As hospitals close and doctors flee, the Sudanese healthcare system collapses

As the struggle for control of Sudan enters its third week, health services in Khartoum, the country’s capital, are rapidly crumbling, a grim aftermath of the brutal fighting that has raised fears the conflict is becoming a wider humanitarian crisis could.

The total collapse of the health system could be days away, the Sudan Doctors’ Union has warned.

According to the World Health Organization, hospitals have been shelled and two-thirds of hospitals in Khartoum have been closed. More than a dozen healthcare workers were killed, officials said. In addition, “hidden victims” are dying of diseases and epidemics, as has become the case for basic medical care tight, said Dr. Abdullah Atia, General Secretary of the Doctors’ Union.

“We get a lot of calls every day, ‘Where do you want me to go?'” he said. “Those are the questions we cannot answer.”

Millions of civilians remained captive. The latest ceasefire, designed to allow civilians to flee, was due to end at midnight on Sunday, and although Rapid Support Forces said they would extend a humanitarian ceasefire by three more days, fighting was reported in the capital.

The Sudanese army said it was willing to extend the ceasefire in a statement on Sunday, but accused the Rapid Support Forces of violating the ceasefire and occupying a hospital. The RSF, in turn, said the army had looted medical supplies.

In response to the deteriorating situation, the United Nations Office of the Secretary-General announced it would dispatch Martin Griffiths, Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator, to Sudan “immediately”.

“The scale and speed of what is developing is unprecedented in Sudan,” Stéphane Dujarric, spokesman for the Secretary-General, said in a statement.

Other nations have scramble to evacuate their citizens by any means necessary as the situation has deteriorated. Britain had airlifted more than 2,122 people on 21 flights as of Saturday, with another flight scheduled for Monday from Port Sudan in eastern Sudan. This was announced by the British government on Sunday. Americans have fled in long convoys of buses, trucks and cars to Egypt north or to Port Sudan, where they hope to board ships bound for Jeddah, Saudi Arabia.

The State Department said Sunday that a second convoy of US citizens had arrived in Port Sudan, bringing the number of Americans evacuated to nearly 1,000. The department added that fewer than 5,000 Sudanese citizens have reached out to the US government for help through a “Crisis Intake” website set up for Americans and their families. About 16,000 Americans live in Sudan, many of them dual nationals.

Sudan’s health ministry is nowhere to be found, and the doctors’ union says it has received no support and little communication from the government. Health facilities have been used as defensive positions by militants, witnesses and officials say.

In addition, the paramilitary forces have occupied the national laboratory, officials say. Samples from diseases like malaria or tuberculosis could become weapons in the wrong hands, said Dr. Atia, who, like others, spoke by telephone from Khartoum. Uncollected bodies at morgues and others on the street are another problem, he added.

Hundreds of doctors have fled, and there are rumors that Rapid Support Forces fighters are kidnapping medics and forcing them at gunpoint to treat their wounded comrades. While the kidnappings have not been confirmed, Dr. Atia, dozens of members of the Sudan Doctors Union are missing.

The shortage of medical staff has left hospitals with barely enough staff to deal with it. Al Ban Jadid Hospital in eastern Khartoum normally has at least 400 staff but now has just eight medical staff. Al-Joda Hospital in southern Khartoum is limping along with four people: a surgeon, an anesthesiologist and two nurses, Dr. Atia.

Some NGOs offered a glimmer of hope. MSF said it had donated medical supplies to three hospitals in Khartoum, while the International Committee of the Red Cross announced on Sunday that eight tons of medical supplies were on their way from Saudi Arabia to Port Sudan.

“Health workers in Sudan have done the impossible by tending to the wounded without water, electricity and basic medical supplies,” Patrick Youssef, the Red Cross’s regional director for Africa, said in a statement.

The Sudan Doctors’ Union posts a notice on Facebook several times a day listing the few hospitals in Khartoum that are still operational, or an urgent warning to doctors to report to the field hospitals set up in homes across the city.

Outside of hospitals, medical staff must use whatever means they can to treat the wounded.

At a field hospital in Al Mamoura, Dr. Mohamed Karrar developed an intercostal drainage system in which he used a sterilized soda bottle to pump the blood out of a gunshot victim’s punctured lung. Long shifts in the trauma ward at the now-closed Ibrahim Malik Teaching Hospital in central Khartoum helped him prepare, but Dr. Karrar must now contend with the noise of war while working in a living room converted into an operating room.

“I know I’m in danger in these areas,” he said, “but these sick, wounded people need me.”

In Al Nada, medical workers and their patients take cover under beds and tables several times a day to hide from airstrikes and heavy artillery fire. Everyone is so nervous, said a doctor there, Mohamed Fath, that the sound of an open oxygen canister can cause employees to flee.

At the start of the conflict, the management of Al Nada, a private facility, decided to only treat pregnant women and children in order to provide a safe haven for a small proportion of the more than 24,000 women who, according to the WHO, are expected to give birth in Sudan in the next few weeks.

In the weeks since the fighting began, 220 babies have been born there and most have survived, Dr. fath

One woman sped through active combat zones and barely made it to the emergency room, he said. Later her husband Dr. Fath 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 locked in their home for days as artillery fire blasted over them, the doctor said. When they finally made it to the hospital, it was too late for the child, who died.

“You have to go through this hell to get to the hospital,” said Dr. fath

Neighbors seeking care ring the doorbell at Dr. fath Twice last week he said he pronounced two people dead in Omdurman Althawra, north of the city. Both were diabetics running out of insulin in a city where pharmacies have been looted and a medical black market thrives.

Now, the doctor said, he conjures up home remedies that are hidden in his car. But in neighborhoods that can quickly transform from ghost towns into active war zones, even driving miles between the hospital and his home can put his life in jeopardy.

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, decided to stay.

“If you would see what I saw every day in a daily practice,” said Dr. Fath, “Would you understand my situation.”

Edward Wong contributed reporting from Washington, Naila Morgan from New York and Isabella Kwai from London.