Khartoum — Six months into the war in Sudan, people's lives are still in danger from bombings, shelling and the shootings, both directly and indirectly. Sudanese health staff and volunteers are struggling to respond to people's medical needs, and the country's health system is on the edge of collapse, says Médecins Sans Frontières (MSF).
Our teams note a shameful absence of humanitarian organisations working in the country. In those areas where assistance is being provided, the response is insufficient for people's immense needs. MSF is calling for an immediate increase in humanitarian efforts.
"Sudan's crisis epitomises a catastrophic failure of humanity, marked by the warring parties' failing to protect civilians or facilitate essential humanitarian access, and by the dire neglect and shortcomings of international organisations in delivering an adequate response," says Dr Christos Christou, International President of MSF. "Without an immediate, substantial escalation of the humanitarian response, what we are witnessing now will be the beginning of an even larger tragedy yet to unfold - meaning more people will continue to needlessly die."
Across Sudan, the fragile health system is struggling; emergency rooms are congested, and many hospitals have closed completely. In the capital, Khartoum, MSF medical teams are witnessing one of the most intense urban conflicts currently taking place worldwide. Large numbers of injured people are arriving at the hospitals with life-threatening wounds, often leaving medical staff with no choice but to amputate.
"In both Khartoum and Darfur, many patients are critically injured to the extent that they need to have multiple rounds of surgery," says Shazeer Majeed, an MSF surgeon. "On more than seven occasions in September alone, the hospitals where MSF operates received significant influxes of injured people following shelling, airstrikes, and explosions."
Even for people who are not directly affected by the violence, they are suffering the indirect effects of the war. There is a chronic shortage of medications across Sudan. Pharmacies have either run out of supplies or have hiked their prices, making many medicines unaffordable for those who need them. As a result, patients with chronic illnesses are suffering serious complications and sometimes dying.
"We are seeing critical cases arrive at the hospital, due to the lack of medicine, especially patients with illnesses like diabetes," says Frauke Ossig, MSF head of mission. "By the time they reach us, there's often very little we can do."
Sudan's crisis epitomises a catastrophic failure of humanity, marked by the warring parties' failing to protect civilians or facilitate essential humanitarian access, and by the dire neglect and shortcomings of international organisations in delivering an adequate response. Dr Christos Christou, International President of MSF
Even in places easier to access, millions of displaced people are living in overwhelmed camps and makeshift sites like schools, after being displaced from their homes by the violence. People, including children, in these sites are dying of preventable diseases, such as malaria and measles, as there is a shameful lack of humanitarian response.
In Khartoum, as well as in many displacement camps, the water systems have been destroyed or are inadequate for people's needs, raising the risk of outbreaks of cholera and suspected cholera amid war. MSF teams are supporting the Ministry of Health in many locations to make sure that health staff are ready to respond to possible cholera outbreaks.
MSF's own humanitarian response is being hindered by considerable bureaucratic and administrative hurdles imposed by Sudanese authorities. These include restrictions on movements of staff, travel permit rejections, delays in releasing medical supplies and bans on specific supplies, including those needed for surgery. In south Khartoum one of the hospitals supported by MSF has less than one week's worth of essential supplies left to provide emergency trauma care to injured patients. Once these supplies run out, MSF teams will no longer be able to provide this care.
Without urgent action, the most vulnerable people will continue to bear the brunt of the violence, resulting in more avoidable deaths. Frauke Ossig, MSF head of mission
"Any supplies that do reach healthcare facilities are quickly exhausted, leading to dire health consequences and even fatalities," says Claire Nicolet, MSF deputy head of emergencies. "We desperately need surgical and medical equipment not just for trauma care, but also for obstetric surgeries, as we see many pregnant women in life-threatening conditions."
With no end to the war in sight, MSF is calling for a substantial increase in efforts to provide humanitarian aid; for the safeguarding of medical, humanitarian workers, and civilians; for the removal of administrative blockages on medical and humanitarian staff and supplies; and for people to be allowed unhindered access to aid.
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"Sudan's healthcare system is on the brink of collapse," says Ossig. "Without urgent action, the most vulnerable people will continue to bear the brunt of the violence, resulting in more avoidable deaths."
MSF response in Sudan
MSF teams work in 10 states: Khartoum, Al-Jazeera, White Nile, Blue Nile, River Nile, Al Gedaref, West Darfur, North Darfur, Central Darfur and South Darfur state. MSF teams are also providing assistance to refugees and returnees across Sudan's borders in South Sudan, Central African Republic and Chad.
MSF 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.
