Sudanese struggle with a medical meltdown as doctors flee and hospitals close

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The conflict in Sudan has left more than 12,000 dialysis patients, pictured (main) at the Soba Hospital in southern Khartoum, at grave risk as hospitals across the country have run out of medications. (AFP)
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This picture taken on May 2, 2023 shows a destroyed medical storage in Nyala, the capital of South Darfur province, on the third week of fighting between rival generals' forces. (AFP)
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A patient is transported on a gurney at the Medani Heart Center hospital in Wad Madani, the capital of the Al-Jazirah state in east-central Sudan, on May 25, 2023, amid fighting between rival generals' forces. (AFP)
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Relatives stand by a patient at a makeshift emergency room installed by Sudanese volunteers in a school building in Omdurman, the capital's twin city, on May 27, 2023, amid fighting between the forces of two rival generals. (AFP)
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Updated 05 July 2023
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Sudanese struggle with a medical meltdown as doctors flee and hospitals close

  • ICRC estimates just 20 percent of health facilities in Khartoum are still operational after weeks of fighting
  • Health centers have been occupied, medicines and supplies looted, and medical professionals driven out

CAIRO: Hospitals across Sudan have been bombed, looted and occupied by armed factions since fighting broke out more than two months ago between the Sudanese military and the Rapid Support Forces (RSF), a paramilitary group. As a result, millions of civilians are being denied vital healthcare.

Medical supplies rapidly dwindled after the conflict began on April 15, with shipments of medicines and other medical supplies stolen or undelivered. Meanwhile, scores of health professionals have been killed, wounded or forced to leave the country.

Dr. Adel Mohsen Badawi Abdelkadir Khalil, 65, is among the many medics who chose to flee with their families, abandoning the private clinic in the capital Khartoum he had managed for more than 15 years.




Dr. Adel Mohsen Badawi Abdelkadir Khalil at his new refuge in Cairo. (AN photo)

On April 21, fearing he would be conscripted by the RSF to treat the paramilitary group’s wounded, he made the painful decision to join the flood of refugees making the perilous journey north to the border with Egypt.

“I was inside my clinic preparing my tickets to go to Cairo when I saw attacks outside. People were yelling and weeping,” Mohsen told Arab News from an apartment in the Egyptian capital he shares with other displaced Sudanese families.

“I immediately locked all my doors and turned off the lights and hid there. If the RSF know you’re a doctor, they will take you to tend to their army.”

Mohsen said that when he and his family caught the bus to Egypt, he was careful not to tell officials or fellow passengers he was a health professional, instead concealing his 30 years of medical experience for his own safety.




A video screengrab from social media shows the East Nile Hospital in Khartoum, one of many medical facilities damaged in the fighting since April 15. (Reuters)

The public-health sector has long been fragile in Sudan, where 65 percent of the population lives in poverty. With the departure of so many medical workers, aid agencies have warned that the nation is facing a major health emergency. According to the International Committee of the Red Cross, only 20 percent of health facilities are still operational in Khartoum.

“We have been witnessing the near collapse of the health system in Sudan,” Alyona Synenko, the Africa region spokesperson for the organization, told Arab News.

 

 

Those unable or unwilling to flee Khartoum have been forced to hunker down in their homes with little or no access to clean water or electricity. According to several Sudanese Arab News spoke to in Cairo, many of those who remained behind face the threat of dehydration and starvation, such is the scale of the need for aid in Khartoum and nearby cities.

The collapse of basic utilities and other public infrastructure is having an especially serious effect on hospitals by undermining their hygiene protocols, rendering vital medical equipment inoperative, and depriving chronically sick people of potentially life-sustaining treatment.

“Besides the departure of some of the medical personnel and the shortages of medical supplies, hospitals are suffering from a lack of food, clean water and electricity,” said Synenko.

 




Hundreds of medical centers had closed in Khartoum since war erupted between Sudan’s army and the paramilitary RSF group in in mid-April. (AFP)

The fighting has, for example, left 12,000 dialysis patients at mortal risk as hospitals have run out of the medications they need and the fuel to power generators, according to the trade union that represents the country’s doctors. It has also impeded the delivery of humanitarian aid that 25 million people — more than half the population — now desperately need.

In addition, there are fears that the summer rainy season will bring with it seasonal epidemics such as malaria, which wreaks havoc in Sudan every year, and a shortage of drinking water could cause a cholera outbreak.

“Sudanese health workers and the volunteers of the Sudanese Red Crescent Society have been accomplishing the impossible, working in such extreme conditions,” said Synenko.

 

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It is believed that fewer than 20 percent of health facilities in Khartoum are still operational.

As of late May, 14 medical professionals had been killed, 21 hospitals evacuated and 18 bombed, according to a doctors’ union.

“While we are working with the Ministry of Health to deliver urgent surgical supplies to hospitals, we are also calling on all actors to respect and protect medical facilities and personnel. This is not only an obligation under international humanitarian law, it is a moral imperative because numerous lives depend on their work.”

Dr. Atia Abdalla Atia, secretary-general of the Sudan Doctors trade union, told Arab News that he and his colleagues have documented the deaths of at least 14 medical professionals since the fighting began. The union has also confirmed the evacuation of 21 hospitals, the bombardment of 18, and one case of a doctor going missing, he added.

On Saturday, the trade union accused the RSF of raiding the Shuhada hospital, one of the few still operating in the violence-torn country, and killing a staff member. The RSF denied the accusation.




View of an abandoned hospital in El-Geneina, the capital of West Darfur, on May 1, 2023 as deadly fighting continued in Sudan between rival generals’ forces. (AFP)

The targeting of health facilities and medical personnel during a conflict is considered a war crime under international humanitarian law. The RSF has reportedly seized control of several hospitals to use as bases of operation.

During a meeting of the UN Security Council on May 22, Volker Perthes, the UN’s special representative for Sudan, highlighted reports of such activities and said the “use of health facilities as military positions is unacceptable.”

In a report published by medical journal The Lancet, aid agency Doctors Without Borders said that health professionals at facilities across Sudan have been repeatedly confronted by fighters who steal medicines, other health supplies and vehicles.

Jean-Nicolas Armstrong Dangelser, the agency’s emergency preparedness coordinator in Port Sudan, told the journal that although some instances of looting are financially motivated, others appear callously calculated to deliberately deprive patients of care.

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In Khartoum, for example, medical warehouses were raided several days in a row. When staff were able to return, they found fridges unplugged and medicines spilled on the floor.

“The entire cold chain was ruined so the medicines are spoiled and can’t be used to treat anyone. We are shaken and appalled by these deplorable attacks,” said Armstrong Dangelser.

“We are experiencing a violation of humanitarian principles and the space for humanitarians to work is shrinking on a scale I’ve rarely seen before … People are in a desperate situation and the need for healthcare is critical, but these attacks make it so much harder for healthcare workers to help.”

Clashes between the military and the RSF intensified on Sunday as the fighting in Khartoum and the western regions entered its 12th week, according to a Reuters news agency report.

Air and artillery strikes as well as small-arms fire could be heard, particularly in the city of Omdurman, as well as in Khartoum, the report said.

More than 2,000 people have been killed since fighting broke out on April 15, according to the Armed Conflict Location and Event Data Project, which collects data on conflicts and other violence worldwide.

The UN estimates that upwards of 1.2 million people have been displaced, out of whom at least 425,000 have fled abroad.

Last week, military chief Gen. Abdel Fattah Al-Burhan called on young men to join the fight against the RSF and, on Sunday, the army posted photos it said were of new recruits.

Saudi Arabia took the lead in efforts to evacuate thousands of foreigners from Sudan in the early days of the conflict. The Kingdom’s diplomats have also been working with their US counterparts to help broker a lasting ceasefire in the country.

A five-day extension of the last truce expired last month with little sign of a let-up in the violence. That ceasefire did, however, allow surgical supplies donated by the International Committee of the Red Cross to be distributed to seven hospitals in Khartoum by the Ministry of Health, including anesthetics, antibiotics, dressings, sutures and infusions.

 

 

But according to Atia, the doctors who chose to remain in Sudan are generally working with only the most basic of medical equipment and supplies, which is putting patients at risk, and many of the remaining medical staff are desperate to leave.

“Everyone is asking where they can go to escape this,” he said.

In many areas, field hospitals staffed by volunteers have been set up in schools and other public buildings in an attempt to make up for the lack of operational state institutions, and help treat the chronically sick and, increasingly, those who succumb to the effects of dehydration and malnutrition.

“Everything has been left in the hands of civilians and the few doctors and hospitals that are left,” said Atia.

“We are trying to focus on the chronic diseases (and) also at home where people are dying due to lack of water, food and no access to drugs.”

 


Israel accuses Turkiye of ‘malice’ over UN arms embargo call

Updated 05 November 2024
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Israel accuses Turkiye of ‘malice’ over UN arms embargo call

  • Turkiye’s letter, seen by AFP Monday, called the “staggering” civilian death toll “unconscionable and intolerable”

UNITED NATIONS, United States: Israel’s ambassador to the United Nations on Monday accused Turkiye of “malice,” after Ankara submitted a letter signed by 52 countries calling for a halt in arms deliveries to Israel over the war in Gaza.
“What else can be expected from a country whose actions are driven by malice in an attempt to create conflicts with the support of the ‘Axis of Evil’ countries,” said Ambassador Danny Danon, using a pejorative term to describe the Arab countries who signed the letter.
Turkiye’s foreign ministry said Sunday it had submitted the letter to the United Nations, with the signatories including the Arab League and the Organization of Islamic Cooperation.
Israel has faced international criticism for the conduct of its war in Gaza, where its offensive has killed at least 43,374 people, most of them civilians, according to health ministry figures which the United Nations considers to be reliable.
The war was sparked by Palestinian armed group Hamas’s October 7 attack on Israel, which resulted in the deaths of 1,206 people, mostly civilians, according to an AFP tally of Israeli official figures.
“This letter is further proof that the UN is led by some sinister countries and not by the liberal countries that support the values of justice and morality,” said Danon.
Turkiye’s letter, seen by AFP Monday, called the “staggering” civilian death toll “unconscionable and intolerable.”
“We therefore make this collective call for immediate steps to be taken to halt the provision or transfer of arms,  munitions and related equipment to Israel, the occupying Power, in all cases where there are reasonable grounds to suspect that they may be used in the Occupied Palestinian Territory,” the letter said.
It added that the UN Security Council (UNSC) must take steps to ensure compliance with its resolutions “which are being flagrantly violated.”
The UNSC called in March for a ceasefire in Gaza, but has struggled to speak with a unified voice on the issue due to the veto wielded by Israel’s key ally, the United States.
Asked about the joint letter on Monday, the spokesman for UN Secretary-General Antonio Guterres said he had not seen it.


Gaza aid situation not much improved, US says as deadline for Israel looms

Updated 05 November 2024
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Gaza aid situation not much improved, US says as deadline for Israel looms

  • Aid workers and UN officials say humanitarian conditions continue to be dire in Gaza

WASHINGTON: Israel has taken some measures to increase aid access to Gaza but has so far failed to significantly turn around the humanitarian situation in the enclave, State Department spokesperson Matthew Miller said on Monday, as a deadline set by the US to improve the situation approaches.
The Biden administration told Israel in an Oct. 13 letter it had 30 days to take specific steps to address the dire humanitarian crisis in the strip, which has been pummeled for more than a year by Israeli ground and air operations that Israel says are aimed at rooting out Hamas militants.
Aid workers and UN officials say humanitarian conditions continue to be dire in Gaza.
“As of today, the situation has not significantly turned around. We have seen an increase in some measurements. We’ve seen an increase in the number of crossings that are open. But just if you look at the stipulated recommendations in the letter, those have not been met,” Miller said.
Miller said the results so far were “not good enough” but stressed that the 30-day period had not elapsed.
He declined to say what consequences Israel would face if it failed to implement the recommendations.
“What I can tell you that we will do is we will follow the law,” he said.
Washington, Israel’s main supplier of weapons, has frequently pressed Israel to improve humanitarian conditions in Gaza since the war with Hamas began with the Palestinian militant group’s Oct. 7, 2023, attacks on southern Israel.
The Oct. 13 letter, sent by Secretary of State Antony Blinken and Defense Secretary Lloyd Austin, said a failure to demonstrate a sustained commitment to implementing the measures on aid access may have implications for US policy and law.
Section 620i of the US Foreign Assistance Act prohibits military aid to countries that impede delivery of US humanitarian assistance.
Israel on Monday said it was canceling its agreement with the UN relief agency for Palestinians (UNRWA), citing accusations that some UNRWA staff had Hamas links.
UNRWA head Philippe Lazzarini said Israel had scaled back the entry of aid trucks into the Gaza Strip to an average of 30 trucks a day, the lowest in a long time.
An Israeli government spokesman said no limit had been imposed on aid entering Gaza, with 47 aid trucks entering northern Gaza on Sunday alone.
Israeli statistics reviewed by Reuters last week showed that aid shipments allowed into Gaza in October remained at their lowest levels since October 2023.


Israel hostages forum demands probe in secrets leak case

Updated 05 November 2024
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Israel hostages forum demands probe in secrets leak case

  • “The (hostage) families demand an investigation against all those suspected of sabotage and undermining state security,” the Hostages and Missing Families Forum said in a statement

JERUSALEM: A Gaza hostages campaign group called Monday for an investigation into the alleged leak of confidential documents by an ex-aide to Israel’s premier, which may have undermined efforts to secure their release.
A court announced Sunday that Eliezer Feldstein, a former aide to Benjamin Netanyahu, had been detained along with three others for allegedly leaking documents to foreign media.
The case has prompted the opposition to question whether Netanyahu was involved in the leak — an allegation denied by his office.
“The (hostage) families demand an investigation against all those suspected of sabotage and undermining state security,” the Hostages and Missing Families Forum said in a statement.
“Such actions, especially during wartime, endanger the hostages, jeopardize their chances of return and abandon them to the risk of being killed by Hamas terrorists.”
The forum represents most of the families of the 97 hostages still held in Gaza after they were seized in the unprecedented October 7, 2023, Hamas attack on Israel that sparked the war.
The Israeli military says 34 of them are dead.
“The suspicions suggest that individuals associated with the prime minister acted to carry out one of the greatest frauds in the country’s history,” the forum said.
“This is a moral low point like no other. It is a severe blow to the remaining trust between the government and its citizens.”
Critics have long accused Netanyahu of stalling in truce negotiations and prolonging the war to appease his far-right coalition partners.
Israel’s domestic security agency Shin Bet and the army launched an investigation into the breach in September after two newspapers, British weekly The Jewish Chronicle and Germany’s Bild tabloid, published articles based on the classified military documents.
One article claimed a document had been uncovered showing that then Hamas leader Yahya Sinwar — later killed by Israel — and the hostages in Gaza would be smuggled into Egypt through the Philadelphi corridor along the Gaza-Egypt border.
The other was based on what was said to be an internal Hamas leadership memo on Sinwar’s strategy to hamper talks toward the liberation of hostages.
The Israeli court said the release of the documents ran the risk of causing “severe harm to state security.”
“As a result, the ability of security bodies to achieve the objective of releasing the hostages, as part of the war goals, could have been compromised,” it added.
On October 7, 2023, Hamas militants attacked southern Israel, resulting in the deaths of 1,206 people on Israeli soil, mostly civilians, according to AFP’s count based on official Israeli data, including hostages who died or were killed in captivity in Gaza.
Israel’s retaliatory military offensive in Gaza has so far killed at least 43,341 people, a majority of them civilians, according to the territory’s health ministry. The UN considers these figures as reliable.
Meanwhile, late on Monday Netanyahu asked the attorney general to begin investigating other alleged leaks from cabinet meetings during the war.
“Since the beginning of the war, we have witnessed an incessant flood of serious leaks and revelations of state secrets,” he said in a letter to the attorney general, which was posted on his Telegram channel.
“Therefore, I am appealing to you to immediately order the investigation of the leaks in general.”


UNRWA ban in Gaza ‘will not make Israel safer’: WHO

Updated 05 November 2024
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UNRWA ban in Gaza ‘will not make Israel safer’: WHO

  • “This ban will not make Israel safer. It will only deepen the suffering of the people of Gaza and increase the risk of disease outbreaks,” Tedros says

GENEVA: The chief of the World Health Organization on Monday denounced Israel’s decision to cut ties with the UN agency supporting Palestinian refugees, saying it would not make the country safer while increasing civilian suffering in Gaza.
“Let me be clear: There is simply no alternative to UNRWA,” the United Nations Relief and Works Agency for Palestine Refugees in the Near East, Tedros Adhanom Ghebreyesus said in a video posted on X.
“This ban will not make Israel safer. It will only deepen the suffering of the people of Gaza and increase the risk of disease outbreaks,” Tedros added.
His comments came after Israel said it had formally notified the UN of its decision to sever ties with UNRWA, after Israeli lawmakers backed the move last week.
The suspension of the agency, which coordinates nearly all aid in war-ravaged Gaza, sparked global condemnation including from key Israeli backer the United States.
The move is expected to come into force in late January, with the UN Security Council warning it would have severe consequences for millions of Palestinians.
Israel has accused a dozen UNRWA employees of taking part in the October 7, 2023 attack by Hamas, the deadliest in Israeli history.
A series of probes found some “neutrality related issues” at UNRWA but said Israel had not provided evidence for its chief allegations.
The agency, which employs 13,000 people in Gaza, fired nine employees after an internal probe found that they “may have been involved in the armed attacks of 7 October.”
UNRWA, which was established in 1949 after the first Arab-Israeli conflict following Israel’s creation a year earlier, provides assistance to nearly six million Palestinian refugees across Gaza, the West Bank, Lebanon, Jordan and Syria.
“Every day, it provides thousands of medical consultations and vaccinated hundreds of children,” Tedros said, adding that many humanitarian partners rely on UNRWA’s logistical networks to get supplies into Gaza.
He said that the UNRWA staff his organization had worked with were “dedicated health and humanitarian professionals who work tirelessly for their communities under unimaginable circumstances.”
Hamas’s October 7 attack on Israel resulted in the deaths of 1,206 people, mostly civilians, according to an AFP tally of official Israeli figures.
Israel’s retaliatory campaign has killed 43,374 people in Gaza, most of them civilians, according to figures from the Hamas-run territory’s health ministry, which the United Nations considers to be reliable.


GCC’s chief urges regional collective action at counter-terrorism conference in Kuwait

Updated 04 November 2024
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GCC’s chief urges regional collective action at counter-terrorism conference in Kuwait

  • Meeting gathers ministers, UN agency representatives, international organizations

KUWAIT CITY: Gulf Cooperation Council Secretary-General Jasem Al-Budaiwi addressed a high-level conference on counter-terrorism and border security on Monday.

The conference, which is being held in Kuwait and ends on Tuesday, has been organized by Kuwait in partnership with Tajikistan and the UN Office of Counter-Terrorism.

It gathered ministers, UN agency representatives, and international and regional organizations to help bolster international counter-terrorism efforts.

Al-Budaiwi said: “This important regional conference focuses on border security and combating terrorism, which are vital issues requiring collective action.”

Al-Budaiwi spoke of the GCC’s achievements in security collaboration, including information-sharing and laws targeting terrorism financing.

He added: “The GCC countries have built a common security system through joint agreements, enhancing cooperation in border protection and addressing security threats.”

He stressed the region’s proactive approach in utilizing technology and training personnel to safeguard borders against transnational threats like arms and human trafficking.