Sudan: Recent violence exacerbates a health care system already in need

Everywhere in the country, and especially in Khartoum, Darfur, North Kordofan and Gedaref states, our teams face serious challenges.

Our premises in Nyala, South Darfur, have been looted – including one of our warehouses. In Khartoum, most teams are trapped by the ongoing heavy fighting and are unable to access warehouses to deliver vital medical supplies to hospitals.

In Khartoum, even ambulances are being turned back. They are not being permitted to pass in order to retrieve the bodies of the dead from the streets – or to transport those who have been injured to hospital.

In Khartoum and other cities where fighting is intense, we have received reports of overstretched and closed hospitals - running out of supplies, water, electricity, fuel for generators. The staff in those medical facilities are working nonstop since the violence erupted and are completely exhausted. Many have been on duty for many hours, providing lifesaving care in extremely difficult circumstances despite the impact of the situation on them and their own families. On the other hand, the medical staff off duty cannot reach the hospitals to provide lifesaving care due to intense fighting and insecurity.

We are ready to provide supplies and medical personnel to key functional health facilities that need support, but it is too dangerous for anyone to move within Khartoum and other cities. We urge all parties to the conflict to guarantee safety for medical staff and patients, so that they can access healthcare facilities without fearing for their lives. And we additionally request that all parties to the conflict ensure that all health facilities – including hospitals, clinics, warehouses and ambulances – are protected. They should never be a target.

The majority of the wounded we’re seeing in Al Fasher are civilians who were caught in the crossfire – and among them are many children. They have extremely serious injuries and, until Saturday afternoon, there was no surgical capacity in this hospital. All other hospitals in North Darfur have had to close due to their proximity to the fighting, or due to the inability of staff to get to the facilities because of the violence. As a result, over the past five days, we have received 220 wounded patients. Very sadly, 34 have died from the severity of their injuries.

Currently, although we now have some surgical capacity, there are only 38 beds in this hospital. There is not enough space for them and many are being treated on the floor in the wards and in the corridors.

As things stand, the hospital is rapidly running out of medical supplies to treat survivors. It is running out of blood for transfusions. Fuel supplies for the hospital generator are also running low. It’s important to mention that, without those vital supplies, there will be further loss of lives. We received a list of surgical items that the surgical team urgently requires and were able to get some of these to them – but it is not enough.

With the number of wounded we are receiving, these supplies will soon run out. The airport has been closed since Saturday, and it is vital that it is re-opened so that we can bring in additional medical supplies and possibly an MSF surgical team to support the surgeons who are currently at work.

I would also like to mention that, following the military coup in 2021, most international support to Sudan was frozen and the ensuing economic crisis has caused the cost of living to increase for the population, resulting in increased food insecurity. The hospitals were already struggling to function due to lack of medical supplies and the brain drain of medical personnel.

Sudan's health system has been on the verge of collapse for decades; the economic crisis and political crisis pushed it to breaking point and this latest development is going to further exacerbate the deteriorating humanitarian needs in the country, which were already at their highest in a decade.

This article was originally published on El País. 18 April 2023.