Sudan’s Health Care System Turning Into “Sickling State” Due To Ongoing Battle – A Lesson Nigeria Can -By Caleb Onah

A Glimpse of Sudan’s Health State and the Terror

According to the World Health Organisation, a cease-fire was declared after another collapsed, throwing Africa’s third-largest country into chaos. As the battle for control of Sudan enters its fourth week and health rapidly deteriorates in the capital, Khartoum, fears are growing that the conflict could be deadly in the bleak aftermath of the brutal fighting.

The Sudanese Medical Association has warned that a complete collapse of the health care system could occur within days. According to the World Health Organisation (WHO), hospitals were bombed and two-thirds of hospitals in Khartoum were closed. Officials said more than a dozen medics had died. “Hidden victims” are also dying of various diseases as basic health care is lacking, said Dr. Abdullah Atia, executive director of the Medical Association. “We receive a lot of calls every day: ‘Where shall I go?’”, he said.

The New York Times had reported millions of civilians are still trapped. The ceasefire, allowing civilians to flee, ends at midnight on Sunday, January 30, 2023, and the Rapid Support Forces led by General Mohammed Hamdan Dagolo – who is widely known as Hemedti announced it would extend its humanitarian aid, but another day of fighting was reported in the three-day truce’s capital. On Sunday, Sudanese forces which agreed to extend the ceasefire accused the Rapid Support Forces of violating the ceasefire and occupying hospitals.

As the situation escalated, the UN Secretary-General’s office said it had “immediately” sent Martin Griffiths, Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator. “The scale and speed of what is unfolding is unprecedented in Sudan,” Secretary-General Spokesman Stefan Dujarric said. As the situation worsened, many countries had rushed to evacuate their citizens by any means necessary. In the midst of all these, The Sudan Ministry of Health could not be found anywhere, and the doctors’ association received little support from the government with little contact.

According to eyewitnesses and officials, the sanitation facility was used by the militants as a defensive position. Officials also said paramilitary groups had taken over the national laboratory. Like others, Dr. Atia, who spoke by phone from Khartoum to correspondence of the New York Times by phone from Khartoum, said samples of diseases like malaria and tuberculosis could become weapons of death if they fell into the wrong hands.

Another problem, he added, was the uncollected bodies in the morgue and other bodies on the streets. The Medical Association later said in a statement that more and more corpses were strewn about on the streets, causing catastrophe to the environment. Hundreds of paramedics have fled, and rumors are circulating that rapid support forces are kidnapping paramedics and forcing them to use weapons to treat wounded personnel. Dr. Atia said the abduction was not confirmed, but dozens of Sudanese doctors’ association members were missing.

The lack of medical staff with little manpower to deal with the situation is even worsening; Only eight medical staff remain in Al Ban Jadid Hospital in eastern Khartoum which normally employs at least 400 people. Dr Atia said there were four people working at Al Joda Hospital in Khartoum in the south: an anaesthetist, a surgeon, and two nurses. However, glimmers of hope have been offered by some NGO’s.

On the way from Jordan to Sudan Port, the International Committee of the Red Cross announced on Sunday that eight tons of medical supplies were being delivered, while Medecin Sans Frontieres (Doctors without Borders) said it had donated medical supplies to three hospitals in Khartoum. In a statement, Patrick Youssef, African Red Cross regional director, said “Health care workers in Sudan have been doing the impossible, caring for the wounded without water, electricity and basic medical supplies,”

At a field hospital in Al Mamoura, Dr. Mohamed Karrar improvised an intercostal drainage system using a sterilised soda bottle to pump blood from the punctured lung of a gunshot victim. Working long shifts in the trauma ward of the now closed Ibrahim Malik University Hospital in central Khartoum has helped him prepare, but now Dr. Karrar must deal with the noise of war coming from his room. Guests home are now turned into an operating room. “I know I’m in danger in these areas,” he said, “but those sick, wounded people need me.” In al-Nada, medics and patients hid under beds and tables several times a day to avoid aerial bombardment and heavy artillery fire. Dr. Mohamed Pars, who was present at the scene, said everyone was so nervous that the sound of the oxygen tanks opening scared the staff.

At the start of the conflict, a private agency Al-Nada decided to treat only pregnant women and children in order to provide shelter to a handful of more than 24,000 women. According to WHO, these people should give birth in the next few weeks. Dr. Fath said 220 babies were born here in the first weeks of the “war”, most of which survived. He said a woman had travelled to a war zone and barely made it to the emergency room. Her husband showed Dr. Fath the bullet holes in his car. “They have to go through this hell to get to the hospital,” said Dr. Fath. Neighbours seeking help come to Dr. Start ringing his doorbell. Now, according to him, he is preparing medicine at home and hiding in his car.

Waking Up the Nigeria Healthcare

On the one hand, we should realise that this country is all we have. And that when our ship breaks down elsewhere, we can only return home safely; It’s one thing to have the “japa” idea and another to have a safe and secure Nigeria to always return to. This is by no means obvious and therefore the territorial integrity and internal security of our country should always be at the top of our list of priority national concerns.

Another lesson is that Nigerian battle drummers are considering indiscriminate destruction of life and property in Sudan, if only to ease their hearts and linger for a while. War never really solved anything; it only creates problems that can only become a reality in the years to come. The headquarters of the Commander-in-Chief of the Sudan Armed Forces was once an operational organisation. Today it has turned into hideous ruins. The beautiful city of Khartoum is abandoned. Everyone is terrified, hiding in fear, longing for the sweet release of peace. Another lesson is the futility of inciting separatism.

Sudan and South Sudan were once a country until they parted ways in 2011 after southern Sudan voted for independence following decades of armed struggle by the mainly Christian and Animist south against rule by the Arab Muslim north. Neither country has been at peace ever since, with both contending with further rebellions that have exerted a heavy toll on their respective population.

In regard to the health sector, adequate funding is essential for the “untold day” of a well-functioning health system. Its lack thereof negatively impacts service delivery in any health system, including primary healthcare. Nigeria must prioritise its primary healthcare system including its financing mechanisms. In addition to capital allocation, it is important to ensure timely disbursement as well as efficient and transparent use of allocated funds.

At this point, it is essential that the federal government and stakeholders design a solid framework for the use of funds and have sustained advocacy for funds to be directed toward health. The sugary drink tax could be a win for public health, a win for public revenue, and a win for health equity. However, public awareness is also needed to ensure consumers are aware of the adverse effects of sugary drinks, and evidence from other countries that have imposed similar taxes on sugar shows that the price of higher sugar intake had a greater impact on reduced consumption.

This which is a common factor is the brain drain of medical professionals – is a matter of immediate concern. The pandemic, although not a new development, has accelerated the rate at which healthcare workers leave Nigeria, not even yet in “warring circumstances.” Health worker retention rates will continue until the “drivers” of healthcare worker migration, promotions, wage increases and quality of life improvements are not addressed.