Dr Mohammad Bashirm, Médecins Sans Frontières (MSF) deputy medical coordinator, reflects on his experience as a doctor in Sudan and his dedication to saving lives in the absence of sufficient resources since conflict erupted in his country.
Before 15 April 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 have been displaced in Sudan and in neighbouring 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.
I've never seen anything like the suffering that people in my country now are enduring daily. This conflict is devastating. Dr Mohammad Bashirm, MSF deputy medical coordinator in Sudan
Collapsed healthcare system
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 ceasereans 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 1,500 births since last July.
But across the country, many maternity services have not been functioning regularly, 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.
Vaccination and nutritional support are crucial
As a citizen and as a doctor, I feel deep concern when I consider the growing health needs in my homeland. Some of these needs pre-date the conflict, but all of them have been 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 it, they can be fatal, especially for young children. One factor 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 violence, often living in crowded makeshift camps, large-scale vaccination programmes and nutritional support are more than crucial - they are a potential lifeline.
Working with communities
In Sudan, most of the areas where we work remain active battle zones. This makes our work incredibly challenging and dangerous, but it also makes us more determined.
The determination I mention here isn't solely focused on MSF; I extend it to the communities who come together to support each other. 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.
It's now a matter of life and death that all parties to this conflict recognise MSF's sole purpose: to offer medical care to the most vulnerable. Dr Mohammad Bashirm, MSF deputy medical coordinator in Sudan
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However, 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 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.
But how do I hold on to 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 recognise MSF's sole purpose: to offer medical care to the most vulnerable, free of charge. We need access, as well as safety for our patients, teams and supplies, not tomorrow, but now. The lives we strive to save depend on it.
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 I can to relieve suffering in the face of conflict. And I remain dedicated to this cause.
