Salam Centre for Cardiac Surgery
Cardiac surgery for patients from around the world.
Fighting in Sudan: Impact on EMERGENCY’s Facilities Across the Country
On the morning of 15 April 2023, armed conflict began in the streets of Sudan’s capital, Khartoum. Fighting has since spread throughout the country, and displaced millions.
EMERGENCY immediately reshaped its activities in Sudan. In Khartoum, the Salam complex continues to perform cardiac surgeries, albeit at a limited capacity, and has responded to growing needs of the population for treatment of both war injuries and trauma from civilian causes. Since mid-March 2024, a Paediatric Outpatient Clinic has been operating in the Salam complex: our concrete commitment for children who are unable to access essential care. The Outpatient Clinic receives mostly patients living in the neighbourhoods surrounding the hospital, but also many displaced people who have fled areas with intense fighting.
The Centre
In 2007, EMERGENCY opened its Salam Centre for Cardiac Surgery, situated on the outskirts of the Sudanese capital, Khartoum. The hospital is named ‘Salam’ – the Arabic word for ‘peace’.
The Salam Centre remains the only completely free cardiac surgery hospital in an area home to over 300 million people, and one of very few on the African continent offering highly specialised, free treatment to patients suffering from acquired and congenital cardiovascular diseases. Severely limited access to treatment in Sudan and the wider region leads many to postpone visits to healthcare facilities. As a result, their conditions continue to deteriorate, putting their lives at serious risk.
19th April, 2007: The First Operation in the Hospital
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Across Africa, there are an estimated 18 million people suffering from rheumatic fever, an inflammatory disease of the heart valves caused by untreated group A streptococcal infections (GAS). Patients operated on at the Salam Centre suffer primarily from valvular conditions caused by rheumatic fever. These complications have a very high incidence rate among young people: 56% of our patients are under the age of 26. While in wealthier regions rheumatic fever has been effectively eradicated and affects only 1 in every 100,000 people, the incidence rate in Sudan is 1 in every 1,000 people. This marked contrast is linked to poverty, limited hygiene infrastructure and a lack of healthcare facilities.
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Our guesthouse provides board and lodgings – completely free of charge – for the relatives of patients travelling from beyond Khartoum for treatment. The Salam Centre also houses a multi-faith Meditation Hall for use by patients and their relatives. Upon discharge, patients continue to receive regular and close monitoring by staff at the centre, especially those who have undergone valvular surgery and must follow anticoagulant therapy. While hospitalised, and subsequently during follow-up at the Anticoagulant (INR) Clinic, patients receive information on nutrition and on the importance of following their tailored therapy programmes in order to avoid cardiac and neurological complications.
Collaboration and Training
EMERGENCY collaborates closely with the Sudanese Ministry of Health. After ten years of activity, in 2017 the Salam Centre was recognised as a specialist centre in anaesthetics, cardiology and cardiac surgery. Furthermore, the centre has been accredited as a certified training centre and hosts trainee doctors and nurses during their specialisations. The Sudanese Medical Specialisation Board has authorised the Salam Centre to educate cardiologists; intensive care nurses; anaesthesiologists; cardiac surgeons; and specialist theatre nurses.
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Additionally, Sudanese generalist doctors can spend a year of their National Service at the Salam Centre, with the potential to obtain a certification in cardiology. The hospital is, therefore, an integral part of the national and regional healthcare system, contributing to local capacity-building and developing future autonomy. In recent years, the country’s national healthcare system has suffered after seeing many of its doctors and nurses emigrate to the Gulf. As such, the training of young Sudanese specialists has become a fundamental part of our work in the country.
The Sudanese government provides a financial contribution that covers a considerable part of the running costs of the hospital, for which we are thankful.
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The African Network of Medical Excellence
The Salam Centre for Cardiac Surgery was the first facility in the African Network of Medical Excellence (ANME). ANME is an initiative between EMERGENCY and more than a dozen African health authorities to develop an integrated network of high-quality, free medical centres across the continent.
The Salam Centre provides – completely free of charge and available to all – medical and surgical care according to the most advanced international standards and making use of the latest innovations, while simultaneously working to promote the autonomy of the Sudanese national healthcare system. Additionally, the Centre’s Regional Programme for Cardiac Surgery creates critical connections between different health systems to integrate the network and encourage collaborations.
The Regional Programme for Cardiac Surgery
Through the Regional Programme for Cardiac Surgery – and in collaboration with numerous local authorities – EMERGENCY’s international team of cardiologists conduct regular screening missions to identify patients from a vast area who require transfer to Khartoum for urgent cardiac surgery, and guarantee the necessary follow-up care for patients who have already been operated on.
The Regional Programme also coordinates between medical centres and health systems, bringing young medics to the Salam Centre for specialist training periods. These collaborations strengthen and increase the long-term sustainability of the local, national and regional health systems.
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Part of the Regional Programme includes our work in the cardiac OPD the Orotta Hospital in Eritrea, funded entirely by the Italian Agency for Development Cooperation (AICS).
Patients from 33 countries have undergone surgery at the Salam Centre: Afghanistan, Bangladesh, Burkina Faso, Burundi, Cameroon, the Central African Republic, Chad, the Democratic Republic of Congo, Djibouti, Eritrea, Ethiopia, Gambia, Guinea, Iraq, Jordan, Kenya, Liberia, Libya, Nigeria, the Philippines, Rwanda, Senegal, Sierra Leone, Somalia, South Sudan, Sudan, Tanzania, Togo, Uganda, Yemen, Zambia, and Zimbabwe. Italian citizens temporarily residing in Sudan have also undergone treatment at the centre.
Architecture and Awards
The Salam Centre for Cardiac Surgery has won numerous architectural prizes, including the Aga Khan Award for Architecture in 2013: awarded to ‘innovative buildings that combine architectural excellence with a positive impact on the quality of life of surrounding communities.’ The facility is highly innovative and designed to minimise its environmental impact: it uses effective ventilation to mitigate the heat and an extensive system of solar panels to generate energy for cooling.
EMERGENCY’s scientific publication in the journal “Frontiers in Pediatrics”
This scientific publication presents the activities and clinical results of the Salam Centre for Cardiac Surgery in Sudan, and in particular those obtained on paediatric patients under 15 years of age suffering from advanced rheumatic heart disease. It also takes an in-depth look at EMERGENCY’s model of care.
The results obtained in those years of activity show that building a hospital of excellence and offering free cardiac surgery and post-operative assistance can be a vector of positive change in the long term. Sharing these results means sharing our mission: allow African citizens to be recipient, like every other citizen in the world, of healthcare benefits coming from the best scientific developments in medicine, in the name of equality, dignity and human rights.
Programme Data
Location: Khartoum
Activities: Paediatric cardiac surgery, cardiac surgery for adults, cardiology, interventional cardiology.
Facilities: Accident and emergency, clinic, 3 operating theatres, sterilisation, intensive care, wards, physiotherapy, radiology, laboratory and blood bank, pharmacy, classroom, play room, technical and support services, guest accommodation.
Outpatient consultations: 88,018
Specialist cardiological examinations: 91,482
Admissions: 11,402
Surgical interventions: 10,261
Diagnostic and interventional haemodynamic procedures: 1,454
Non-Sudanese patients: 2,031
(Data correct as of January 2023)
