In the line of fire: Sudan’s doctors speak out amid scores of hospital attacks

ITV News gets a rare look inside Sudan as two months of conflict sees hospitals and healthcare workers under fire and struggling to save lives - all while trying to survive themselves. Rachel Younger reports.

Words by Roohi Hasan, Senior Producer

Struggling to save lives, Struggling to survive, and struggling to let the world know of their plight.

Sudan’s healthcare workers and hospitals are on one of the frontlines of this conflict and are also becoming part of its growing casualties (the death toll two months on has been confirmed today to have crossed 2,000).

Two months ago, the conflict in Sudan between its army and a former general began, and since then has played out largely behind closed doors.

As the fighting continued between the Sudanese army and paramilitary unit the Rapid Support Forces (RSF), the violence combined with a lack of power and internet for days on end sometimes meant the outside world hasn't been able to see what is going on there.

Including increasing attacks on hospitals, healthcare facilities and even doctors.

What is being done to support people in Sudan and how can you help?

Two-thirds of Sudan's hospitals are currently not operating due to the conflict and at least 20 doctors and healthcare workers have been killed.

To try and tell this important story we contacted several Sudanese doctors on the ground for firsthand accounts of what was going on.

It was difficult to reach many, but a few who did respond said they were very keen to let the world know what was going on there because of how bad the situation had got there. They agreed to film their daily lives inside these hospitals and speak out.

This took weeks, not days to achieve, as they would often go days without power or internet to communicate or share anything, and other times they would simply be crushed with their workload as casualties from the conflict continued to rise.

They were so incredibly polite and keen to help throughout, despite all the challenges they were facing locally, not least the daily threat to their own lives ( they even apologised when they emerged from days of ‘darkness’).

Here is the story of three brave doctors, in their own words:

The doctor forced to operate on a gunshot victim with a Coca Cola bottle

Dr Abdul Raheem has been working across three separate hospitals in Sudan's capital Khartoum. Credit: ITV News

Dr Abdul Raheem is a busy doctor in Sudan’s capital Khartoum, working across three hospitals.

He highlighted early on how few were still operating as so many had been hit during the fighting or taken over by the RSF forces, at times leaving little safe havens for the constant daily injured, who already struggle to even travel to a healthcare facility through the violence around them.

In one of the videos, that he films for us, he walks around his hospital telling us: "We are inside the ICU. It is completely empty, no patients. Darkness, no light."

He is referring to the brutal reality of Sudan’s hospitals going days with no electricity, and even their generators have been of no use due to a shortage of fuel and inability to travel to get it.

We spent weeks trying to reach Dr Abdul Raheem for an interview, but the line was not strong enough so eventually he kindly managed to record video messages to send us, in which his exhaustion was clear.

Low on sleep and lower on supplies, Dr Raheem managed to save a gunshot patient with a Coca-Cola bottle

He tells us many stories of how he tried to save patients and couldn’t: “I remember one patient shot at 10pm but we waited till 4pm the next day for electricity, so, unfortunately, the patient died.”

Yet he is not defeated, and is so determined to save lives he shows us in one of his videos a Coke bottle being used in one operation, and he explained why when he spoke to us: “The video I sent with the bottle; it was a gunshot.

"The idea was to drain the blood from the chest. We mimic the test tube by using a bottle. That is all that was available at the time.”

On this occasion, thanks to Dr Raheem’s resourcefulness, he managed to save the patient.

The doctor who delivered a baby by the light of mobile phone torches

Dr Howida Ahmed Alhassan managed to complete a Caesarean section via the lights on mobile phones after the power went out.

Dr Ahmed Abbas, from the Sudan Doctors Union, was in Sudan when what he calls the “horrible war” broke out.

On his return here, he spoke to us about how critical the situation is for doctors there, how they are working around the clock 24/7 and are utterly exhausted.

He also described the awful scenes he had seen out there, and why the death toll isn’t accurate: “The reported cases are only those which manage to reach the hospital. The streets of Khartoum are littered with dead bodies.

"Some of them have been lying there for days. Some of the corpses have started to decompose producing a very nasty smell and obviously, this itself is a humanitarian crisis and could be a medical and environmental disaster.”

He struggles to reach his colleagues out there now but keeps trying as he’s keen to support them and finally reaches obstetrician Dr Howida Alhassan whilst we are with him: "What she is saying is that life is becoming virtually impossible...that life is becoming harder and harder and more difficult.

"There is almost a continuous cut-off in the electricity and water supply. Hospitals are running short of medication, oxygen, blood and essential medication, including lifesaving medications.”

He says she sounded: “depressed, tired, overwhelmed, terrible.”

Dr Howida used the lights from her colleagues' mobile phones to deliver a baby after the hospital's power failed

He showed us a video sent by Dr Howida, who was delivering a baby on one of the occasions when the hospital's power failed: "This is a colleague of ours carrying out a Caesarean.

"While she was operating the electricity was cut off, so she had to complete the operation by the light of her mobile phone.”

He told us she told him: “She said she was frightened to death.”

The doctor grieving her fallen colleagues

ITV News has been given the latest figures on the status of healthcare in Sudan by SAPA (The Sudanese American Physicians Association), which show the conflict has cost Sudan two-thirds of its hospitals and the lives of 20 staff.

Ayman Omar Fejahla is one of those casualties and the latest doctor known to be killed at work.

After several attempts to reach Dr Asma Emam, she finally finds a quiet spot at her hospital and enough signal to speak to ITV News. She breaks the news of Dr Fejahla's death, saying her colleague was one of several she has lost since the conflict began.

Dr Asma Emam, who helped film footage for ITV News' report, has seen a number of her friends killed in the conflict but refuses to stop helping patients

"He thought that he might help at the hospital better than staying at home…. not knowing he would die there,” she says.

She wants to continue her work in his name but spoke to us about her sadness also at the patients she is unable to save due to a sheer lack of resources.

She said: "The shortage of the medical supplies and the emergency situation, all of this is contributing to the death of many people... You feel helpless that you could have done something for them, but you can't do anything.

"They pass away. So you try to help those who are alive.”

In a true testament to the Hippocratic oath, Dr Emam explains why she keeps going: “At the beginning, we were all afraid. If we all stayed at home who would help those in need. We have to continue our work. We must continue. We don’t have a choice."

She wanted to give us her message for the outside world, but the line goes again. Although what she has told us is probably testament enough.

Hospitals and healthcare facilities have been attacked and destroyed in the conflict. Credit: AP

The United Nations has reiterated that attacks on any healthcare facility or worker are against international law and must be stopped.

The head of the Sudanese American Physicians Association (SAPA) told ITV News the world needs to act now.

They said: “Inaction in the face of these atrocities is a license for impunity.

"We are staring down the prospect of another civil war in the region, and as long as the international community continues to bury its head in the sand, Sudan will continue to burn."

Yet amidst all this danger and dying, the doctors in Sudan are determined to keep going.

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