As hospitals close and doctors flee, the healthcare system in Sudan is collapsing
As the battle for control of Sudan enters its third week, healthcare services in the country’s capital, Khartoum, are rapidly unraveling, a grim result of the relentless fighting that has raised fears the conflict could turn into a wider humanitarian crisis.
The total collapse of the healthcare system could take days, the Sudanese doctors’ union warned.
Hospitals have been shelled and two-thirds of those in Khartoum have been closed, according to the World Health Organization. More than a dozen health workers have been killed, according to officials. Beyond that, “hidden victims” are dying of illness and disease, as basic medical services have become scarce, said Dr Abdullah Atia, secretary general of the doctors’ union.
“We get a lot of calls every day: ‘Where should I go?'” he said. “These are the questions we can’t answer.”
Millions of citizens were trapped. The latest ceasefire to allow civilians to escape was due to end at midnight on Sunday, and although the Rapid Support Forces said it would extend a humanitarian ceasefire by three days, fighting was reported in the capital.
The Sudanese military agreed in a statement on Sunday to extend the ceasefire, but accused the Rapid Support Forces of violating the ceasefire and occupying a hospital. The RSF, in turn, has said the military has looted medical supplies.
In response to the deteriorating situation, the United Nations Secretary-General’s office said it would “immediately” send Martin Griffiths, the Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator, to Sudan.
“The scale and speed of what is unfolding is unprecedented in Sudan,” Stéphane Dujarric, spokesman for the secretary-general, said in a statement. rack.
Other nations have hastily to evacuate their citizens by all possible means, as the situation has deteriorated. Britain had flown more than 2,122 people on 21 flights on Saturday, with another flight from Port Sudan in eastern Sudan scheduled for Monday, the British government announced on Sunday. Americans have fled in long convoys of buses, trucks and cars en route to Egypt in the north or to Port Sudan, where they hope to board ships bound for Jeddah, Saudi Arabia.
The State Department said on Sunday that a second convoy of US citizens had arrived in Port Sudan, bringing the number of Americans evacuated to just under 1,000. The department added that fewer than 5,000 Sudanese citizens had sought help from the US government through a “crisis intake” website set up for Americans and their families. Sudan is home to approximately 16,000 Americans, many of whom have dual citizenship.
The Sudanese health ministry is nowhere to be seen and the doctors’ union says it has received no support and little communication from the government. Health facilities have been used by fighters as defensive positions, witnesses and officials say.
In addition, paramilitary forces have occupied the national laboratory, officials say. Samples of diseases such as malaria or tuberculosis could be used as a weapon in the wrong hands, said Dr. Atia, who, like others, spoke by telephone from Khartoum.
Uncollected bodies in morgues and others on the streets are another concern, he added. The doctors’ union reports this later a statement tThe number of bodies scattered in the streets grew, creating “an environmental disaster.”
Hundreds of doctors have fled and Rapid Support Forces fighters are rumored to be kidnapping medics and forcing them at gunpoint to treat their wounded comrades. While the abductions have not been confirmed, Dr. Atia, dozens of members of the Sudanese doctors’ union are missing.
Due to the shortage of healthcare personnel, the hospitals hardly have enough staff to cope. Al Ban Jadid Hospital in eastern Khartoum usually has a staff of at least 400 people, but now has only eight health workers. Al Joda Hospital in southern Khartoum is stumbling along with four people: a surgeon, an anesthetist and two nurses, Dr Atia said.
“Health workers in Sudan have done the impossible, caring for the injured without water, electricity and basic medical supplies,” Patrick Youssef, the Red Cross regional director for Africa, said in a statement.
The Sudanese doctors’ union publishes a message on Facebook several times a day listing the few hospitals still operating in Khartoum, or an urgent warning for doctors to report to the field hospitals set up in homes in the city.
Outside of hospitals, medical personnel must use whatever tools they can find to treat the injured.
At a field hospital in Al Mamoura, Dr. Mohamed Karrar improvised an intercostal drainage system using a sterilized soda bottle to pump the blood out of a victim’s punctured lung. Long shifts in the shuttered trauma ward of the Ibrahim Malik Teaching Hospital in central Khartoum helped him prepare, but Dr. Karrar must now battle against the sound of war while working in a living room that has been converted into an operating room.
“I know I’m in danger in these areas,” he said, “but those sick, injured people need me.”
At Al Nada, medical staff and their patients take cover under beds and tables several times a day, hiding from aerial bombardments and heavy artillery fire. Everyone is so nervous, said a doctor there, Mohamed Fath, that the sound of an oxygen bottle being opened could send staff fleeing.
Early in the conflict, the management of Al Nada, a private facility, decided to treat only pregnant women and children in order to provide refuge for a small portion of the more than 24,000 women who, according to the WHO, are expected to give birth in Sudan in the coming weeks.
In the weeks since the fighting began, 220 babies have been born there and most have survived, Dr Fath said.
A woman sped through active combat zones and barely made it to the emergency room, he said. Later, her husband Dr. Fath see the bullet holes in his car. Another woman gave birth at home, but due to complications, the baby required urgent medical attention. The mother and child were trapped in their home for days with artillery fire overhead, the doctor said. When they finally reached the hospital, it was too late for the baby, who died.
“They have to go through this hell to get to the hospital,” Dr. Fath said.
Neighbors seeking care have a home with Dr. Fath rang the doorbell. Twice last week, he said, he pronounced two people dead in Omdurman Althawra, north of the city. Both were diabetics who ran out of insulin in a city where pharmacies have been looted and a medical black market is thriving.
Now, the doctor said, he drinks home medicine, stashed in his car. But in neighborhoods that can quickly turn from ghost towns to active war zones, even the mile-long journey between the hospital and his home could endanger his life.
Before the war, Dr. Fath filled out application forms to work in hospitals in South Africa, where he planned to specialize in pediatric neurology. But he and his wife, also a doctor, whose final exams were scheduled for May 6, made the decision to stay.
“If you saw what I saw every day, in everyday practice,” Dr. Fath said, “you would understand my situation.”
Edward Wong contributed reporting from Washington, Naila Morgan from New York and Isabella Kwai from London.