Voices of Resilience: Addressing Migrant Health in War-Torn Sudan

The outbreak of war in Sudan has led to a major humanitarian crisis and mass displacement. Displaced people are more vulnerable to health risks and face barriers to accessing health services.

I am Mahmoud Hilali, a Sudanese academic and an active researcher in migration health, I work for the Blue Nile National Institute for Communicable Diseases, an affiliated institute to the University of Gezira, Gezira, Sudan as an assistant professor of epidemiology.

I joined the MENA Migration Health Consortium in 2021 and ever since I started to have focused research in the area of migration health. Migrant communities do require a considerable attention from governments and the international community and I and my team believe that better information on migration health will provide the opportunity to implement effective and impactful public health interventions and this is our aspiration while we develop the migration health country-profile tool (MHCPt).

The outbreak of war in Sudan on 15 April 2023 has led to a major humanitarian crisis and mass displacement. According to the UNHCR, 5.4 million people have been internally displaced, while 1.4 million are headed into international destinations in search of safety and security. Displaced people are more vulnerable to health risks and face barriers to accessing health services.

Fighting started in Khartoum, the capital of Sudan and home to some 12 million people. Soon the war spread to other states in Sudan, from the far western region of Darfur to the central Sudanese states near Khartoum. Not only did the situation involve the horrors of displacement, but also serious civilian casualties due to the escalating inferno and violence. Since 20 May 2023, peace negotiations have been underway to stop the fire and open safe corridors for humanitarian relief, but no tangible progress has been made.

Even though negotiations are underway, will this calm those living under the inferno and prevent further displacement?

Sadly, there is another dimension to the crisis in Sudan: millions of people are trapped in active conflict zones, surrounded by indiscriminate fires while their needs grow. Major hospitals have been closed for more than a year now in Khartoum, and for more than six months in Wad Medani, the capital of Gezira State, where the bulk of internally displaced people (IDP) –particularly those with special health needs- have found shelter and basic humanitarian assistance. Significant investment was made in Wad Medani by the Refugee Working Group (RWG), a UN-led coordination body with UNHCR, IOM, and WHO as lead agencies, in partnership with several national Sudanese stakeholders. Unfortunately, this investment was lost when the war spread to Gezira State and key health facilities either closed or lost their functional staff.

If you left your home for the nearest safer neighbourhood or village, would that qualify you as an internally displaced person?

The Sudanese Federal Ministry of Health thrived to restore the public health programmes for disease control and prevention. These efforts are unique, given the circumstances of continuous mobilisation of people from one place to another in search of safety. No simple mathematics could enable the stakeholders to assess, adjust preparedness and implement proper public health responses. As international staff from agencies including the UN have been evacuated from Sudan, with the majority returning to their home countries, only critical staff remain.

Perhaps we need special equations for planning and solidarity in times of war, but who has them?

According to the UNHCR, 500,000 Sudanese from different Sudanese states have reached Egypt safely. Meanwhile, Chad received a significant number of refugees following the ethnic attacks in the state of West Darfur. The UAE also offered a one-year crisis visa for Sudanese, which can be renewed without penalty. Countries such as Chad, Saudi Arabia, Qatar, Ethiopia, and the Sultanate of Oman have also received thousands of Sudanese, but not under the migrant classification; rather, they arrived in these countries as tourists, as visitors to their families, or with work permits, even if these permits are not accompanied by a work contract.

Would it help to be in an international destination without migrant status and therefore without the legal involvement of migration authorities or humanitarian organisations? Would access to health care and shelter be possible?

Despite ongoing efforts, the tragic situation in Sudan underscores the urgent need to prioritise the health of displaced people within Sudan and to establish an international coordination mechanism with neighbouring countries hosting new vulnerable Sudanese arriving after the war. National and international responses are equally important. By addressing the specific health needs and challenges faced by both IDPs and international migrants, we can work towards health equity and prevent further catastrophes caused by the ongoing war in the country. The situation in Sudan, which was previously compromised by a lack of funding for public health programmes, a shortage of health workers, and ongoing instability since 2013, has indeed become much more complicated; requiring an outstanding commitment from the Sudanese government and the international community to alleviate the current burden on the health, safety, and future prosperity of the Sudanese people.

In World Refugee Day, could the Sudanese hope for a sooner improvement in their status?