El Geneina Teaching Hospital, West Darfur: 5 key points on the recent violence and humanitarian needs

The looting of El Geneina Teaching Hospital, which is supported by Médecins Sans Frontières-Doctors Without Borders (MSF) since 2021, made headlines in the last week of April.

Reports suggest that widespread looting, destruction, and burning of property took place in El Geneina city, the capital of West Darfur, including at sites where displaced people reside.

In five facts, Fleur Pialoux, MSF outgoing project coordinator in El Geneina, sheds light on the status of the hospital and the rising humanitarian needs, and MSF’s commitment towards supporting the hospital and the communities during these challenging times.

1. MSF has been supporting El Geneina Teaching Hospital, with a plan to scale up its support to include neonatology and maternity services. But since the current conflict broke out, all patients and staff have fled the hospital, and the planned expansion was put on hold due to the security situation.

Since 2021, MSF has supported the Ministry of Health in the paediatric department of El Geneina Teaching Hospital in West Darfur, Sudan, providing services such as emergency room/stabilisation, inpatient department, and intensive therapeutic feeding centre. Emergency preparedness and response activities were another part of our work. In 2022, teams provided over 82,000 outpatient consultations, including for malaria, acute watery diarrhoea, and respiratory tract infections.

Over the years we have witnessed a steady stream of patients coming not just from El Geneina city and the nearest sites for displaced families, but from all over West Darfur.

However, since April 20, 2023, the hospital has been closed due to the violence, making it impossible for MSF to continue its work in paediatrics or start supporting the hospital neonatology and maternity departments.

2. The looting of the hospital and the ongoing violence had a significant impact on healthcare services in West Darfur.

Sadly, there is a lack of respect for the protection of the hospital, as we have witnessed violence, destruction, and damage within the hospital. As a result, all patients and medical personnel have fled the premises despite the rising needs.

The city of El Geneina, much like other areas in Sudan and Darfur, has been a victim of widespread looting since the beginning of the current conflict. Private homes, shops, pharmacies, several INGOs, as well as the Ministry of Health premises and the market, have all been targeted.

On April 26, 2023, El Geneina Teaching Hospital was looted, including the hospital pharmacy, the X-Ray, and the Blood Bank. This creates additional challenges for the medical personnel to resume activities even when the security situation improves. The paediatric department supported by MSF was also affected by the looting.

Inside the inpatients departments supported by MSF in El Geneina Teaching Hospital, in West Darfur. The hospital was partially looted on April 27. The hospital is out of services at the moment. ©MSF

3. MSF has faced immense challenges in providing medical assistance to the people of West Darfur even before this conflict broke out.

Awareness messages promoting safety and protection for patients and staff on the entrance of El Geneina Teaching Hospital, MSF-supported hospital in West Darfur. ©MSF

Even prior to the outbreak of current conflict, the populations in West Darfur, including more than 100 000 displaced persons in El Geneina and half a million in West Darfur, faced significant challenges, with acute humanitarian needs, lack of functioning referral systems, and high prices for medical services. Patients had to spend significant amounts to reach the El Geneina Teaching Hospital, often presenting late which negatively impacts their outcome.

Strikes were frequent and most health structures lacked qualified personnel as well as drugs and equipment. Limited coverage of quality malnutrition treatment facilities as well as delayed and reduced cash and food assistance amidst a worsening food security and malnutrition situation had a dramatic impact on the number of malnutrition admissions. In 2022, 31.1% of children screened in the El Geneina Teaching Hospital were suffering from malnutrition.

An outbreak of measles was declared early 2023 with no isolation capacity available outside of MSF-supported paediatric services in El Geneina Teaching Hospital. The economic situation remained bleak while humanitarian funding continued to be insufficient.

Back in April 2022, a brutal attack on Kreinik town caused over 200 deaths, injuries to many, and displacement of tens of thousands of people. The hospital in the town, which MSF was starting to support, was attacked, resulting in the death of two staff members from the Ministry of Health and eight patients, as well as the looting of the pharmacy. MSF was only able to return to Kreinik in December 2022 to relaunch its activities in the hospital. In the meantime, MSF restarted mobile clinics to provide healthcare to communities in the area that lacked access to medical services.

Since the current conflict began, patients have been unable to access medical care due to fear of violence both outside and within medical structures. Additionally, patients fear being targeted based on their ethnicity or affiliation.

Despite the dangerous conditions, MSF's medical personnel continued to provide essential care to critical patients in the first week of the conflict. However, after the situation deteriorated significantly in El Geneina, medical doctors fled their homes for fear of being looted or harmed.

4. Due to the lack of functioning healthcare facilities in El Geneina, patients have faced difficulties in receiving necessary medical care, including access to medical items and medications.

One heartbreaking example is the death of a young patient who was unable to receive a blood transfusion before the looting began.

Additionally, our MSF colleagues on the ground have reported their friends and family members being killed or injured and unable to access the care they needed. Some days, there were no functioning healthcare facilities in all of El Geneina.

Although a few clinics would occasionally open in different neighborhoods, with the help of medical assistants and sometimes doctors, they were only able to provide basic wound dressing. Access to medical items and medications remains extremely difficult in this already challenging environment.

In other locations in West Darfur, our teams have not been able to conduct mobile clinic activities in the nomadic communities of Galala, Mogshasha, Wadi Rati and Gelchek. We have been able to continue providing services in Kreinik hospital, but we have seen a reduction in the number of patients coming from outside the town.

5. Locally hired staff working with MSF in West Darfur have shown dedication to providing free, quality healthcare to children and have worked to make the hospital a safer environment for patients, caretakers, and staff. However, being a healthcare professional amid the violent conflict has put their safety at risk.

Since the inception of this project supporting the El Geneina Teaching hospital in 2021, MSF has put forth substantial efforts towards capacity-building of Ministry of Health staff, including bedside trainings, and collaborated on co-managing the paediatric wards. Key Ministry of Health staff and administrators have exhibited unwavering dedication to delivering free, high-quality primary and secondary healthcare to children aged between one month and 15 years.

They also supported MSF in making the hospital a secure environment for patients, caretakers, and staff before the conflict erupted. Throughout the conflict, they have actively advocated for keeping the premises safe alongside MSF. Some local staff members have even endangered their lives by coming to the hospital before its closure, while others risk their lives and safety by continuing to work as medical personnel amidst the conflict.

MSF remains deeply committed to supporting the people of West Darfur, especially in light of the recent degradation of the security and humanitarian situation. We have provided extensive technical support to train key Ministry of Health staff in managing mass casualty incidents, including pre-positioning kits and donating drugs. Despite the challenging circumstances, MSF continues to closely monitor the situation on the ground and has already deployed emergency teams to the border to respond to potential displacements and to scale up our response within West Darfur when the security situation will allow.

We will continue to work tirelessly to ensure that the people of West Darfur and elsewhere in Sudan where we are able to support have access to the lifesaving medical care they need.

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