Gezira States Healthcare System at Risk of Collapse
Khaled Mohamed Taha: Wad Madani
As the influx of people fleeing military conflicts in various cities and parts of Khartoum state continues towards Gezira State, in search of safe shelter and access to healthcare services, many problems within the healthcare sector are becoming evident. Some of these issues are longstanding and chronic, while others are more recent and directly related to the war that erupted in mid-April of last year, with its ongoing repercussions. All of these problems indicate the potential collapse of the healthcare sector in Gezira State, especially in Wad Madani city. The increasing burden on hospitals, medical centers, and healthcare facilities, coupled with the scarcity of medical supplies, medication shortages, and a lack of necessary materials for medical laboratories, kidney dialysis centers, and operating rooms, contribute to this risk.
Although there has been no comprehensive census conducted on those fleeing the ongoing war in Khartoum State, except for a limited count of those who have arrived at the twenty shelter centers in Wad Madani, the city has received tens of thousands of people who have sought alternative housing outside the shelter centers, either by renting houses or staying with relatives or acquaintances from Gezira.
This dense and growing presence of war survivors highlights additional urgent needs, placing them in a complex humanitarian situation that requires immediate intervention to prevent an imminent health catastrophe.
The Situation Was Not Ideal Before the War
Dr. Marwa Hassan, a volunteer doctor at the displaced persons shelters in Wad Madani city, stated that the catastrophic consequences of the war have impacted an already weakened and crumbling healthcare system. This makes its resilience during times of war and displacement weak and unexpected unless there is swift intervention to meet the needs of the residents of Gezira State and its guests.
Dr. Marwa explained that the healthcare facilities in Wad Madani are currently operating at only two-thirds of their capacity. This continuous decline in capacity is accompanied by an increasing demand for medical services and medication. Many hospitals will not be able to provide necessary assistance to patients due to the severe shortage of medical supplies. Despite the presence of an oxygen production unit in the city, there is insufficient oxygen available. There is also a shortage of life-saving medications, intravenous solutions, blood bags, and anesthesia drugs. The medical supply chain has been disrupted due to the war conditions.
The shortage of human resources and the limited capacity of centers and hospitals in terms of beds or accommodation could have been managed with additional measures. However, multiple methods have been employed, putting pressure on doctors and medical staff, but still facing humanitarian challenges that are willingly addressed by those working in the medical field. The problem lies in the shortage of medical supplies, medications, and other aid such as fuel and operational necessities.
Dr. Marwa emphasizes, Even when discussing urgent assistance, we must ensure that aid reaches hospitals, healthcare centers, and laboratories directly. We have had bitter experiences in managing and delivering assistance to those in need in a timely manner. Currently, the drug warehouses belonging to the Ministry of Health in Wad Madani are stocked with expired tools and medications, accumulated since the time of the coronavirus pandemic and floods. This is a crisis in resource management and identifying needs, which can open up unfair avenues for the distribution of medicine and medical supplies and the methods of reaching beneficiaries in a timely manner.
Shortage of Medications and Operating Rooms on the Verge of Closure
Dr. Elfatih Ibrahim Mohammed, who works in the field of providing medical laboratory supplies in the private sector, confirms a 20% shortage during the first two weeks of the war and the beginning of displacement to Gezira State. This shortage includes essential test materials such as blood coagulation assessment, blood typing, blood transfusion requirements, and a worsening shortage of blood transport and storage bags, which have no alternatives. These supplies used to be provided by the Medical Supply Authority, but they faced difficulties in reaching their destination about a month and a half before the recent events. As a result, their availability has dwindled in just a few days.
Dr. Elfatih further adds that there is a shortage of all medications for patients with chronic mental and neurological conditions. The war has led to the emergence of new cases and the deterioration of existing or chronic conditions, and there is no medical aid available for this category. This will undoubtedly put significant pressure on families and society.
Additionally, there is a crisis in the availability of the improved insulin medication (Lantus), which has a longer duration of action than zinc-mixed insulin, the current limited quantity of which is about to run out. It can be said that most life-saving medications are scarce or unavailable.
War survivors are in urgent and continuous need of medical care. Many families who decided to leave Khartoum State due to the war have sought to secure a safe treatment environment for patients with chronic illnesses, especially kidney patients, kidney transplant recipients, users of diabetes, heart, blood, and other chronic disease medications. This also includes children, the elderly, and people with disabilities.
Dr. Marwa states, In general, the displaced populations are in need of therapeutic and preventive medical care. Among them are already sick individuals, and others are susceptible to illness due to the current conditions they are living in. For example, in one shelter in Wad Madani, which suffers from water scarcity and a shortage of sanitary facilities (bathrooms), there are 54 families from Eritrea and Ethiopia, including 73 children, one family of 22 individuals from the Democratic Republic of Congo, 13 mothers, and some pregnant women and newborns, one cancer case, and one child with autism. Recently, cases of diarrhea and epidemic fevers have emerged, and all indicators point to deteriorating health conditions, not only in the shelters but throughout the city, which has received a massive influx of people surpassing its capacity to provide services or readiness to meet essential needs.
Dr. Elfatih indicates that the deterioration of the health situation is progressing slowly but steadily. Compared to the number of displaced people to Wad Madani city, it is expected that pharmacies will dry up and be unable to provide their services, and operating rooms are on the verge of imminent closure.
Dr. Marwa emphasizes that allocating only one hospital for the displaced from Khartoum is not sufficient in terms of specialization and the multitude of existing and potential diseases. Moreover, the shelter centers themselves are not designed or equipped for habitation. Most of them were established with popular support to address the humanitarian crisis, and they require medical and health efforts to mitigate expected problems. These include diseases related to malnutrition, especially among children and the elderly, as well as the poor housing conditions, shortage of blankets, bedding, cooking utensils, and meals. It is worth noting that in some shelter centers, there is only one bathroom for a hundred displaced individuals.
Dr. Marwa adds, The official authorities insistence on imposing conditions for receiving the displaced and neglecting some of them further exacerbates the situation. However, on the other hand, the cooperation of various entities has contributed to solving the water crisis, resolving shelter problems without conditions, and containing the possibilities of epidemic spread. Several cases have been treated within the centers, and the rest have been referred to hospitals. Overall, self-reliance remains the primary means, and we hope for coordination between popular and official efforts to contain the situation before it reaches a complete collapse, and that medical obstacles are addressed promptly.
Despite all of this, the shortage of meals designated for children remains a pressing issue, as there are no other options. Children have begun to experience stress, and cases of constant crying and sleeplessness have been observed, in addition to the poor psychological state of all displaced individuals across different age groups.
