Sudan’s Health Crisis, From War Zones to Refugee Camps

In areas where forcibly displaced people from Sudan are living, basic necessities are nonexistent, says Dr. Ihsan Fagiri, a physician and member of the Sudanese Communist Party.

For over a year, the Sudanese Armed Forces (SAF) and Rapid Support Forces (RSF) have been engaged in a bloody conflict, forcing thousands to flee their homes. Some are living in forests, while others tried to find refuge in neighboring countries like Chad. However, without adequate support from international organizations, these camps have become breeding grounds for disease outbreaks. According to Fagiri, health activists worldwide should prioritize the establishment of clinics in the camps to protect hundreds of thousands of people from complications arising from treatable diseases.

Sanitation infrastructure in some camps consists merely of holes in the ground serving as latrines, leading to dangerous conditions, especially for children, who often fall into these holes, Fagiri reported at a press conference organized by the International Peoples’ Assembly (IPA), Peoples Dispatch and Madaar. Additionally, women and girls at the camps lack access to menstrual hygiene products and face constant threats of gender based violence.

Within Sudan, women face similar risks, with hundreds of documented rape cases possibly representing only a fraction of the true number. The stigma associated with rape exacerbates mental health issues among survivors, pushing their mental health to critical levels. Adequate care and psychological support for women, girls, and families are imperative, which will only be possible if the war stops, Fagiri asserted.

Despite calls for international action to push for an end to the civil war which sees millions of Sudanese attacked on a daily basis, the response has been limited. Far from bolstering aid efforts, United Nations (UN) agencies have actually scaled down activities due to blockades by authorities and direct attacks from both warring parties, adding to the burden of hunger shouldered by the people.

The World Health Organization (WHO) has documented 82 attacks on healthcare facilities since April 2023, with 17 occurring in the past six weeks. Fagiri warned that the military has been targeting hospitals with airstrikes, noting that both the SAF and RSF have committed crimes against the Sudanese people. More than two-thirds of the vital health infrastructure in areas affected by the fighting has been destroyed, severely impacting access to healthcare, which was already limited before the war.

The loss of specialized care has been particularly hard. Many healthcare services, such as dialysis, vaccination centers, and pediatrics, have been devastated. Doctors Without Borders (MSF) recently ceased operations at the Turkish Hospital in Khartoum after their team was threatened by armed groups inside the facility. This was not the first time MSF staff faced such threats, leading to the decision to abandon the hospital, which now can no longer provide surgical care. Notably, 80% of the surgical procedures at the Turkish Hospital were C-sections over the past year.

The war has highlighted the fragility of Sudan’s health system, which was already weakened by structural adjustment programs (SAPs) enforced by the International Monetary Fund (IMF) since the late 1970s. These programs introduced user fees and reduced health budget allocations, leading to decreased access, particularly for rural and poor communities. Healthcare infrastructure was unevenly distributed, with most facilities located in urban centers despite the majority of the population living in rural areas.

Decentralization of healthcare during SAP implementation further strained the system, as regions lacked the financial means to support devolution policies. As a result, the onset of the war quickly led to the collapse of health services, despite attempts to strengthen the system during the 2018 revolution. WHO estimates that the combination of conflict and a weak health system will leave approximately 15 million people in urgent need of care in 2024.

Sudan is currently experiencing outbreaks of malaria, dengue, measles, and cholera. Measles has claimed over 100 lives, while more than 300 have died from cholera. The spread of cholera is exacerbated by the inability to bury the dead properly, leaving bodies buried in homes or on the streets, where they are consumed by stray animals, recounted Fagiri.

The situation is devastating. To stop this crisis, Fagiri reasserted the need to end the war and eventually reactivate Sudan’s health system, with support from international solidarity initiatives.

People’s Health Dispatch is a fortnightly bulletin published by the People’s Health Movement and Peoples Dispatch. For more articles and to subscribe to People’s Health Dispatch, click here.