Q&A on Health in Darfur with our Sudan Program Manager

Recently, Sudan has faced escalating humanitarian crises – including the effects of record-breaking floods, the spread of COVID-19, a wave of Ethiopian refugees fleeing violence in the Tigray region, and renewed clashes in the Darfur region. MedGlobal has supported 22 health facilities supported across 7 states in Sudan, and is currently working to build a critically needed oxygen generator station in Darfur. Our Sudan Program Manager, Abdelsamad Abdalla, reflected on his home state of Darfur and provided details on the recent violence that has led to hundreds killed, thousands displaced, and countless in need of support.

1. Can you describe the escalating violence and displacement in the Darfur region?

The latest interethnic violence to erupt in Sudan’s Darfur region has killed nearly 250 people, including three humanitarian workers, in clashes that started on January 15 in West Darfur and quickly spread to South Darfur the next day. On January 24, an intense round of violence in Eastern Jebel Marra in South Darfur led to the burning of more than 11 villages, the looting of 15,000 heads of livestock, and the destruction of mills and water stations. More than 15,000 families were displaced and the resulting humanitarian crisis will only deteriorate further. This is the worst violence since the signing of a peace agreement in October, which had raised hopes of ending years of war.

There are many reflections from people in Darfur who can give a better picture of the horrible loss, like Abdullah Yassin, who is 30-years-old, who said: “I lost my father and four of my brothers to the Janjaweed attacks… when the militias attacked the village, they were a lot, and we could not defend. They burned the village and then killed some of the residents and fled some of them.”

2. How is this impacting the need for healthcare and services in the region?

The poor health situation in Sudan has been worsened by the hardships created by the COVID-19 pandemic and deteriorating economic situation. Displaced persons and others affected by the violence in the Darfur region, the majority of whom are women and children, are particularly vulnerable. Since all residents depend on agriculture, the burning and looting of crop stocks will contribute to food insecurity. Despite the previously high rates of malnutrition diseases, this will likely double the rate of epidemic and childhood diseases and the need for basic health and nutritional care services. The lack of safe drinking water and sewage canals will also increase the risk of waterborne disease spreading.

In general, there are only 5 medical specialties in most states of Sudan: internal medicine, general surgery, gynecology, obstetrics, and orthopedics. The lack of medical specialties – such as kidney and urology surgery, pediatric surgery,cardiothoracic surgery, brain and nerve surgery, breast and endocrine surgery, and many more – make many types of needed healthcare difficult to access.

3. Are health and humanitarian workers able to access populations in need? 

Though active violence has subsided around Geneina town and locality, the overall security situation is still tense, hindering the ability of staff and humanitarian actors to launch an effective response. Delays caused by administrative processes in the international procurement supply chains have also slowed the delivery of much needed supplies.

4. What are the most pressing needs for civilians in the area? 

Insecurity in the region continues to threaten people’s lives. Additionally, a large number of people have been forced to shelter in government facilities, greatly disrupting their ability to function. Hospitals are full of wounded people and there is a dire lack of medical personnel in the state. West Darfur state, where thousands of displaced people live, faces a health situation that may be the worst in Sudan. It lacks the most basic elements of treatment and health services.

The displaced people in Darfur face a major decrease in food availability, which leads to the spread of diseases and a decrease in the immunity of the population there. Children and pregnant women there are exposed to many diseases, including malnutrition, malaria, and intestinal diarrhea. Women in particular are clearly suffering. Most of the women in Darfur do not have any work opportunities. There is great suffering in childbirths, and too many women give birth without the presence of doctors specialized in obstetrics and gynecology.

As for water, it is another humanitarian catastrophe. There are always long lines in the water stations in the camps. Although women are mostly present in these stations, there are also many children, some of whom carry heavy water jerry cans, which may expose them to diseases. There is a major need of increased healthcare support, job opportunities especially for women, and safe, clean water. 

5. Can you briefly describe the other health and humanitarian crises facing Sudan?

The COVID-19 crisis has put an immense amount of pressure on national and local health systems. As of February 27, the Ministry of Health has reported 28,408 confirmed cases and 1,890 deaths from the virus. Just last week, Sudan received over 800,000 doses of the AstraZeneca COVID-19 vaccine through COVAX. The shipment is a first batch of over 3 million doses which are expected to arrive during the coming period. Of course like most countries, citizens’ reactions to the vaccine vary. Even among medical workers, some believe that vaccination is good and necessary to return to normal life, while others reject the idea due to fears of possible side effects.

Sudan is also grappling with a major malaria epidemic with at least 1,462,980 cases reported. In South Darfur, there have been 11 suspected cases of diphtheria and at least 3 resulting in deaths, creating concerns of an outbreak amid the security crisis. 

There is also a growing humanitarian crisis in the east caused by violence in Ethiopia. More than 61,000 Ethiopian refugees have entered Sudan and many of the refugee sites have reported cases of COVID-19, malaria, dysentery, and other diseases. 

In order to effectively manage the multiple disease outbreaks and health emergencies, Sudan requires additional laboratory diagnostic equipment to allow health workers to identify and treat patients. Essential medicines and supplies, such as trauma and emergency health kits, are also vital for response efforts. The strengthening of Early Warning Alert and Response Systems and support for mobile health clinics is also essential for addressing the health emergencies.