Sudan: nearly half of hospitals in Khartoum damaged in first 500 days of conflict

Nearly half of all hospitals in Sudan’s Khartoum State have been damaged since the outbreak of the civil war in mid-April 2023, severely hampering access to medical care for at least one-third of people living in the heavily populated state.

A report from the Sudanese American Physicians Association (SAPA) and the Yale School of Public Health Humanitarian Research Lab (HRL) reveals concrete data and imagery of devastating attacks on hospitals in Khartoum State, despite protections under international humanitarian law (IHL). The report — “Widespread damage and disruption to healthcare in Khartoum State, Sudan” — reveals attacks on hospitals that resulted in direct harm to healthcare workers and patients, curbing people’s access to healthcare significantly due to the physical risk of seeking medical care, broken supply chains and high rates of absenteeism and health workforce turnover, creating a major humanitarian crisis.

“Every damaged hospital examined in this report represents the story of a patient turned away, a surgery delayed or a life lost,” said SAPA President Dr Yasir Elamin. “Beyond the immediate security risks to healthcare personnel and patients, the damage to hospitals documented in this report will have devastating long-term effects on the health and well-being of people in Sudan and across the region. These findings are a call to action for governments, humanitarian organisations, and global leaders to prevent further devastation and work to rebuild this critical infrastructure.”

Prior to the ongoing conflict between the Sudan Armed Forces (SAF) and the Rapid Support Forces (RSF), Khartoum’s healthcare system provided a comprehensive range of specialised care, and the Sudanese people relied on Khartoum State as the main referral and medical hub for patients across the country, explained Elamin. “These healthcare facilities offered specialised treatments such as interventional procedures, complicated surgeries, oncology care, paediatrics specialties and infectious disease management. These devastating attacks on hospitals will have wide-ranging effects that go far beyond the impacts felt by the residents of Khartoum and Omdurman alone.”

Key findings from the report include the fact that 41 out of 87 hospitals sustained damage visible on satellite imagery in 55 separate incidents between 15 April, 2023, and 26 August this year. Eleven of those hospitals were damaged in more than one incident.

Moreover, at least 60 per cent of the damaged hospitals provided care in Outpatient Departments (25 of 41 damaged hospitals) and Inpatient Departments (25 of 41), and nearly half of the hospitals provided care in Emergency Rooms (19 of 41). At least one damaged hospital had a Paediatric Intensive Care Unit (PICU).

Seventeen of the 25 teaching hospitals in Khartoum State have been damaged. This has an impact on public health today as well as the training of future generations of healthcare workers.

On 5 February this year, UN experts reported that approximately 70 per cent of Sudan’s healthcare facilities are no longer operational, a majority of which are in Khartoum State.

“I have seen first-hand the empty halls of hospitals that once saved lives,” said Dr Safa Ali, an obstetrician at El-Saudi Hospital in Omdurman. “These hospitals should be sanctuaries for healing, not targets or collateral damage. Sudanese healthcare workers and the people of Sudan need the world to stand with them and help rebuild what conflict has destroyed. The world has a moral obligation to help rebuild this critical infrastructure and support the millions who depend on these hospitals for survival.”

Hospital damage was assessed for the report using SAPA local experts and open source data as well as satellite imagery from 15 April 2023 to 26 August 2024. All 87 hospitals were verified by a combination of SAPA local health experts and Yale HRL open source and remote sensing analysts using available data and imagery, across 270 to 400 satellite images available per location. Alleged attacks on hospitals were identified using multimedia content from open sources, primarily user-generated content on social media and local news, along with Armed Conflict Location & Event Data (ACLED) and Insecurity Insight datasets.

The report’s quantification of damage underestimates the actual number and severity of damage incidents due to multiple factors. These factors include network connectivity disruptions (blackouts) affecting timely and detailed reporting of damage incidents in open sources; human security risks for user-generated reporting; satellite imagery resolution, angle, and environmental factors such as cloud-cover affecting quality; and availability of satellite imagery. This study does not include incidents of looting, attacks on healthcare workers and denial of services, which can affect and exacerbate the disruption of healthcare.

READ: Sudan: 65 killed, hundreds wounded in RSF shelling of Omdurman