Sudan: "We are still hearing gunfire from our compound"

Cyrus Paye, MSF project coordinator, describes the situation in El Fasher, North Darfur.

South Hospital, El Fasher, North Darfur. Sudan 2023 © MSF/Ali Shukur

Since Saturday, April 15, intense fighting has been taking place between the Sudanese Armed Forces (SAF) and the Rapid Support Forces (RSF) in Khartoum and other parts of Sudan. Many people, including healthcare workers, are currently trapped. Teams from Doctors Without Borders/ Médecins Sans Frontières (MSF) are treating hundreds of people and calling for the protection of civilians, medical personnel, and health facilities.
By Cyrus Paye, MSF project coordinator

Heavy fighting is taking place in El Fasher. We are still hearing gunfire from our compound as I speak. It is very unsafe because of the shooting and the shelling—there are many civilian casualties.

At the hospital we support, we have treated 279 wounded patients since the fighting began on Saturday. Tragically, 44 have died. The situation is catastrophic. The majority of the wounded people are civilians who were hit by stray bullets, and many of them are children. They have fractures caused by bullets, or they have gunshot wounds or shrapnel in their legs, their abdomens, or their chests. Many need blood transfusions. There are so many patients that they are being treated on the floor in the hospital hallways because there simply aren’t enough beds to accommodate the vast number of wounded.

"There are so many patients that they are being treated on the floor in the hospital hallways because there simply aren’t enough beds."
Cyrus Paye, MSF Project Coordinator in El Fasher, North Darfur

Cyrus Paye, MSF Project Coordinator in El Fasher, North Darfur. Sudan 2023 © MSF

Until last weekend, South Hospital had no surgical capacity. It was a maternity hospital that MSF began to support last year in order to help reduce the high rates of maternal mortality in the region. Since the fighting began, we have had to repurpose the hospital to make it possible to treat the wounded.

All other hospitals in the city have had to close due to their proximity to the fighting, or the inability of staff to reach them due to the intensity of the conflict. Surgeons from those hospitals have now come to South Hospital and have been able to carry out a number of operations. However, they are rapidly running out of supplies. We were able to reach the hospital to restock it on Tuesday, when there was a lull in the fighting, but if we cannot get more supplies to Darfur. If we continue to receive such high numbers of wounded people, there are only enough medical supplies to last another three weeks.

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Currently, within Sudan, nothing can move. The airports across the country have all been closed since the fighting began and there is fighting in the streets, so we cannot get more supplies to North Darfur or into the country. Chad has closed its border. If the situation doesn’t change and humanitarian access is not granted, there will be even greater loss of life.

As things stand, the two operating theaters that have been established cannot cope with the non-stop influx of trauma and emergency OBGYN patients. In the maternity ward, there are currently two women in each bed. Previously, a neighboring hospital was carrying out all emergency caesarian sections—usually around three to five per day—and with more than 30 normal deliveries in a 24-hour period. Now, all of these are taking place in South Hospital at the same time as the trauma surgeons are at work.

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Kalma Camp, Darfur

We just heard that last night, the pediatric hospital where we used to refer newborns was completely looted, which means that we now have nowhere to refer babies who have sepsis or those who are born preterm. There are no incubators in South Hospital, which will make it difficult to keep those children alive. The current team of medical staff is overwhelmed. They have been working around the clock. We are exploring options to bring supplies and experienced trauma surgeons into the country to provide support when the situation allows.

It is critical that we gain access to all health facilities across the country so that we can save people’s lives. Health facilities are running out of supplies and staff cannot get to work. Health workers, relief workers, and rescue workers have all become immobilized by the fighting and people are dying as a result. We need access to health facilities, supplies, and a guarantee from the warring parties that they will spare the lives of civilians.

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