Sudan: Need for Intervention as Child, Maternal Deaths Increase
By Sharon Atieno
The war between Sudanese forces which broke out in April 2023 is resulting in one of the worst maternal and child health emergencies in the world.
With hospitals destroyed pregnant, birthing, and postpartum women, as well as children, are dying from preventable conditions as their health needs are not being adequately met.
According to a report released by Médecins Sans Frontières/Doctors Without Borders (MSF), from January to August, there were 46 maternal deaths in Nyala Teaching and Kas Rural hospitals in South Darfur, where MSF teams provide obstetric care and other services. This is more than seven percent of the total number of maternal deaths in all MSF facilities worldwide in 2023.
An additional, 68 deaths were recorded in the internally displaced people (IDP) community in Nyala during an assessment in April.
The report, Driven to oblivion: the toll of conflict and neglect on the health of mothers and children in South Darfur, finds that nearly eight out of ten (78%) of the deaths witnessed in MSF facilities occurred in the first 24 hours following admission.
“A pregnant patient from a rural area waited two days to collect the money needed to get care,” says Maria Fix, MSF medical team leader in South Darfur. “When she traveled to a health centre, they had no drugs, so she went back home.”
“After three days, her condition deteriorated but again she had to wait five hours for transportation. She was already in a coma when she reached us,” says Fix. “She died from a preventable infection.”
The report notes that sepsis is the most common cause of maternal death in all MSF-supported facilities in South Darfur. The shortage of functioning health facilities forces women to give birth in unsanitary environments that lack basic items such as soap, clean delivery mats, and sterilised instruments. Without these basic items, women are getting infections. And with antibiotics in low supply, they can arrive at a hospital only to be met with no treatment option.
From January to June 2024, 48 newborns died from sepsis in Nyala Teaching and Kas Rural hospitals, meaning one in five newborns with sepsis did not survive.
“This is a crisis unlike any other I have seen in my career,” says Dr Gillian Burkhardt, MSF sexual and reproductive health activity manager speaking in Nyala, South Darfur’s capital. “Multiple health emergencies are happening simultaneously with almost no international response from the UN and others. Newborn babies, pregnant women, and new mothers are dying in shocking numbers. And so many of these deaths are due to preventable conditions, but almost everything has broken down.”
Between January and August, MSF teams in South Darfur provided 12,600 ante- and post-natal consultations and assisted in 4,330 normal and complicated deliveries.
A Rapid Needs Assessment (RNA) carried out by the Norwegian Refugee Council in Nyala, on May 24-27 2024, found that out of 250 health centres, only 80 are operational due to looting and destruction. Key challenges experienced included a lack of maintenance, medicines, equipment, staff incentives, and financial resources.
In June, the United Nations reported a similar crisis in North Darfur, where the Rapid Support Forces (RSF) soldiers attacked South Hospital, the only facility with surgical capacity in El Fasher, the provincial capital. The fighters also destroyed equipment and stole an ambulance leading to the closure of the hospital.
During the same period, a similar attack took place in Wad Al-Nura in Al-Jazirah state south of Khartoum, leading to the death of a nurse who was on duty and caring for patients at the time.
Malnutrition
In June, the UN World Food Programme (WFP) reported that 18 million people in Sudan are acutely food insecure including nearly five million who are now in the grip of emergency levels of hunger.
According to the MSF report, a screening for malnutrition conducted in August, for 30,000 children under two years old in South Darfur found that 32.5% were acutely malnourished. This is below the World Health Organization (WHO)’s emergency threshold of 15%. Furthermore, eight in 100 (8.1%) of the children screened were severely acutely malnourished.
Across Sudan, interrelated crises are compounding to cause immense suffering, with little help available, as Dr Burkhardt, who worked in North Darfur before her assignment in South Darfur, explains.
“The disparity between the huge needs for healthcare, food, and basic services, and the consistently lacking international response is disgraceful,” she says. “We call on donors, the UN, and international organisations to urgently increase funding for, as well as scale up and supply, maternal health and nutrition programmes.”
“We know that Sudan is a challenging place to work but waiting for challenges to disappear by themselves is getting nowhere,” says Dr Burkhardt. “For many mothers and children, it’s already too late. Risks must be managed, and solutions found before more lives are lost.”
The MSF calls on the UN to act decisively to prevent further loss of life in Darfur. The UN must accelerate the return of UN staff and agencies to Darfur and leverage all available resources and political influence to ensure that aid reaches those in need. Only a coordinated international response, supported by robust funding and unyielding pressure on the warring parties, can avert mass starvation and alleviate the suffering of millions.