Violence is threatening Al Nao hospital, a vital lifeline for people in Omdurman, to the northwest of Khartoum, as the conflict in Sudan enters its fifth month, causing immense suffering for people in Khartoum and elsewhere across the country. 

Fighting in Omdurman has been particularly intense in recent weeks with airstrikes, gun battles and shelling, causing intense pain, suffering and death. Hundreds of men, women and children are being injured, and the unabated violence makes it dangerous and difficult for people in desperate need of healthcare to reach the few functioning facilities in the area. 

“Last week, a family came in who had been caught up in an exchange of shelling. The mother died, a young daughter died, another daughter lost a leg and a son was severely injured,” says Omer, an MSF medic working in Al Nao hospital in Omdurman. 

“Another family brought in three of their children who had suffered gunshots. A nine-year-old who was shot in the back and a six-year-old who was shot in the right eye, both survived, but their four-year-old passed away,” says Omer.

In the two weeks from 29 July to 11 August, MSF staff working in Al Nao, alongside teams from the Sudanese Ministry of Health, provided emergency trauma care to 808 patients, 447 of whom had suffered injuries caused by gunshots, shrapnel from explosions or stabbings. 

In the same period, the hospital treated 787 patients for other medical, non-trauma related, health conditions such as diabetes, respiratory infections, hypertension and other cardiovascular diseases, among others.

Each day, on average, the medical staff in Al Nao hospital treated 34 patients with violent trauma injuries and 77 with other medical conditions. 
 
Al Nao hospital remains one of the last health facilities open in Omdurman, which explains the high number of patients. Al Nao is the only trauma emergency room and hospital with surgical capacity in north Omdurman, so all wounded patients are brought there. 
 
On 4 July, a Ministry of Health staff member at the MSF-supported Al Saudi Maternity Hospital in Omdurman died after being shot while moving within the hospital compound, forcing the hospital to close. The hospital staff moved their activities to Al Nao hospital so that pregnant women in the area still had a safe place to give birth.

Heavy fighting in nearby neighbourhoods impacts people immensely. Two out of three war-wounded patients in Al Nao have gunshot wounds. Others have stab wounds or injuries from explosions. Even in the midst of a conflict, accidental injuries and broken legs also still need attention. 

Violence is escalating around Al Nao, threatening patients and staff. On 16 August, shells landed to the north and southwest of the hospital. On days when fighting nearby is at its heaviest, Al Nao mostly receives people injured by the violence, although it remains available for patients with other medical emergencies. 

Patients, such as those who have suffered strokes, heart attacks or those with gastro-intestinal emergencies, may find it too dangerous to travel or delay seeking healthcare due to fear of being caught in the violence. Some patients reach the hospital too late. The insecurity also affects hospital staff with medics working double shifts when it is too dangerous for their colleagues to travel. 

Even those without immediate health needs in Omdurman face consequences of the violence. Daily life is impeded by continuous water and electricity cuts, shortages of fuel for cooking, and people lack cash or any means to provide for themselves. The desperate situation takes a heavy psychological toll. 

Like anywhere MSF works, Al Nao hospital provides medical care to people based on their medical needs alone, regardless of whether they are on one side of the conflict or the other, or are simply civilians trapped in the middle of the fighting. 

We support eight hospitals in Khartoum state, with our staff working in four hospitals in Khartoum city and Omdurman, on both sides of the frontlines. In addition to Al Nao, we also provide care for wounded patients in Bashair Teaching Hospital and the Turkish Hospital in south Khartoum. In July, 1,770 war wounded patients received trauma care across all three hospitals. 

“People face relentless tragedies from this unspeakable violence,” says Frauke Ossig MSF emergency coordinator in Sudan. “It’s heart-breaking to see that the most vulnerable and innocent are being so devastated by this conflict.” 

“As medics in Al Nao work round the clock, shells are landing nearby, causing yet more horror and threatening the hospital’s lifesaving work,” says Ossig. 

“We call on warring parties to spare civilians from this unacceptable violence and ensure the protection of hospitals and healthcare workers. If hospitals can’t function there will be even more misery and suffering.”