19 Apr 2023; MEMO: Sudan's Doctors Syndicate has warned that healthcare services are close to collapse as 16 hospitals across the country are out of service, some after being bombed.
Fighting has been ongoing across the country since Saturday as two generals in charge, army chief General Abdel Fattah Al-Burhan and his deputy, the paramilitary commander Lt. General Mohamed Hamdan Dagalo, have turned on each other following a power struggle which has been ongoing for several months.
The two men disagree on how the RSF, headed by Dagalo, should be integrated into the military and what authority should oversee the process. This affects the implementation of civilian rule in Sudan following the toppling of dictator Omar Al-Bashir during a popular uprising in 2019, that many believed would usher in a new era of democracy.
Al-Burhan's Sudanese Armed Forces and Dagalo's Rapid Support Forces(RSF) have engaged in gun battles, artillery and air strikes in an explosion of violence that has killed at least 270 people and injured almost 2,000 as the conflict reaches day five.
Hope for a lasting ceasefire brokered by the US crumbled as exchanges of gunfire and the sound of fighter jets could be heard despite the truce.
The Vice President of the Sudan Doctors' Trade Union told Al Jazeera that several major teaching hospitals in Khartoum have been targeted by both factions.
On Monday, one of the wards at the Khartoum Teaching Hospital and the Al-Shaab Teaching Hospital were damaged by shelling. Both were shut down.
READ: Explained: The power struggle behind fighting in Sudan
Some hospitals have been evacuated under heavy shelling, with staff leaving everything behind, including children in incubators.
Ambulance drivers have reported that their vehicles have been hijacked whilst transporting patients to hospitals. As the fighting intensifies, medical staff are unable to travel to the hospitals to tend to their patients.
In one hospital a six-year-old child died, whilst in another a maternity ward was hit by shelling.
Others have shut their ICU units because there is almost no oxygen or electricity: "We lost some of the patients and if the war continues for more than 24 hours, we're going to lose all of them," Dr Abdalla told the BBC from a hospital in Khartoum.
Hospitals are swamped and are facing a severe shortage of medical staff, anaesthesiologists, supplies, food, water and fuel for generators.
Hospitals still managing to operate are running low on medical supplies and fuel for their generators. They have also reported a shortage of blood, oxygen, transfusion equipment and intravenous fluids leaving 16 further hospitals at risk of closure at any moment.
The fighting has exacerbated an already existing humanitarian crisis in which one third of the country's 45 million people face food insecurity.
Sudan has one of the world's highest rates of child malnutrition with almost four million children under the age of five acutely malnourished.
The depreciation of the Sudanese currency, inflation, the impact of the war in Ukraine and the aftermath of the coronavirus pandemic have had a dire effect on the country in recent years.
Now there is limited electricity and water and the banks are not operating.
The UN World Food Programme announced the immediate suspension of all operations in Sudan after three employees were killed in North Darfur.
On Saturday, an aeroplane managed by the WFP was damaged in an exchange of gunfire, which meant it could not transport aid and humanitarian workers around the country.
The International Federation of Red Cross and Red Crescent societies has said that it is almost impossible to provide humanitarian services in the streets or the hospitals due to the fighting, and has called on the military rivals to facilitate the implementation of humanitarian work.
Medecins Sans Frontieres has said that their teams are unable to get out to access medical supplies and deliver them to hospitals.
Most international humanitarian operations have been suspended.
