Sudan: MSF forced to close only functional hospital at Wad Madani

The extremely difficult decision to withdraw from Wad Madani comes after more than three months of relentless challenges trying to provide care at the hospital, including the growing insecurity; the inability to bring new staff and medical supplies into the area due to the denial of travel permits; and repeated security incidents, such as looting and harassment, affecting our ability to provide medical care.

“The health system and basic services in Al Jazirah state have collapsed as a consequence of the fighting and the systematic blockade on supplies and personnel entering the area,” says Mari Carmen Viñoles, operations manager for MSF in Sudan. 

“MSF was the only international NGO providing some support in Wad Madani. Our departure leaves a deep void for people struggling to access healthcare and living in a very insecure environment without transportation to move around.”

In mid-December, fighting reached Wad Madani—the capital of Al Jazirah state located about 136 kilometers southeast of Khartoum—at least 630,000 people were forced to flee Al Jazirah towards other parts of Sudan according to the International Organisation for Migration—many of whom had already been displaced. At the end of that month, MSF evacuated all staff from Wad Madani following the offensive from the paramilitary group Rapid Support Forces (RSF) in the city, which until then had been controlled by the Government led-Sudanese Armed Forces (SAF).

By January 13, MSF was able to send a team back to Wad Madani, where several hundred thousand people remained in which used to be one of the most populated cities of Sudan. Since then, MSF has been supporting the emergency room, operation theatre, maternity, inpatient department—including paediatrics, the therapeutic feeding centre, and adult and surgical wards—and pharmacy at Madani Teaching Hospital. We also provided mental health support and care for sexual violence. On top of this MSF also provided training, salary incentives to 240 Ministry of Health (MoH) staff, and food for patients. 

Between mid-January and the end of April, MSF provided nearly 10,000 outpatient consultations—malaria was the most common illness treated—2,142 antenatal consultations, and care to 16 survivors of sexual violence. During this period, there was a constant influx of patients into the emergency room, totaling 2,981 admissions. A significant number of these admissions involved physical injuries sustained in the ongoing violence. 

MSF has now suspended all support to the facility, and we have relocated our staff to safer areas of Sudan. Over the last three months, our team and the supported MoH staff have faced repeated security incidents that have been either carried out or tolerated by the RSF, including looting of the hospital, stolen vehicles, and staff being retained, among multiple other incidents and pressures. Since January, Sudanese authorities have persistently denied travel permits to bring new staff and medical and logistic supplies into the city. 

“While the humanitarian and medical needs in Wad Madani and Al Jazirah are immense, we have no other option than to stop our work immediately and leave the area,” says Viñoles. “The deliberate administrative blockages, the increasing insecurity, and the constant violations of the hospital as a neutral space made it impossible to continue providing services.” 

MSF is willing to return to support the Madani Teaching Hospital to support people in Al Jazirah if the warring parties commit to respecting our medical work and ensure safe and uninterrupted access to the area. MSF calls on the RSF to stop violating medical facilities and guarantee the safety of MoH and MSF personnel. MSF also calls on the Government of Sudan-led military and civilian authorities to grant the necessary travel permits for our staff and supplies.