The Face of Truth: Sudan’s Health Sector: Challenges Amid War Consequences!
Ibrahim Shglawi
During our visit yesterday, alongside a group of journalists, to Al-Nau Teaching Hospital in Karari locality, the scene was alarming: an overcrowded hospital with insufficient space, forcing the administration to set up temporary wards in tents to accommodate the increasing number of patients. Despite the presence of two other hospitals, “Al-Walideen” and “Al-Jazeera Aslang,” which are also under immense pressure due to the influx of patients and injured individuals, Al-Nau Hospital remains the only one serving citizens in a locality affected by indiscriminate shelling from the Rapid Support Forces (RSF).
Despite these circumstances, medical staff and volunteers continue to work tirelessly to provide treatment and save lives amidst a destroyed infrastructure and a severe shortage of resources. This scenario highlights the severe health challenges facing Sudan, where the RSF intentionally destroyed health and medical institutions, leading to an almost complete collapse of the sector.
This visit raised questions about the health situation in Sudan, which has been suffering from the ongoing war that entered its second year in April 2023. The health conditions represent one of the most prominent aspects of the humanitarian crisis affecting Sudanese people. The strategic challenges faced by the Ministry of Health require an urgent response from the international and regional community, not only to provide immediate support but also to rebuild the health system and ensure the sustainability of services in the future.
Despite these challenges, the Ministry of Health in Khartoum State has achieved significant milestones, such as rehabilitating 20 dialysis machines after they were systematically sabotaged by the RSF. Dr. Fath Al-Rahman Mohamed Al-Amin, the Director-General of the Ministry of Health in the state, emphasized that this effort reflects the determination of health workers to confront threats and sustain health services in safe areas, in parallel with the Armed Forces’ efforts to restore stability. The ministry has become a hub of continuous activity, repairing medical equipment retrieved from liberated areas to meet the needs of patients, particularly kidney failure patients suffering from inadequate healthcare.
The Ministry of Health estimated the direct losses in the sector at around $11 billion due to the destruction of public and private hospitals and the looting of medical equipment and pharmaceutical supplies. According to reports from the Federal Ministry of Health, 75% of hospitals have been either completely destroyed or are operating at partial capacity. This situation has increased pressure on health facilities in safe areas, which are striving to accommodate the rising numbers of displaced individuals and patients. Meanwhile, the health situation in RSF-controlled areas is dire.
Many health institutions have been destroyed or repurposed to serve the RSF alone, exacerbating civilian suffering. Some hospitals have resorted to emergency measures, such as performing surgeries under phone lights, as seen in El Fasher, reflecting the magnitude of the humanitarian crisis. The visit of the Director-General of the World Health Organization (WHO) to Port Sudan late last year highlighted the urgent needs of the health system. During the visit, the international organization committed to rehabilitating parts of the health sector, a promise that requires follow-up to ensure its fulfillment.
Drawing lessons from countries that rebuilt their health systems after wars is crucial. Rwanda, for instance, presented an exemplary model of rebuilding from scratch after a war that left its health system in ruins. Rwanda adopted an approach based on integration between the government and the community, where local communities contributed to rehabilitating health facilities through internationally supported community initiatives.
Similarly, Iraq leveraged international funding to rebuild its health infrastructure through solidarity between the community, government, and international organizations. In Lebanon, the private sector played a significant role in compensating for the lack of public services, rebuilding several hospitals through public-private partnerships under government supervision to ensure service quality.
Inspired by these international experiences, the Sudanese community could become a key partner in rebuilding the health sector through local initiatives led by the private sector, showcasing the resilience of Sudanese communities in adapting to post-war realities. Adopting a Sudanese strategy for rebuilding the health system is essential, focusing on primary healthcare, as rural areas in Sudan have suffered from a lack of health services even before the war.
Additionally, establishing a comprehensive national network to redistribute health facilities fairly across states could alleviate pressure on Khartoum. This network would ensure service integration between major hospitals and primary healthcare centers in the states, promoting equitable access to health services.
Efforts must also prioritize sustainability by adopting monitoring mechanisms to ensure transparency in resource utilization. Building a national emergency system to address health crises and disasters, maintaining a strategic stockpile of medicines and medical equipment, and training rapid response teams are equally crucial. Regional and international partnerships should also be leveraged.
International sanctions imposed on the RSF and its frozen companies could be used to establish a national fund to support reconstruction and compensate victims. The future of Sudan’s health sector lies in adopting serious strategies for rebuilding through national and international financing mechanisms that ensure resources reach the most affected areas.
In conclusion, from the perspective of truth, rehabilitating Sudan’s health sector requires a long-term strategic vision balancing rapid crisis response with sustainable planning to build an effective health system. This effort must rely on community involvement, regional and international organizations, and the private sector. Moreover, national will is essential to prioritize public health as a national priority and a bridge toward peace and sustainable development.
Wishing you health and well-being.
Wednesday, January 15, 2025
Shglawi55@gmail.com