Sudan: MSF Surgical Team in Khartoum

22 May 2023

Since 9 May 2023, a Médecins Sans Frontières (MSF) medical and surgical team has been working in collaboration with community volunteers in Bashair Teaching Hospital in South Khartoum.

Two MSF team members share their testimony.

Each day feels like a week in an environment like this 

Will Harper is an experienced MSF Emergency Coordinator. He is leading the MSF team that is providing life-saving surgical care in a hospital in south Khartoum. 

"We first gained access to south Khartoum one week ago and identified Bashair Teaching Hospital as a site that we could place our surgical team to be close enough to the frontline and the conflict to really save lives and respond to the needs of conflict-affected people but also to be in a place that our teams could be safe and we could operate. Bashair Teaching Hospital made sense in this zone in south Khartoum.  

MSF is working in collaboration with community volunteers – doctors and nurses but also young people from the area and the community who made a decision to try to restart this hospital after it has closed and staff had left for their own safety. When the surgical team arrived in south Khartoum, we found a hospital where people are really working as hard as they can and taking risks. So we’ve joined them hand-in-hand to try to bring healthcare and life-saving surgical care to the people in this area.  

The situation here is difficult, to put is simply. We have huge challenges with our drug supply and power. We’ve been running off of diesel generators for the past four days. There has been no electricity aside from our generators."

When the surgical team arrived in south Khartoum, we found a hospital where people are really working as hard as they can and taking risks.  

Will Harper
MSF Emergency Coordinator in south Khartoum

"We’re now running 24/7 operations. We have our operating theatre, post-operative care, and we’ve built up an intensive care unit. And we’re hoping, day-by-day, to increase the quality of care. And receiving dozens of patients – gunshot wounds, stabbings, people injured by airstrikes. All of the things people need surgery for in their daily life plus the effects and impacts of the conflict. 

For MSF it is essential that we are here with the community. We’re living and based inside this hospital – living and working here and ensuring that this is a humanitarian space, a medical space that is protected. Taking our principles of impartiality and neutrality and implementing those here on the ground.

We’re trying to ensure that anyone from any side of the conflict and any civilian who needs life-saving surgical care has access to that care. We’ve got people coming from across the city to this operating theatre. The word is spreading that MSF is present and working with these volunteers and the staff that are already here. So we’re trying to access people in any way we can and to make sure they’ve got access to us."

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Jessica Comi (left) and Dr Federica Iezzi extracting a bullet from a patient. He was struck by a stray bullet above the knee. © MSF/Ala Kheir

"We’ve seen progress. We’ve been able to increase the quality of care and we’ve already been able to build some capacity within the volunteers and the staff here.

We’ve done multiple major surgical interventions already, complicated surgeries, because of the violence. But also increasing our post-operative care, infection control, all of those things that are a challenge in any day-to-day hospital and they’re especially a challenge when we have limits on our water, on our electricity, on our medical supply. And so putting all of those things together, we see the progress day-by-day but there’s a very long way to go for us to reach a standard that these people deserve."

 

Our response in Sudan

 

Building the capacity to do war surgery 

Shahzid Majeed works as a surgical referent in one of MSF’s headquarters offices in Brussels. When MSF began scaling up our response to the current violence in Sudan, he joined the team to start emergency and surgical activities, alongside Sudanese doctors and volunteers, in a hospital in south Khartoum.  

"Since we arrived, we have seen multiple patients with gunshot wounds and stab wounds who are highly critical and would not survive without surgery. These injuries were to the chest, to the abdomen, to the liver, to the spleen, to the kidney, to the intestine. And we’ve also performed vascular reconstructive surgery here, without which the patient would have died or would have lost a limb. 

The capacity to do war surgery in this hospital was minimal. We’re quite happy that there is a good volunteer spirit among the people in this hospital but again not everyone’s accustomed to war surgery so we are working together with them to train them in managing patients who require surgery and also to provide post-operative care, which is quite critical as well."

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Dr Shahzid Majeed in a discussion with his colleagues as the operating theatre is busy and trying to balance the operation time with the generators running out of fuel. © MSF/Ala Kheir

"Performing these surgeries under this austere environment is very challenging. Supplies have always been a big issue here. MSF has been bringing in supplies to the hospital with which we are able to perform life-saving surgeries.  

The type of patients we’ve been seeing have complex injuries and because MSF has experience working under these conditions and managing the patients with these complex injuries, we’ve managed to provide good surgical care and some of the patients have even been discharged after major surgery. And if we can continue providing these services, we will improve the survival and also the outcomes of these patients."

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