GLOBAL EM
Um Sangour camp's only primary health-care facility now receives 700 patients a day. Photo: © UNHCR/Ala Kheir
Sudan's Struggle for Health Care Amidst Escalating Conflict: An Unfolding Humanitarian Emergency
SAEM PULSE | MARCH-APRIL 2024
By Habab A. Iraqi, MBBS; Charlotte Roy, MD, MPH; and Mallika Manyapu, MD, MPH, on behalf of the GEMA Humanitarian Task Force
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Sudan has a long history of coups d’état and military rule, which has stood in opposition to the persistent struggle of the Sudanese people to establish a democratic political order. In 2019, a transitional government emerged following the coup that deposed President Omar al-Bashir, raising hopes for democracy. However, since April 2023, the power struggle between the Sudanese Armed Forces (SAF) and the Rapid Support Forces (RSF) has escalated into a large-scale conflict, driving a worsening humanitarian crisis. Sudan is not merely a country on the brink of collapse; it is in a free fall that has devastated public services, including, and especially, health care. Even before the most recent conflict, Sudan faced a humanitarian
catastrophe due to protracted political unrest and economic strain, with 15.8 million people needing humanitarian aid as of November 2022, according to the United Nations Office for the Coordination of Humanitarian Affairs (OCHA). Now, due to the deepening conflict, nearly 25 million people, over half of Sudan’s population, are in need. Sudan is grappling with the largest internal displacement crisis globally, with more than 6 million internally displaced Sudanese and 1.4 million seeking refuge abroad. Approximately half of those forced to flee are children. At the same time, humanitarian efforts face intense violence and movement restrictions, making it difficult for relief to reach vulnerable communities.
The conflict has destroyed Sudan’s public infrastructure, especially in the health sector. Continuous attacks, looting, and occupation of medical facilities have led to severe staffing, financial, and medical supply shortages. In conflict-affected areas, 70-80% of health facilities are closed or inoperable. The RSF’s control over key health institutions, such as the National Public Health Laboratory, the Central Blood Bank, and the National Medical Supplies Fund, has depleted medical supplies and blood reserves, resulting in a loss of an estimated $700 million for the health care system. This will have a significant impact on a system that was already chronically underfunded and facing severe financial limits as a result of economic decline in 2023.