More than a year since the outbreak of war in Sudan, the country is facing…
Updates From Sudan as Fighting Erupts Across the Country
On the morning of 15 April 2023, armed clashes between the Sudanese army and the Rapid Support Forces (RSF) began in the streets of Sudan’s capital, Khartoum. Fighting has since spread throughout the country.
EMERGENCY immediately reshaped its activities in Sudan, where it is present with the Salam Centre for Cardiac Surgery and a Paediatric Clinic in Khartoum, a network of cardiology clinics to support patients from the Salam Centre, and with Paediatric Centres in Mayo (Khartoum), Nyala (South Darfur) and Port Sudan, where it offers free treatment to children under the age of 14.
In Khartoum, the activities of the Salam Centre continue, albeit at a limited capacity. Paediatric activities continue in Khartoum and Port Sudan, and in Nyala with reduced services. However, the Paediatric Centre in Mayo is closed for security reasons.
Updates from Our Hospitals And Clinics Across the Country
11 November 2024
Paediatric Activities Resume in Nyala
In the midst of a devastating war, good news: in recent days we have restarted outpatient activities at our Paediatric Centre in Nyala, Sudan, to offer free treatment to children under 14.
A year ago, some of our Sudanese colleagues in Nyala were taken from the hospital and arrested. Our colleagues were released a few days later without charges, but the Centre had been looted and damaged, forcing us to temporarily suspend activities.
“In recent months, our Sudanese colleagues have worked tirelessly to restore the clinic and return it to its former state,” says Laura, Medical Coordinator of the Paediatric Centre.
In just a few weeks, they had already restarted activities supporting cardiac patients. In the following months, the vaccination programme and health education sessions resumed.
And in the last few days, outpatient activities for children under 14 and their mothers have also resumed.
“In the context of constant war, and with all the logistical and bureaucratic difficulties we have had to face, the reopening of the Paediatric Centre is an important moment for the families of South Darfur, who can access free care here.”
We are not abandoning Sudan.
17 October 2024
Shrapnel at the Entrance of the Salam Centre in Khartoum
Yesterday morning, we found this shrapnel at the entrance of our hospital complex in Khartoum, Sudan.
It came from two air strikes that landed a few hundred metres from the compound, where we operate the Salam Centre for Cardiac Surgery and a Paediatric Clinic.
For days, fighting for control of Khartoum has been intensifying between the government armed forces and the paramilitary RSF.
“This incident was the nearest to us since the war began. To protect the safety of patients and colleagues, we had to temporarily suspend the activities of the Paediatric Clinic, which have now resumed,” said Giovanni Tozzi, EMERGENCY’s Country Director in Sudan.
The war in Sudan does not always draw significant attention, but its impact is devastating: almost 25,000 casualties have been confirmed so far, and more than 10 million people have been displaced.
“We call on the warring parties to respect the health facilities that are still operational, and to ensure the continuation of humanitarian activities in support of the Sudanese population.”
10 October 2024
We have reached 15,000 mothers and children since May
After months of constant bombardment, attacks and looting, the humanitarian situation in Darfur in Sudan is disastrous. Many villages have been completely razed to the ground.
Since war broke out in April last year, people fleeing Darfur for safety make up an estimated 34% of all internally displaced people in Sudan.
In Nyala, the capital of South Darfur, we are providing medicines and vaccinations against diseases such as tuberculosis and tetanus. We also continue to provide health education sessions on breastfeeding, hygiene, and diets during malnutrition, as well as good practices to prevent diarrhoea, cholera and malaria.
Since May, we have reached more than 15,000 mothers and children with our maternal and child health promotion activities. Nearly 3,000 children have been vaccinated,” says Islam, our Head Nurse.
“People are struggling with famine and with diseases that would be easily preventable elsewhere, but can have extreme consequences in a collapsed health system.”
1 October 2024
In Khartoum, 110 children arrive daily
“In September, more than 60 per cent of the children were assigned a code yellow or code red.”
In our Paediatric Clinic in Khartoum, Sudan, an average of 110 children arrive every day.
Right now, the capital is the hotspot of another wave of fighting that only further strains an already exhausted civilian population. After nearly 18 months of war, the local health system is weak and often inadequate. Hunger is becoming more and more extreme. Infection levels are increasingly acute.
Compared to two months ago, the number of patients arriving at the Clinic has more than doubled. The health conditions in which they arrive are increasingly critical.
“Cases of shock caused by acute forms of malnutrition are on the rise,” reports Caterina, one of our nurses in Khartoum.
“There is a lack of food, even the nutrition centres struggle to get therapeutic food. Supplies often fail to reach their destination – yet another consequence of the fighting. We are also treating many cases of gastroenteritis, caused by contaminated food and stagnant water. Bacteria are proliferating everywhere.”
19 August 2024
The situation for displaced people in Port Sudan
There is a lack of hospitals, housing and adequate sanitation facilities.
In Port Sudan, the health and living conditions of those displaced by the war are precarious: the city was unprepared to receive so many people in such a short period of time, and now serves as a refuge for hundreds of thousands of Sudanese people.
At our Paediatric Centre in the city, EMERGENCY’s President Rossella Miccio provides an update:
EMERGENCY’s Paediatric Centre in Port Sudan is funded by the European Union.
5 August 2024
Shagan’s Story
Shagan was just over one week old when she arrived at our Khartoum Paediatric Centre – weak, with a high fever, and unable to take her mother’s milk.”
Her twin brother died five days after delivery,” her mother told us.
Further tests revealed signs of infection due to neonatal sepsis.
“This is a condition that we encounter often and which is usually caused by the poor hygienic conditions that home births take place in, managed without any obstetrical assistance,” says our nurse Caterina.
In an environment devastated by more than a year of war, giving birth at home is almost always the only option.”We also see many pregnant women in a state of severe malnutrition, another consequence of the conflict on maternal and child health.”
In #Sudan, 14 million children are in need of humanitarian assistance: the health, social and economic disaster wrought by the war has a direct impact on the likelihood of survival after birth and during a child’s early years.
7 July 2024
Malak’s Story
Malak is 18 months old but weighs just 7.3 kg (16lbs).
She arrived at our Paediatric Clinic in Khartoum, Sudan, accompanied by her older sister. “Malak has been refusing to eat for three days,” she told us.
“She was already severely malnourished and anaemic. In addition, gastroenteritis had made her completely lose her appetite,” says Caterina, our nurse. “We placed the little girl in one of our beds for observation and so that we could administer antibiotics and the rehydrating solution for patients at such an acute stage of malnutrition.”
We arranged an ambulance for Malak so she could transfer from our Clinic to one of the few hospitals still functioning for continued treatment.
In areas of the country where the conflict is particularly active, like Khartoum, food insecurity further strains daily life for Sudanese families, who are experiencing an unprecedented humanitarian catastrophe. The energy crisis – the scarcity of fuel and the frequent electrical blackouts – incessant fighting, and widespread destruction of the city have forced people to flee. 36% of all internally displaced persons in the country come from the capital. Those who have remained, on the other hand, have nothing left.
“Our parents are in Port Sudan,” Malak’s sister told us, the only person left who can now take care of the child. Over 800 kilometres separate them from eachother, amid a horrific situation in Sudan: 449 days of war, continuous hunger, violence, and disregarded human rights.
14 June 2024
World Blood Donor Day
“Every single donation makes a difference.”
Among the millions who have fled war in Sudan were thousands of blood donors who made it possible for us to ensure supplies for our blood bank at the Salam Centre, our hospital complex in Khartoum.
A year of conflict and bombing has destroyed the capital, whose streets are deserted and dangerous. It is increasingly difficult to find blood donors, especially for the rarer blood types.
“Today, every single donation makes a difference, in a context already hampered by continuous logistical and supply constraints,” says Elisabetta from the Salam Centre.
It is thanks to the generosity of patients’ relatives and residents of the nearby Soba neighbourhood, who still spontaneously arrive to donate blood, that we are able to continue our activities. This act of generosity is essential to ensure timely transfusions and adequate supplies of blood for our hospital.
6 June 2024
Health Promotion in Khartoum
In the new Paediatric Outpatient Clinic in Khartoum, our colleague Albino is in charge of community health promotion, a crucial activity in our paediatric facilities across Sudan.
During special sessions in the triage area, Albino and the health promotion team share important tips with parents to protect the health of their children, from methods for preventing food contamination to good practices for avoiding infections.
“Many families are suffering. There is a lack of electricity, water, food,” Albino explains. “Our completely free health education and promotion work is an additional support for the Sudanese people during this extreme crisis.”
Albino has been working with EMERGENCY since 2015 at the Paediatric Centre in Mayo, a densely populated area on the outskirts of Khartoum. When the war broke out in April 2023, we had to suspend activities in Mayo due to security conditions – but Albino moved to our facility in Khartoum to continue supporting Sudanese families and children, who have been dealing with the consequences of a country-wide health catastrophe for more than a year.
30 April 2024
Vaccinations resume at the Nyala Paediatric Centre
In Nyala, we have resumed vaccinations for children at our Paediatric Centre. This essential activity is part of a vaccination campaign launched by the local health authorities to prevent diseases such as polio, measles, tetanus, yellow fever, tuberculosis and meningitis.
“We are happy to be able to provide this service again in our Paediatric Centre,” says Laura, Medical Coordinator in Nyala.
We also vaccinate against rotavirus, which is responsible for viral gastroenteritis, especially among infants. The diarrhoeal disease brings a risk of dehydration, even more difficult to manage due to war, displacement and compromised infrastructure.
Thanks to this immunisation service, children living through war and its harsh consequences can be vaccinated against diseases that are easily treated in Western countries, but still contribute to high child mortality rates in Sudan.
18 April 2024
Operational challenges during one year of conflict,
from the perspective of an NGO
As the devastating war in Sudan continues into its second year, EMERGENCY has published a new paper on the possibilities and constraints of humanitarian interventions during the current conflict:
Nearly 25 million people need humanitarian assistance, including 11 million in need of urgent healthcare. Amid collapsing national healthcare infrastructure, EMERGENCY continues to care for some of the most vulnerable people in Sudan. Since April 2023, we have conducted 200 open-heart surgeries, over 1,500 cardiological examinations, more than 25,000 paediatric examinations, and around 3,000 midwifery consultations.
Read EMERGENCY’s latest paper on our humanitarian interventions in Sudan throughout one year of war, challenges we’ve faced, and our recommendations to address the current crisis.
12 April 2024
One Year of Neglected War
One year after the outbreak of conflict, Sudan is experiencing one of the world’s worst humanitarian crises.
More than 6.5 million people are internally displaced, about 65% of the population have no access to healthcare, and 70% of hospitals in the areas affected by fighting are no longer functional.
Continuous electricity blackouts and interruptions to the internet and telecommunications networks; exponentially increased fuel prices; shortages of basic goods; and difficulties in procuring essential medicines and equipment: one year after the outbreak of war in Sudan, EMERGENCY’s interventions in the country face enormous difficulties that jeopardise the survival of the population and the viability of its projects.
17 March 2024
New Paediatric Clinic Open in Khartoum
A new, dedicated facility – set up in the Salam Centre complex – where we provide care for children up to 14 years of age.
Children are among the most affected by the ongoing conflict in Sudan: they make up more than half of those in need of humanitarian and medical aid to survive.
The Outpatient Clinic is equipped to carry out examinations, observation of patients with more acute problems, laboratory analyses, and the distribution of medicines; a team of health promoters also talks to parents and carers, sharing important tips to protect the health of the children.
15 March 2024
Special Transport of Supplies to Khartoum
“Because of the war, many of the main transportation routes are blocked or no longer viable,” reports Roberto, Director of our African Network of Medical Excellence, from Sudan. “Our logisticians have studied new routes to enable us to continue to supply our facilities to meet the needs of the population.”
Here are some photos from the challenging journey – which included a 200-kilometre stretch in the Shendi desert – to transport medicines and supplies from Port Sudan to our Salam Centre in Khartoum.
This special transport also included the medicines necessary to open a Paediatric Clinic within our Salam complex.
13 March 2024
Open Heart Surgery Continues in Khartoum
Alima, 8, arrived at our Salam Centre for Cardiac Surgery with severe heart failure: she suffers from rheumatic disease, a condition that causes an abnormality in her heart valves. She needed urgent surgery and blood transfusions.
“In the operating room, we employed the haemo-recuperator: a machine that allows us to reduce the number of transfusions needed by reusing the patient’s own blood,” explains Elisabetta, a Perfusionist. “We use it when our blood supply is limited, as in these months of war.”
The availability of this machine, in a specialised and fully-equipped centre like ours, ensured the operation was a success.
More than 300 days have passed since war broke out in Sudan.
A war that has also entered the hospitals: 80% of the country’s health facilities have closed. In those that remain open, there is a shortage of skilled workers – many have been displaced or fled the country – and many machines have been destroyed. Over 15 million people cannot access the care they need.
8 March 2024
International Women’s Day
On International Women’s Day, we want to introduce you to Aziza.
Aziza lives in a camp for displaced people in Chad, where women and girls make up nearly 60% of refugees (UN Women). Since war broke out in Sudan last April, over 8 million people have been forced to flee their homes (OCHA). This International Women’s Day, we share Aziza’s story.
Aziza is one of our “patients for life”: after a mitral valve replacement at the Salam Centre for Cardiac Surgery several years ago, she needs life-long treatment. Before the war, she was regularly receiving free medications and checkups at our facilities. Now, far from her home, accessing treatment is almost impossible.
We recently reconnected with Aziza during a cardiology screening mission in Chad, delivering the medications she needs for the next six months.
“I am totally on my own, I have lost all contact with my family,” she told us. To get water, she must walk half an hour every day. To earn enough to survive, she has started cooking for other refugees in the camp with the little she has available: some red corn, lentils, oil. “With that money, I manage to pay for transport to a laboratory for blood tests: it takes two days to get there, two days to return.”
Today, we recognise women around the world like Aziza who are struggling to survive amid conflict and displacement. Everyone deserves a future based on peace, human rights and equality.
14 February 2024
Network Blackout Across Sudan
For an entire week, Sudan went offline due to a total network blackout which also had serious consequences on our work in the country:
- slowed the exchange of information between our facilities in the country and coordination offices in Italy, and completely isolated both our Paediatric Centre in Port Sudan and the satellite cardiology clinic in Atbara;
- interrupted online medical services for our cardiac surgery patients undergoing anticoagulant therapy, monitored remotely by our healthcare staff since the beginning of the conflict;
- prevented the bank transfer of essential economic resources to maintain the supply of medicines and essential materials for our hospitals.
Leaving an entire country without the ability to communicate has deprived the entire civilian population, caught in the grip of a humanitarian crisis without historical precedent, of the possibility of accessing essential services.
Every person, especially during war, has the right to be protected as well as the right not to be forgotten by, nor disconnected from, the rest of the world.
8 February 2024
Moving goods and people is increasingly difficult
Moving goods and people is increasingly difficult and unsafe because of war. The impact on our work is considerable:
- While restrictions are slowly easing for internal movements, it is still very difficult for our international staff to obtain visas to enter the country.
- We are forced to continually rearrange the overland transfer of stocks of medicines and materials from warehouses to hospitals. It is difficult to manage supply and storage of goods without knowing when we will be able to organise transport, constrained by time limits on permits provided by the different groups and authorities controlling various parts of the country.
Without enough qualified personnel to manage the ongoing health and humanitarian emergencies, the risk is that the country will completely collapse. During these months of conflict, the Sudanese staff who have chosen to remain in the country have continued to handle immense workloads, in the enforced absence of international health and non-health specialists, who are central to our interventions.
Facilitating the movement of people and materials, and not limiting the work of NGOs – committed to treating those in need, even in war – is fundamental to protecting people’s health.
3 February
In Port Sudan, Admissions Have Nearly Doubled
Port Sudan has become the country’s de-facto capital. The city now looks like a huge refugee camp: in recent months, the east of the country has received some 500,000 displaced persons, at least 270,000 of them in Port Sudan.
“We see malnourished children with respiratory and gastrointestinal tract diseases. Some days, admissions almost double the pre-war average. We also monitor the health of cardiac patients, with echocardiograms, INR control and anticoagulant therapy,” says Franco Masini, cardiologist and Coordinator of the Salam Centre in Khartoum, who is currently visiting Port Sudan.
According to the most recent UN estimates, more than 9 million Sudanese people have fled their homes since 15 April. Half of them are children.
Families who cannot afford housing live on the streets, without water and in very poor hygienic conditions, which has contributed to the spread of diseases such as cholera. Despite the ever-increasing health needs, the continued influx of adult and paediatric patients and the multiplied workload – due to the overcrowding in the city – we are doing all we can to continue to treat those in need.
We are not abandoning Sudan.
1 February
Cardiac Activities Continue in Nyala
“Many of them were forced to flee here, to South Darfur, to reach safety from the fighting in Khartoum.”
From Nyala, our Head Nurse Islam reports on the situation in the region and the efforts of our local colleagues to get our paediatric centre back up and running at full capacity.
“Recently, we are seeing about 60 people a week, cardiac patients operated on at the Salam Centre. They are between 15 and 50 years old, they come here to receive the anticoagulant medication that prevents their heart valves from getting blocked.”
The war in Sudan has caused a surge in prices for essential goods and services; the price of this medication has risen fivefold. Here, as in all of our facilities, it is available free of charge to patients who need it.
At the end of October, EMERGENCY’s Paediatric Centre in Nyala was looted and vandalised. Just a few days later, our Sudanese staff started working to reopen it.
For now, cardiology activities continue in Nyala. However, getting medicines and biomedical equipment into the country to resupply the Centre remains difficult, and paediatric activities continue to be suspended.
20 December
Update from Gina, Sudan Programme Coordinator
The humanitarian situation in Sudan has continued to deteriorate. Earlier this week, increased fighting forced EMERGENCY to suspend activities and evacuate staff at the Satellite Cardiology Clinic in Wad Madani.
Gina Portella, our Sudan Programme Coordinator, spoke to the BBC with the latest updates:
“[Wad Madani] is the first big city south of Khartoum and it was full of Internally Displaced People. We needed to evacuate because the situation was getting worse [due to increased fighting].
When we opened [the cardiology clinic] it was immediately clear that it was very much needed [to guarantee life-saving care to our cardiac patients]. So now we are thinking where we can relocate.
[In Khartoum], the situation is more or less the same for eight months now. It is not safe to move around the city, not at all. We have the cardiac surgery open and running, we are doing one operation a day. That is what we continue to try to do.”
Listen to the full interview here starting at 08:12 minutes.
17 December
Activities Suspended in Wad Madani
The intensification of fighting in Wad Madani – around 130 km from the capital Khartoum – forced us to evacuate our cardiology outpatient clinic in the city, where we offered treatments and follow-up to heart patients awaiting surgery or already operated on at the Salam Centre for Cardiac Surgery. Ten colleagues, including surgeons and pharmacists, were evacuated.
In Wad Madani, we still have a warehouse where essential supplies for the Salam Centre’s medical and surgical activities are storied.
11 December
ICRC Convoy Treated in Khartoum
On 10 December, an International Red Cross convoy came under attack in Khartoum, Sudan.
Of the nine passengers, one died instantly. The others were taken to our hospital in the city; one wounded person who was in a very serious condition died on arrival, three were operated on and four who had less serious injuries were treated in the outpatient department.
6 December
M.’s Story from Nyala to Khartoum
At the Salam Centre for Cardiac Surgery, 14-year-old M. was able to receive the proper care he urgently needed.
About three years ago, symptoms of the boy’s heart disease began to appear. His condition worsened over time, especially since April when fighting broke out and seriously impacted healthcare in the country.
To reach our hospital in Khartoum and receive the life-saving care he needed, M. and his father had to face several obstacles, which the war continues to multiply for the entire population.
17 November
Update from our Satellite Cardiology Clinics
For heart patients operated on at the Salam Centre for Cardiac Surgery in Khartoum, receiving the medication, therapies and tests they need after surgery is crucial.
After more than seven months of fighting, many of our patients have fled Khartoum or struggle to reach the capital because of deteriorating security conditions.
That’s why we have set up a network of Satellite Cardiology Clinics throughout the country, in places that are easier and safer to reach: to guarantee access to care to our heart patients, even in the midst of conflict.
12 November
Restoring the Nyala Paediatric Centre
Our Sudanese colleagues are working to restore the Nyala Paediatric Centre in South Darfur after it was vandalised and looted.
They want to re-open as soon as possible because mothers, children and cardiac patients need a place to receive care, especially at this time.
We don’t know when we will be able to resume operations: we lack medicines – the ones we had were stolen and scattered in the looting – and currently there is no safe way to get new ones to Nyala; we have to replace the equipment that was stolen; and, above all, we have to be able to ensure the safety of our patients and our staff.
A hospital is a place of care. It must not be violated.
30 October
Nyala Staff Released, Activities Suspended
Our colleagues who were arrested last week at the Paediatric Centre in Nyala, South Darfur, have all been released with apologies from the Rapid Support Forces. They are shaken, but all are well.
The Paediatric Centre, however, was looted, so we are forced to suspend activities until further notice.
Our colleagues were the first to ask us to keep the Paediatric Centre open to ensure the continuity of health activities. They see first-hand the impact their work has on their communities every day, and so their commitment has never wavered. However, we will not be able to reopen the hospital without assurances of the safety of our staff, our patients and the ability to work autonomously.
In Khartoum, too, the management of our facilities is becoming increasingly difficult. The city has been torn apart by over six months of continuous fighting, and most hospitals have closed.
There is massive need. Even in our cardiac surgery and emergency surgery centres, there is a shortage of drugs, consumables, and fuel for the generators. Many Sudanese colleagues have fled the escalating fighting, while the issuing of visas to our international staff is very slow; they have been waiting for months to enter the country and relieve colleagues who have been operating the projects since the beginning of the conflict.
Even in war, the right to care must be guaranteed. We demand respect for patients, staff and health facilities so that we can continue our work providing free, high-quality care in Sudan.
UPDATE: EMERGENCY’s activities at the Centre for Emergency and Trauma Surgery in Khartoum are suspended due to operational constraints.
26 October
Staff Taken from Nyala Paediatric Centre
On Tuesday 25 October, a number of Sudanese staff members at EMERGENCY’s Paediatric Centre in Nyala, South Darfur, were taken from the hospital and arrested by the Rapid Support Forces. It seems they are still being held.
EMERGENCY has been present in Nyala since 2020, providing free medical care to mothers, children and cardiac patients. Since the outbreak of war on 15 April, the Centre has continued its work to guarantee essential assistance to a population heavily affected by the conflict. In the last three weeks the hospital has remained open with great difficulty due to the increasing intensity of fighting. However, EMERGENCY managed to stay in touch with the staff until last Tuesday, when the situation seemed to be improving.
At the moment we have not received any communication from the RSF and we have lost contact with the remaining staff members, which since the beginning of the war has only been possible via satellite phone. We therefore have no certainty as to the number of the colleagues arrested or their identities, except for what we have learned from a video circulating on social media.
EMERGENCY asks for the safety of its staff to be ensured, for them to be released immediately, and for the Paediatric Centre to be respected so that it can continue its activities in support of the local population.
19 October
Update from President Rossella Miccio
UPDATE: EMERGENCY’s activities at the Centre for Emergency and Trauma Surgery in Khartoum are suspended due to operational constraints.
15 October
Six months ago, war broke out in Sudan
Six months ago, war broke out in Sudan. Since 15 April, the conflict has claimed over 9,500 lives, while more than 5.5 million people have fled their homes because of the fighting.
In August, we opened a new surgical Centre in Khartoum to provide urgent care to those who cannot receive it in other facilities. Here we receive people burned by explosions, wounded by bullets and mines, but also patients injured in accidents or by civilian trauma.
Since opening the Centre, we have treated more than 500 people.
We continue cardiac surgery and cardiology at the Salam Centre even though it is becoming increasingly difficult for patients to travel. In general, it is difficult to get supplies of even essential goods, fuel and medicines; every day there is a new difficulty, in addition to deteriorating security conditions.
This war attracts few headlines, but it has already triggered a massive humanitarian crisis.
We will remain here. We are not abandoning Sudan.
UPDATE: EMERGENCY’s activities at the Centre for Emergency and Trauma Surgery in Khartoum are suspended due to operational constraints.
6 October
Juma is Another Civilian Victim of War
Juma is just 11 years old, but he has already lost an eye and a hand to a grenade.
When he came to our hospital in Khartoum, he was screaming in fear. A piece of chocolate was the only thing that could calm him down.
Juma’s parents are missing, most likely from the ongoing conflict in the country.
Now, he is doing better. His other eye – which had also been hit – is safe. “Juma is lively again,” Gina, Medical Coordinator, tells us. “He even went out to the garden yesterday to eat.”
Within a city engulfed in fighting, our Centre for Emergency and Trauma Surgery provides care for civilian victims of the war.
We are not abandoning Sudan.
UPDATE: EMERGENCY’s activities at the Centre for Emergency and Trauma Surgery in Khartoum are suspended due to operational constraints.
29 September
Update from the Salam Centre on World Heart Day
Patients continue to arrive at the Salam Centre for Cardiac Surgery in Sudan despite the war. The fighting makes travel difficult for many, but the care they receive at the Centre – surgery, follow-up exams, lifelong therapy – is essential. Our perfusionist Elisabetta gives an update this World Heart Day.
“We have performed about 100 operations since 15 April. Patients slowly keep coming in. We get both pre-op and post-op patients for regular follow-ups and INR treatment.
INR is a parameter that quantifies the time it takes for a clot to form and a key analysis for monitoring patients on oral anticoagulant therapy. In fact, most of our patients undergo valve replacement that requires lifelong anticoagulant therapy.
We have noticed an increase in the number of patients who, because of the war, are unable to reach the Salam Centre for INR therapy and the consequence is a blocked valve.”
“Mariam is a 32-year-old woman we admitted a few days ago. She presented with both valves blocked, mitral and aortic.
She came with her 7-year-old son whom she managed to entrust to relatives.
She was admitted for treatment here, which was fortunately successful without the need for an operation. Now both valves are unblocked. Mariam is already on the ward and doing well.”
19 September
“It seems to be never-ending.”
“The fighting in Sudan is appalling. In Khartoum, we continue to receive injured people,” reports Gina, Medical Coordinator of the Centre for Emergency and Trauma Surgery in Khartoum.
“Recently, a 10-year-old boy named Woul arrived at our hospital. His mother told us that a bullet hit him while he was sleeping. Unfortunately it had lodged in his brain; there was nothing we could do.”
“We are also seeing injuries from looting incidents. There are elderly women who end up with bullets in their abdomens and in need of urgent surgery, perhaps for a ruptured spleen.”
“The situation is really heavy. It seems to be never-ending.”
UPDATE: EMERGENCY’s activities at the Centre for Emergency and Trauma Surgery in Khartoum are suspended due to operational constraints.
12 September
Fighting Continues in Khartoum
“The fighting continues,” reports Gina, EMERGENCY Medical Coordinator in Khartoum. “We often hear explosions, sometimes quite close together. We have received burn patients from the explosions, including a woman, as well as a child who unfortunately did not survive.”
In the new Centre for Emergency and Trauma Surgery, we have already received more than 250 patients amid the deteriorating healthcare infrastructure and safety in the country.
“Colleagues at the Salam Centre for Cardiac Surgery are continuing to operate,” Gina continues. “Our two new satellite cardiology clinics are working at full capacity: on average they receive ten patients per day for anti-coagulation therapy and pre-surgery health monitoring. Many travel from significant distances to receive the medical assistance they need at our clinics.”
“Other hospitals we collaborate with sometimes transfer the patients that they cannot manage to us,” Gina concludes. “The healthcare situation in Sudan is catastrophic.”
UPDATE: EMERGENCY’s activities at the Centre for Emergency and Trauma Surgery in Khartoum are suspended due to operational constraints.
29 August
Second Satellite Cardiology Clinic Open
In Atbara, the second of our new satellite cardiology clinics is open.
Here, as in Wad Madani, we will ensure the necessary check-ups and therapies for patients we have operated on in Khartoum at the Salam Centre for Cardiac Surgery, as well as preoperative care for those awaiting surgery.
The network of cardiology clinics we are opening in different parts of the country is our way of ensuring the necessary care for our patients in a context of war, where movement is limited or impossible for many, even for essential reasons like treatment.
22 August
Rocket lands in garden of Nyala Paediatric Centre
In recent days, conflict has resumed in Nyala, South Darfur, with some fighting taking place near our Paediatric Centre. On the morning of 22 August 2023, a rocket landed in the compound’s garden: fortunately there were no injuries, but the safety of our staff and patients is at its highest risk since the beginning of the war.
🔴 #Sudan: Following renewed fighting in Nyala, South #Darfur, this morning a rocket landed in the garden of EMERGENCY’s Paediatric Centre.
Fortunately there were no injuries, but the safety of our staff and patients is at its highest risk since the beginning of the war. (1/3)— EMERGENCY NGO (@emergency_ngo) August 22, 2023
17 August
EMERGENCY opens Centre for emergency and trauma surgery in Khartoum
At EMERGENCY’s Salam Centre complex in Khartoum, already home to a cardiac surgery hospital, the NGO has opened an emergency and trauma surgery hospital to treat people in a context where few other medical facilities are available because of the war that began in Sudan on 15 April 2023.
“We know Sudan well, having worked here for 20 years. When the country became the scene of a new conflict in April, we decided to stay, although we had to reshape our activities, so as not to abandon our patients,” comments Rossella Miccio, President of EMERGENCY. “As the war has continued, needs have increased, and that is why we decided to expand our activities: in addition to supporting various hospitals with medical supplies, we have refitted a part of our existing cardiac hospital where we used to host patients from other African countries, to create an emergency surgery centre. Here we treat war-wounded, civilian trauma cases and surgical emergencies.”
Within the Guest House, which usually houses 40 patients from the Regional Programme for Cardiac Surgery, are now two operating theatres, an observation ward, an emergency room (up to 7 beds), a sub-intensive care unit (8 beds), dedicated locker rooms, storage rooms for sterile and clean material, and a decontamination space for material that needs to be sterilised. A 30-bed ward has been created in another building.
“So far we have received 77 patients, of whom 44 had war wounds and 2 were dead on arrival,” says Gina Portella, Medical Coordinator at the Salam Centre. “27 have been admitted, and the rest have been managed in the outpatient clinic.”
EMERGENCY’s New Hospital: The Centre for Emergency and Trauma Surgery
UPDATE: EMERGENCY’s activities at the Centre for Emergency and Trauma Surgery in Khartoum are suspended due to operational constraints.
24 July
100 Days of Fighting in Sudan
Today, we mark the 100th day of fighting in Sudan since conflict broke out on 15 April.
The UN reports about 2.6 million people have been internally displaced. 24.7 million are in need of humanitarian assistance.
The conflict is disappearing in the international media, but on the streets it can still be seen and heard. Many report stories of abuse, looting, occupied hospitals. The national health system is collapsing.
We continue to treat cardiac patients at EMERGENCY’s Salam Centre for Cardiac Surgery in Khartoum, albeit at a slower pace. Our Paediatric Centres in Port Sudan and Nyala are also open, mainly providing anticoagulant therapy for former cardiac patients and vaccinations, while in Mayo we remain closed.
Hunger and malnutrition were already at record levels before the conflict broke out. Now, instability and the skyrocketing cost of food have led to an estimated 3 million malnourished children, and cardiac patients who have previously received surgery at the Salam Centre are at risk of adverse health effects.
At our Paediatric Centre in Port Sudan, about 120 children a day queue for triage and vaccinations in the corridors. Although the city is not experiencing direct clashes, it is the main destination of those trying to escape the country. Many people are sleeping in the streets around the port and living in a perpetual state of waiting, suffering the logistical, sanitary and social consequences of overcrowding.
It is clear that EMERGENCY remains a key health provider for the population, made possible by the dedication of our colleagues in the country. They have spent hundreds of hours on the wards and in the operating theatres, continuing to treat patients despite the obstacles of war.
15 July
Three Months of Fighting in Sudan
“From the Salam Centre we still hear the sounds of fighting. There has been heavy gunfire and we have seen columns of smoke rising.” Three months after the start of armed clashes in Sudan, Franco – Medical Coordinator of our Salam Centre for Cardiac Surgery – tells us about the situation in Khartoum.
The Salam Centre’s activities continue, albeit at a reduced pace. We continue operating on and admitting patients, conducting follow-up examinations and providing anticoagulant therapy, but “many patients cannot get there, transport is difficult if not impossible” in such an insecure context.
For every patient who manages to reach the Salam Centre, many more are stranded by the war, waiting for the treatment they need.
Even some of our colleagues, who used to travel for an hour to commute to the hospital, now face a six-hour journey.
“A health catastrophe. The country will pay the consequences for a long time.”
3 July 2023
The Situation in Port Sudan
“Since the conflict broke out in Sudan, thousands of displaced people have reached Port Sudan, hoping to escape to countries like Egypt or Saudi Arabia.” Mutasim, our Medical Coordinator in Port Sudan, updates us on the situation in the city and the activities of our Paediatric Clinic.
“The number of patients arriving at the Paediatric Centre has doubled compared to a year ago: around 60 children a day, on Sundays often more than 100. Most of them suffer from sickle cell anaemia or respiratory diseases, made even more acute by the heat: temperatures here have reached 40 degrees.”
“The war has drained all economic resources,” Mutasim continues. “Many have lost their jobs and have nothing left. Their children need treatment and vaccinations: only EMERGENCY is providing these completely free of charge.”
14 June 2023
World Blood Donor Day
When fighting erupted in Sudan two months ago, one of the first concerns of our colleagues at the Salam Centre for Cardiac Surgery in Khartoum was the supply of blood and blood components, which are crucial in a facility like ours.
They are usually donated by the relatives of hospitalised patients and the local population but in war context, we feared that the difficulties and dangers of travel would discourage donors.
Instead, “Not even the war stopped them,” says Elena, our anaesthetist. In recent weeks, many have contributed: colleagues, residents of Soba, people who despite the war – and the scorching heat – have come to the Salam Centre to donate. At such a critical time for the country, even these small but vital gestures have made a difference.
17 May 2023
Ongoing Activities in Nyala, South Darfur
“We are one of the few centres still open where parents can get their children vaccinated,” says Laura, Medical Coordinator at EMERGENCY’s Paediatric Centre in Nyala. “In just three days since we resumed immunisation activities, we have administered more than 400 doses.”
The Centre is located in the capital of South Darfur, Sudan.
“Our activities in Nyala have never stopped, even on days when the fighting was most intense. Parents and children continue to arrive, as well as patients from Darfur who have undergone heart surgery at the Salam Centre for Cardiac Surgery in Khartoum and who come to us for check-ups and to receive medications, about 20 every day.”
15 May 2023
Thank You to Our Colleagues in Sudan
Without the incredible efforts of our Sudanese colleagues, we would not be able to continue operations or caring for existing patients. Thank you for all that you continue to do!
9 May 2023
We Are Still Operating at the Salam Centre
On Sunday, our surgical team in Khartoum performed an urgent operation on H., an 18-year-old woman suffering from severe valvular insufficiency.
She had been admitted to our hospital and awaiting surgery, but when the fighting started we discharged her for safety reasons.
She was waiting to return to the hospital when her condition suddenly deteriorated overnight. The surgery could not wait any longer.
She is now recovering in intensive care, constantly monitored by our team.
5 May 2023
Surgery Updates from Khartoum
“Of the 40 people we were hosting in the guest house in mid-April – patients, relatives and translators from various African countries – we have managed in recent days to repatriate most of those coming from Uganda and Burundi, and soon we will also evacuate those from Chad,” says Franco Masini, Medical Coordinator at the Salam Centre for Cardiac Surgery.
Today there are just over 20 patients in the hospital who cannot be moved because of their health conditions. Some have already been operated on, while others are awaiting surgery.
And, despite the insecurity in the country, even during this difficult time, critical patients have arrived for emergency surgery: remaining in Sudan has made it possible for EMERGENCY to provide these people with life-saving care to which they would otherwise not have had access.
Among the admitted patients is K., 15 years old, who arrived from Uganda prior to the fighting thanks to our Regional Programme.
Suffering from an advanced heart problem due to severe valvular dysfunction, it was immediately apparent that his condition was serious.
We operated on K. the day after fighting began. His path has not been easy: he first went into kidney failure, which required us to put him on dialysis, and then developed a serious infection and gastrointestinal bleeding.
Today, K. is fully awake, although his condition remains serious. Next to him sits his sister, who accompanied him on the long journey from Uganda; she visits every day and squeezes his hand to give him strength.
28 April 2023
We continue to provide continuity of care through our Anticoagulant Therapy Outpatient Clinic
“Although the situation in Sudan is difficult, we continue to provide continuity of care through our Anticoagulant Therapy Outpatient Clinic,” reports Nicoletta Erba, Haemotologist at the Salam Centre for Cardiac Surgery in Khartoum. “Patients, albeit in smaller numbers, come to the Salam Centre to perform necessary tests and receive their medication. Those who live far away are sending blood tests from external laboratories so that we can fill their prescriptions.”
“Providing this treatment is critical: after cardiac surgery, patients require anticoagulant therapy for life. Our Outpatient Clinic is a fundamental part of the Salam Centre’s cardiac programme, giving our patients the security of receiving prescriptions and medications.”
We are receiving only half the number of patients as we did before the fighting started: our thoughts are also with those who cannot reach the Centre in these days.
26 April 2023
Thanks to the great work of our Sudanese colleagues
In Khartoum, the Salam Centre for Cardiac Surgery is still open.
We have several in-patients who need our care and medical attention, our colleagues tell us.
It is thanks to the great work of our Sudanese colleagues, who are at the hospital 24 hours a day, that the Intensive Care Unit and the Anticoagulant Therapy Outpatient Clinic are currently open. “They are the beating heart of this hospital,” Elena writes to us from Khartoum.
In recent days we have discharged, when possible, all patients who were fit to leave the hospital. Having done this – and with the hospital’s activities reduced as a result of the situation in the country – a second group of international staff has now evacuated.
The remaining international medical staff members are working with their Sudanese colleagues to provide treatment in the Intensive Care Unit and the Anticoagulant Therapy Outpatient Clinic, both of which are critical for patients who have undergone heart surgery.
Elsewhere, EMERGENCY’s Paediatric Centres in Port Sudan and Nyala are open, while the Paediatric Centre in Mayo remains closed for security reasons.
24 April 2023
EMERGENCY Calls on Warring Parties to Respect for Health Facilities
EMERGENCY calls on all parties to the conflict to respect our health facilities and recognise hospitals as safe zones.
23 April 2023
Khartoum, Nyala, and Port Sudan Continue their Work
Over the weekend, seven EMERGENCY workers returned to Italy with an evacuation convoy, three of whom had already planned to return but had been stranded in the country since the outbreak of fighting. Another 46 international workers have remained, and continue their crucial work.
Colleagues at the Salam Centre for Cardiac Surgery are caring for the 81 patients that were admitted before fighting began. Many of our Sudanese colleagues are unable to travel home because of security reasons and are sleeping at the hospital in the meantime.
The Paediatric Clinic in Nyala is once again accepting patients, as is the clinic in Port Sudan, where the situation has remained more stable and our services have gone uninterrupted. The clinic in Mayo remains closed, until we can guarantee safety for both staff and patients.
19 April 2023
Our Facilities Around the Country Continue at a Reduced Capacity.
Across Sudan, many of our colleagues are unable to reach EMERGENCY’s clinics because of unsafe travel routes. They report a lack of food, water and electricity as the situation becomes increasingly difficult.
At the Salam Centre for Cardiac Surgery, in the south-eastern part of Khartoum, ongoing clashes and fighting have limited our work. Muhameda, Country Director in Sudan, tells us: “Here in Salam Centre, we are still working and taking care of our patients, but we are not performing surgeries anymore because we do not have the necessary blood for ventral transfusions.”
Our colleagues continue to manage patients in our ICU and wards, including 57 from the Regional Programme, from countries like Chad, Uganda and Ethiopia, who have been referred to the Salam Centre through our cardiac screening missions.
Our Paediatric Clinic in Mayo, on the outskirts of Khartoum, remains closed.
Nyala, in South Darfur, has experienced heavy clashes from the beginning of the conflict. At our Paediatric Clinic, our staff and patients had to shelter in the basement because of nearby fighting. As of this morning, we are once again receiving paediatric patients.
In Port Sudan, Red Sea State, the situation is more stable. Our Paediatric Clinic there continues to operate.
18 April 2023
“We have a smaller number of staff that is present with us since the 15th of April.”
EMERGENCY NGO’s Country Director in Sudan, Muhameda Tulumovic, provides an update on the organisation’s activities following several days of fighting across the country.
16 April 2023
EMERGENCY’s Country Director in Sudan, Muhameda Tulomovic, joined CNN to discuss the impact of the ongoing fighting on EMERGENCY’s facilities and programmes across the country.
15 April 2023
Armed clashes between the Sudanese army and the paramilitary Rapid Support Forces (RSF) began this morning on the streets of the capital Khartoum after fighting in recent weeks erupted into violence and conflict across the country.
“At the moment we have reduced activities at our healthcare facilities across the country,” explains Muhameda Tulumovic, EMERGENCY’s Country Director in Sudan. “At the Salam Centre for Cardiac Surgery in Khartoum, many Sudanese colleagues cannot go home for security reasons and will stay here. We closed the Paediatric Centre in Mayo, on the outskirts of the capital, evacuating our staff.”
“In the other cities where we operate two paediatric centres, the news we are receiving at the moment is that police, army and military tanks are on the road in Port Sudan, ready to intervene in case the clashes spread, even if at the moment the situation is still under control. In Nyala, the airport and shops are closed, and armed forces just outside the city.”
According to reports from the country, RSF paramilitaries have taken control of the Khartoum airport and the presidential palace in the city centre, while the army has bombed facilities used by the RSF. Explosions and shootings continue in the capital and other parts of the country, while aircraft are reportedly hitting targets in Khartoum.
EMERGENCY is present across Sudan with the Salam Centre for Cardiac Surgery in Khartoum, and Paediatric Centres in Mayo (Khartoum), Nyala (South Darfur) and Port Sudan, where it offers free medical treatment to children under the age of 14.
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