end up as a refugee. It's a very difficult place to be if you're South Sudanese.

As ever, the poorest countries around the globe — not just in this crisis — absorb the most refugees. Those with the least tend to constantly be asked to give the most, and that's what we're seeing here.

Within this, we're seeing people die from nutrition, seeing people die from bullets, seeing people die from clean water. But there's another type of death that I really noticed going on. I was in Darfur 20 years ago. I went back this last week for the first time in 20 years ... and met a lot of 20-somethings and their dreams had died. And I found that devastating.

These were youth who would have been very small kids during those massacres in Darfur of 20 years ago. But somehow their parents kept them alive, and they latched on to life. They're studying. They're doing economics, medical sciences, I.T., you name it – all the things that a country needs. But these brightest minds are having to abandon their studies and their ambitions are being shattered.

I sat with many people, but one sticks in my mind — this electric 22-year-old woman in Darfur. And we're talking about being a woman in Sudan, and life, and war. And she said, this is pretty much verbatim: "I had a dream. It was to study medical science. I was living that dream. Now, I have nothing. I do not dream. Sadness is my friend."

Pfeiffer: In this part of Africa, there are numerous countries experiencing all types of instability, and instability can lead to power vacuums that can create a rise in violent extremism, which also has ripple effects globally. Is there any particular role that you think the U.S. or other countries in the world should be playing here?

Elder: Across the entire region, east to west Africa, there is a demographic of our population boom that is pretty much unprecedented in human history. And any economist will tell you, if you get that right – and by "getting it right," that means education and making sure that that education gives those young people the right skills and there's a labor market to absorb them — then you have an economic boom. You have this huge base of the working population, almost like the envy of an aging Europe.

If you don't get it right — and there's a clock that ticks on this — you have a massive youth population, they're disaffected, you have tensions, political disorder, all these things, security, instability.

So it's either a demographic dividend or a demographic disaster. And that is very much in the United States', the Europeans', everyone's interest, to make sure that this youth bulge is a dividend to the region, to the countries and the world.

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