Sudan: Health system on the verge of collapse in Khartoum

Previously home to more than 6 million people, the city and state of Khartoum have been devastated by war between the Sudanese Armed Forces (SAF) and the Rapid Support Forces (RSF) since April 2023. The roughly 3 million people who remain in the area or have returned are increasingly cut off from health care as the price of essential medicines has soared and only a few hospitals are still functioning.

"Despite a mass exodus from Khartoum due to ongoing fighting, there are still a huge number of people who either could not afford to flee or were unable to do so due to vulnerabilities or insecurity. They are now struggling to access critical treatment," said Jean-Guy Vataux, MSF head of mission, from Khartoum today.

Authorities must continue issuing travel permits

Patients often arrive in critical condition at MSF-supported medical facilities in Khartoum, including Bashair Teaching Hospital, Turkish Hospital, and Umdawanban Hospital. However, MSF's support has been constrained by the lack of travel permits issued by Sudanese authorities for incoming medical and humanitarian workers. This month, for the first time in more than 90 days, a limited number of travel permits have been granted for humanitarian staff to access RSF-controlled areas.

“For many months, restrictions on the movement of essential medical and other humanitarian staff into Khartoum have prevented people from being able to receive lifesaving treatment for wounds and for entirely preventable diseases,” said Vataux.

“The demand on health services in Khartoum has only increased since violence engulfed Al Jazirah state in mid-December," Vataux continued. "Many health facilities in Wad Madani, the state capital, became nonfunctional, and many [displaced] people returned to Khartoum. Although MSF has just been granted permission to return to Wad Madani, which is positive news, this was the first time in over 90 days. We urge the Sudanese authorities to facilitate our access to Al Jazirah and Khartoum states on a regular basis so we can meet the ever-increasing needs of the population."

MSF teams in Khartoum's Turkish Hospital receive over 100 patients a day, mostly children and pregnant women. Many arrive in a critical state at advanced stages of illness after taking the calculated risk of traveling to the hospital—sometimes, having to walk for miles and cross front lines, since there is no ambulance service and there are very few transport options available.

"A four-year-old girl was brought to our emergency room after being hit in the abdomen by a stray bullet that entered her home,” said Vataux. “Her mother took her to three other hospitals before she was finally able to get surgical treatment at the Turkish Hospital. We had another tragic case where four children were playing with an unexploded rocket. They had no idea it was a dangerous object until it exploded in their hands. They were rushed to hospital, and two of them required urgent abdominal surgery.”

Shortages of medicines and medical supplies continue 

At Umdawanban Hospital, children with diabetes often arrive near death because their families could not find insulin. Oxytocin, an essential medicine for many women in labor, is also missing.

"Before MSF set up our services here [in June 2023], children in Umdawanban had no access to pediatric care,” Vataux said. “We see fewer child fatalities today but now our medical team has been reduced to the bare minimum within the hospital. Mothers and children remain at risk, especially when they suffer from chronic conditions such as hypertension, thyroid problems, or epilepsy, which require medicines that are hard to find for both MSF and Ministry of Health colleagues."

MSF teams have also worked for six months in the emergency department of Bashair Teaching Hospital in southern Khartoum, carrying out more than 6,100 medical consultations. But our teams are struggling to continue.

"As one of the few functioning hospitals available to the communities of Khartoum state, it is a lifeline for many, but we’re starting to miss the essentials," said Slaymen Ammar, MSF medical coordinator. "For example, stocks of medical gloves and antiseptic for cleaning wounds are so low that providing even very basic medical care is becoming a challenge."

MSF in Sudan 

MSF has worked in Sudan since 1979. We currently work in Khartoum city and state and the states of White Nile, Blue Nile, River Nile, Al Gedaref, West Darfur, North Darfur, Central Darfur, and South Darfur. 

MSF teams in Sudan are treating people injured in the fighting, including blast injuries and gunshot wounds; treating communicable and non-communicable diseases; providing maternal and pediatric care; running mobile clinics in locations where displaced people have gathered and hospitals in refugee camps; providing water and sanitation support; supporting health care facilities through donations and incentives to Ministry of Health staff; and providing training and logistical support. MSF is also continuing the majority of our activities that were in place before the start of the conflict.