Spotlight on Sudan: How can we improve healthcare services during war?

Summary

From Kiev to Khartoum to Gaza, people are losing all their rights, including the right to life itself.

From his observations of healthcare conditions in Sudan, Dr Ahmed Khalafalla presents some ideas on how we can improve healthcare services during times of war and uncertainty to make healthcare services accessible for those who need them.

Content

In Sudan, at the beginning of the conflict, people turned to adaptive measures that derived from the inherited and acquired health culture of our local communities. The local people returned to using the tools and resources that they have known for thousands of years to manage their health, including the use of folk healers or natural medicine.

Next, the healthcare systems and healthcare institutions had to adapt because of the comprehensive collapse of the healthcare system and the inability of most health institutions to provide healthcare due to institutions targeted and destroyed by the warring parties during the fighting and for other reasons related to its operational capacity – the workforce and human resources no longer having any organisational body, medical and logistical equipment and supplies becoming almost non-existent, and a lack of financing and financial resources. This led to adaptation methods represented by the displacement of a large part of the workforce from providing healthcare services in urban cities to the countryside. In Sudan there is a big difference and variation between providing healthcare services in urban cities and providing healthcare services in the countryside, where healthcare services are few and limited in rural regions. As the war extended into the cities, doctors were forced to go to the countryside and rural regions to provide their medical services, operating public hospitals and increasing their operational capacity by adding new specialty or operating medical centres as a private sector.

We must also recognise the roles that international organisations working in the health and humanitarian field play. They have made notable efforts in supporting and providing medical and health services, providing financial support, providing medicines and medical consumables, and putting pressure on warring parties to provide safe passages for healthcare providers operating in some hospitals. However, I believe that their role is very small compared to what is expected of them.

All of these abovementioned factors contribute to improving healthcare for people living in countries at war. However, we need more effective measures to improve the provision of healthcare services, including:

• Increasing community awareness and involving local communities in improving healthcare plans.
• Increasing the administrative and technical leadership organisation.
• Launching initiatives to attract support for healthcare services.
• Increasing pressure on the parties at war to first stop the war, and second to adhere to the ethics of war and the humanitarian norms and laws by allowing the provision of healthcare services and protecting medical teams and healthcare providers.
• Appealing to the World Health Organization and other organisations to increase their support for war and disaster areas.

Further blogs from Dr Ahmed Khalafalla:

• Spotlight on Sudan: Patient safety during wartime when healthcare systems collapse

About the Author

Dr Ahmed Khalafalla is a family medicine general practitioner and certified professional in healthcare quality and patient safety CPHQ from NAHQ. He is a certified health improvement knowledge and experience resource (HIKER) from NHS and NHS improvement. He campaigns for healthcare quality, patient safety and healthcare system transformation.