As the war between the Sudanese army and the Rapid Support Forces (RSF) continues, after breaking out on April 15, 2023, Sudan’s health system is facing an unprecedented crisis, with a severe shortage of medicines.

Near-Total Collapse

Twenty-two months of war have led to the systematic destruction of most of Sudan’s hospitals, particularly in areas that have witnessed fierce battles between the army and the RSF. The war has also devastated the country’s healthcare infrastructure, causing widespread closures and disruptions in medical services, especially in conflict-affected areas.

Sudan’s Minister of Health, Haitham Mohamed Ibrahim, stated that the ongoing war, which has lasted for more than 20 months, has caused a near-total collapse of the health system.

According to estimates by the Sudanese Red Crescent, 70% of hospitals in Sudan are closed due to the war, with many either completely or partially destroyed.

Repeated attacks on healthcare facilities have deprived thousands of patients and medical workers—especially in volatile regions—of access to hospitals and treatment. Healthcare facilities, medical warehouses, and the transportation of medical supplies and healthcare personnel have been deliberately targeted.

Huge Losses

Ibrahim reported that losses in the health sector due to the war amount to approximately $11 billion, including $500 million in damages following the destruction of medical supply warehouses in Madani State. The RSF entered the state before it was recaptured by the Sudanese army in mid-January.

The minister also noted that 250 out of 750 hospitals in the country have been damaged. He described the displacement of a quarter of Sudan’s population as part of the country’s largest humanitarian disaster.

The war is pushing Sudan into an escalating health crisis, transitioning from a double to a quadruple burden of diseases, including infectious and non-infectious diseases, physical injuries, and trauma.

The World Health Organization (WHO) has warned of the accelerating collapse of Sudan’s health sector, citing continued hospital bombings and significant risks faced by medical personnel, particularly in combat zones covering about 70% of the country.

According to the WHO, more than two-thirds of the main hospitals in conflict-affected areas are no longer operational. Those that remain open are at risk of closure due to shortages of medical staff, supplies, clean water, and electricity.

Additionally, the Sudanese Ministry of Health is struggling to provide medicines due to the destruction of drug warehouses and supply chains in the capital, Khartoum, and the city of Madani—previously home to most of the country’s pharmaceutical factories and storage facilities. Dr. Ahlam Abdel Rasoul, the Minister of Health in Red Sea State, confirmed these challenges.

Brain Drain

The brain drain of Sudanese professionals, particularly in the medical field, has become a critical issue that successive governments have failed to address. Every morning, thousands leave the country via Port Sudan International Airport or through informal border crossings.

Doctors and health workers continue to operate under extremely difficult conditions, “struggling with the misery of reality” amid a relentless conflict that disregards international laws and conventions protecting healthcare facilities during war.

The Sudanese Doctors Syndicate has reported that doctors, health workers, and emergency responders across Sudan, in both urban and rural areas, are subjected to harassment, torture, arrest, and assassination.

Since the outbreak of fighting, over 70 health workers have been killed. Additionally, more than 60 healthcare facilities have been bombed, and over 400 attacks on medical institutions have been recorded.

Experts warn that the most severe consequence of the war on the health sector is the mass migration of doctors from Sudan, which threatens to exacerbate the already dire healthcare situation.

Outbreak of Diseases

The war, coupled with Sudan’s worsening economic conditions, has severely limited the government’s ability—through the Ministry of Health—to combat diseases. As a result, outbreaks of cholera and dengue fever have spread across large parts of the country.

The Sudanese Doctors Syndicate has reported that a significant number of Sudanese have died due to deteriorating healthcare services since the war began.

Over the 22-month conflict, Sudan has experienced widespread outbreaks of cholera, dengue fever, and other diseases. While the Ministry of Health has managed to contain some of them with the support of international organizations, the situation remains critical.

Last September, during a visit to Port Sudan, WHO Director-General Tedros Adhanom Ghebreyesus warned that Sudan’s healthcare system “has reached the point of collapse,” stating that between 70% and 80% of the country’s health institutions are no longer functioning.

Victims and Attacks

Medical organizations estimate that more than 70 medical workers have been killed since the start of the war, while at least 400 attacks on healthcare facilities have been recorded, including the bombing of 60 hospitals.

According to the Ministry of Health, the RSF has targeted dozens of hospitals with indiscriminate shelling and attacks, leading to the destruction of major hospitals in Khartoum and the Darfur states.

The WHO has documented more than 100 attacks on health personnel and humanitarian workers, highlighting one of the biggest challenges facing humanitarian aid operations: the inability to secure borders and crossings for delivering aid to those in need.