In collaboration with the Ministry of Health, MSF teams have supported the Umdawanban hospital in Khartoum State, to improve healthcare services for the local communities including people directed affected by the ongoing conflict. Sudan, 2023 © MSF
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Sudan: Alleviating suffering in the face of war

Dr Mohammad Bashir
MSF Deputy Medical Coordinator in Sudan

Before April 15 of last year, I never imagined that I would find myself in Khartoum, the capital city of our country, working in a conflict zone.

I am a doctor from Sudan, and I’ve worked with MSF for several years. But I’ve never seen anything like the suffering that people in my country now are enduring daily. This conflict is devastating. More than 7 million people are displaced by this conflict in Sudan and neighboring countries, people have fled the violence, many finding themselves almost destitute in informal camps.

Like so many others, the conflict has not spared me and my beloved ones.

As a citizen and as a doctor, I feel deep alarm when I consider the growing health needs in my homeland.

Sudan has long struggled with a fragile healthcare system, and the ongoing conflict has brought it crashing down. I have been supporting MSF teams in two hospitals in Khartoum State and another one in Um Rakuba refugee camp in the east for the past months. When people think about medical needs in a conflict, often they think about people injured by bombs or bullets. But I’ve also seen growing numbers of medical emergencies caused by complications from untreated chronic diseases. People who might have successfully managed diabetes or asthma for years are now unable to find the medications they need to live.

The need for maternity care is also striking, especially for pregnant women requiring C-sections or emergency deliveries. That is why in Umdawnban, one of the hospitals I have covered, our team has been supporting the maternity team, assisting in over 1500 births since last July. But across the country, many maternity services have not been regularly functioning, leaving pregnant women facing life-threatening complications without access to emergency obstetric care. And where healthcare services are available, the quality of care remains a concern.

More is needed

As a citizen and as a doctor, I feel deep alarm when I consider the growing health needs in my homeland. Some of these pre-dates the conflict, but all of them are worsened by it. Sudan has a troubling history of outbreaks such as measles and meningitis. These highly contagious diseases can be prevented through vaccination, but without they can be fatal, especially in young children. One fact that puts children particularly at risk is malnutrition, which impairs the immune system.

With the collapse of the healthcare system and hundreds of thousands of people now having fled the violence, often living in crowded makeshift camps, large scale vaccination programmes and nutritional support are more than crucial – they are a potential lifeline.

How do I hold onto my pledge in a situation when resources and helping hands are impeded and exposed to dangers? This question echoes in my thoughts both day and night.

In Sudan, most of the areas MSF is operating in remain active battle zones. This makes our work incredibly challenging and dangerous, but it also makes us more determined.

For instance, in Um Rakuba camp, in the east of Sudan, MSF provides desperately needed humanitarian care to thousands of people who live in and around the refugee camp. When the conflict erupted, it was unclear if it would be possible to continue our support there, but with the determination of a core team, there has been no gap in the service. Last year we delivered 40,000 medical consultations to refugees as well as to the host community and assisted 507 women to give birth safely. Our determination is shared: in Um Rakuba I’ve seen first-hand the important role local volunteers and community midwives are playing.

Determination is not enough…

But sometimes determination isn’t enough. My sacred oath as a doctor is to do all that I can for people who need medical care. And in my role as an MSF deputy medical coordinator, that means not only treating individual patients, but also coordinating care on a larger scale, ensuring that staff and supplies are where they are needed most.

Stom Abdulrahman, pictured with her husband, is a refugee in Um Rakuba camp in Sudan. “I have suffered a lot from going to some hospitals to receive treatment,” she says, “especially since we cannot afford the costs … I went to the MSF hospital in Um Rakuba camp… The MSF health promotion team visits me regularly and provides me with [healthcare] information.” Sudan, 2023 © MSF

But how do I hold onto my pledge in a situation when resources and helping hands are impeded and exposed to dangers? This question echoes in my thoughts both day and night.

It’s now a matter of life and death that all parties to this conflict recognize MSF’s sole purpose: to offer medical care to the most vulnerable, free of charge. We need access as well as safeguards for our teams and supplies as much as for patients, not tomorrow, but now. The lives we strive to save depend on it.

A part of me

My work in Sudan, my country, is not just a job; it’s a part of my humanity. And my ethical duty is that I, like my colleagues in MSF, do all we can to relieve suffering in the face of conflict.

And I remain dedicated to this cause.

Dr. Mohammad Bashir (far right) and colleagues outside the Umdawnban hospital in Khartoum state. Sudan, 2023 © MSF

Dr. Mohammad Bashir has worked with MSF for several years.  He has been supervising the medical activities in Umdawnban and Alban Aljadeed hospitals in Khartoum State, supported by MSF since July-August 2023. In Umdawnban hospital, our team addresses the paediatric and maternity health care, furthermore, Alban Aljadeed hospital stands as the sole operational public hospital in East-Nile, where MSF has supported the emergency room and operating theatre, this is where the team provided more than 12,000 emergency outpatient consultations since August 2023.

Dr. Bashir also worked with the medical team for Um Rakuba Refugee Camp in Al Gedaref State where we delivered 40,000 outpatient consultations in 2023 alone.

His role extended to handling some health emergencies such as the response to a cholera outbreak. His efforts in two of these hospitals provided vital support to approximately 500 persons affected by the cholera in 2023.

More about MSF in Sudan

Currently, MSF teams work in 11 states: Khartoum, Al-Jazeera, White Nile, Blue Nile, River Nile, Al Gedaref, West Darfur, North Darfur, Central Darfur, South Darfur and Port Sudan state. We are also providing assistance to refugees and returnees across Sudan´s borders in South Sudan, Central African Republic and Chad.

Our teams in Sudan are providing emergency treatment, carrying out surgery, running mobile clinics for displaced people, treating communicable and non-communicable diseases, providing maternal and paediatric healthcare, including safe deliveries, providing water and sanitation services, and donating medicines and medical supplies to healthcare facilities, and providing incentive pay, training and logistical support to Ministry of Health staff. MSF is also continuing some of its medical activities that were in place before the start of the conflict.