Sudan’s healthcare sector is on the verge of collapse

Ongoing fighting between the Sudan Army and the paramilitary Rapid Support Forces have brought the country’s healthcare sector to the verge of collapse. The situation is compounded by an unprecedented humanitarian crisis characterised by famine and general insecurity after more than two and a half years of civil war.

In the midst of the fighting, medical professionals struggle to keep hospitals and other medical facilities operational. Al-Nao Hospital, for example, is one of the last functioning medical facilities in Omdurman.

“We have no choice but to carry on, even as we hear gunfire in the distance and feel planes roar overhead, shaking the ground beneath us,” explained Dr Mohamed Musa, a 30-year-old general practitioner at Al-Nao. “The bombings and air strikes have numbed us.”

The fighting erupted in mid-April 2023, between the army led by Abdel Fattah Al-Burhan and the RSF, led by his former ally Mohamed Hamdan Dagalo, also known as Hemedti. Tens of thousands of Sudanese have been killed, and more than 12 million have been displaced in what the International Rescue Committee (IRC) has described as “the world’s largest humanitarian crisis.”

At Al-Nao Hospital, the target of recent bombings, medical personnel are treating severe injuries including gunshot wounds, burns, broken bones and amputated limbs, even in children and babies.

The youngest patient is just four months old.

Khartoum state boasts 87 hospitals, but around half sustained significant damage between mid-April 2023 and 26 August, 2024, according to a report by Yale University alongside data from the Sudanese American Medical Association. In October alone, the World Health Organisation (WHO) reported that health facilities experienced 119 attacks, including bombings, artillery strikes, armed assaults, looting and forced intrusions.

“There is a complete disregard for civilian protection,” said Kyle McNally, a humanitarian adviser for Doctors Without Borders (MSF), highlighting how widespread destruction has severely compromised health services.

According to data from the Sudanese Doctors’ Syndicate (SDS), up to 90 per cent of medical facilities within the conflict zones have been forced to close down entirely or operate at minimal capacity, leaving millions without access to essential care.

Reports indicate that RSF fighters have invaded health facilities both for treatment of their own people or in pursuit of adversaries. This violent environment has also seen reprisals against doctors following casualties among RSF members receiving care. The SDS said that at least 78 healthcare workers have been killed either at their workplaces or within their homes since fighting escalated.

“Both sides believe that medical staff are collaborating with opposing factions,” explained SDS spokesman Sayed Mohamed Abdallah, “leaving them increasingly vulnerable to targeted violence.”

MSF was compelled to suspend most activities at Bashayer Hospital on 11 November, the one remaining operational facility in southern Khartoum, as armed men stormed in. Dr Abdullah insists that there can be no excuse for such actions against hospitals or medical personnel. “Doctors do not differentiate between patients.”

With around 26 million Sudanese suffering from extreme hunger, according to UN figures, medical staff face additional challenges. Between mid-August and the end-of October, staff reported treating up to 40 critically ill children every day at an Omdurman children’s hospital with. “Every day, three or four die because their condition is hopeless,” said Dr Noura Idris, largely as a result of the serious shortage of medicines which could save lives.

“Without immediate assistance to health facilities, we fear a rapid deterioration in services,” warned Adnan Hazam, spokesman for the International Committee of the Red Cross in Sudan. He pointed out that international humanitarian law protects medical staff, hospitals and ambulances, but in Sudan these principles carry little weight.

“Some days, we feel that the situation is unbearable, but we cannot stop,” added Dr Mohamed Musa. “This is our duty towards the people who rely on us.”

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