What It’s Like To…Be A Healthcare Worker in Sudan Right Now

"What it's Like to..." is a new series sharing first-hand accounts of life in Africa.

The health sector in Sudan is experiencing the worst crisis of its kind, as fighting in the country enters the eleventh month since clashes between the army and the paramilitary Rapid Support Forces broke out in mid-April last year. According to the Minister of Health of the Red Sea State, Dr. Ahlam Abdel Rasoul, 70 percent of hospitals in Sudan have been closed due to the ongoing war. The Ministry of Health says it’s unable to provide medicine and health supplies to citizens, even in areas not affected by the war, especially after the Rapid Support Forces invaded Al-Jazeera State in central Sudan last December.

“To be honest, I think 70 percent isn't an accurate number,” says Salma Salah. “The healthcare system has completely collapsed in some areas in most of Sudan. The NGOs provide assistance that is not enough, and every day is worse than before,” she tells OkayAfrica in an interview.

Nine months ago, Salma, 38 years old, began working as a community health advisor for Medical Teams International, an aid organization that provides medical care in Sudan, from immunization clinics to pre and postnatal care. According to the United Nations Office of the High Commissioner for Human Rights, at least 12,000 people have died, and about 8 million people have risked their lives to leave conflict-affected areas of Sudan and get to safety, including members of Salah’s family. Salah, who has five children, among them twin girls, lives in Gedaref. Her parents live with her, and Salah’s work with Medical Teams is their only source of income.

Salah, like other doctors and organizations working in safe states, faces restrictions from the security authorities, as they impose a curfew from six in the evening until six in the morning, and limit the movement of health personnel. This is in addition to restrictions on the distribution of medicines and medical equipment, which negatively affects the work of organizations and volunteers.

Here, in edited excerpts, she tells OkayAfrica about her day-to-day life in Sudan, edited for length and clarity:

Salma Salah: The war here in Sudan [has] generated a very harsh situation. The health system has almost collapsed since there is a huge gap. For instance, we are struggling with getting permission to move among sites where we provide our services, and that creates a great delay in service delivery, which is bad. In addition to that, we are expecting an attack maybe anytime, and that puts us under big pressure because we need to make an evacuation plan for our family. So we are working under stress that brings extreme concern about our families.

Let me tell you about my life one month ago. My position was [at] the camp [for displaced people] for seven months. That means I [had] to stay in the camp, leaving behind my family, my kids, which put me under great pressure. It was really a hard situation. I was thinking every night about how to deal with such a situation because [there was] no one to look after my kids. My mom is above 70. She's doing her best, but she cannot properly look after them. So after deep thinking and seeking advice from my colleagues, talking to my manager, I decided to raise a proposal for an office-based position. Now, I supervise and manage all community-based activities in the project, which is highly needed.

I am at the office, managing and supervising community work, and taking care of my family at the same time. That gives me the chance to focus more on how to improve the work, and how I can support women in Sudan. Now, my typical day is like this: I wake up early in the morning, around 5 a.m. I like to wake up early. It gives me time to take care of my kids at home, prepare the food for the whole day, and then hand it over to my mom.

After years of working in the displacement camps, Salma Salah now spends much of her time coordinating community visits from an office.Photo by Medical Teams International.

Some days, I have field supervision visits to the camps, and the visits sometimes take two days, sometimes less, sometimes more. For that I leave the family behind and the pending work at the office. But this is the work; this is how we are dealing with the work and our families at the same time.

The role of a community health worker is to link the community to the health center or the clinic that we have in that area, by informing them about the services we provide. And we do that through the community leaders meeting people, and [through] door-to-door visits, and sessions to tell them about the health services we provide in our clinic.

Salma Salah links people in the community to health services.Photo by Medical Teams International.

The other thing that we are doing is health promotion activities, including raising the awareness of the community about their health status and how to prevent diseases, and how to help them to control all [aspects] of their health using several approaches. And we provide the social support for [those] who need it in the community. Malnutrition is the main issue because they’re all displaced; they’ve lost all their property. In situations like that, you find a lot of sickness. So that’s why in our clinic, we have a primary health care package including nutrition.

My role as an officer here is to supervise all activities on the ground here and in the camps. We support the Ministry of Health’s nutrition program, and we also hold a support group for women. We have a program training mothers to advise them and raise their awareness toward how they have to deal with malnutrition with children and what the suitable time is to seek help.

What gives me hope is encouraging women to find education and achieve things in their lives, especially in light of the current conditions that Sudan is experiencing, where men die in war and women turn into widows. I encourage them to move forward in their lives and obtain advanced degrees in their field.