One doctor, hailed as a mentor, reportedly stabbed to death as he took his father to dialysis. Another doctor, after days of coping with medical crisis in Khartoum, decides he must flee for his life to a safer city.
These are just some of the awful consequences of the now 11-day war in Sudan.
NPR spoke to Dr. Mohamed Eisa after his 11-hour journey. He shared his perspective of what life has been like — and of his friend, Dr. Bushra Sulieman, who like Eisa was a gastroenterologist.
"I told him people are dying on the streets here and we will serve this country better if we are alive," Eisa recalls. "But Bushra said, 'I don't want to leave, that's why I came back here from the U.S. in the first place.' "
On April 12, Dr. Mohamed Eisa, a gastroenterologist from Pittsburgh, flew to Sudan after his father passed away. Three days later, an explosion shook his family's house in the capital of Khartoum, signaling the beginning of turmoil between military forces that has claimed more than 500 lives and injured more than 4,000 people.
"We sheltered for ten days, barely getting any sleep, sheltering under the bed worrying that missiles might land in the house and listening to the continuous gunfire and airstrikes," says Eisa.
Eisa is also the secretary general of the Sudanese American Physicians Association (SAPA), a nonprofit association formed in 2019 to build links among Sudanese doctors in the United States and to support health-care facilities back in Sudan. It is now trying to support beleaguered hospitals during the current violence.
He describes the health situation in Khartoum as "disastrous" — with planned procedures canceled and doctors fearing for their lives. Several hospitals have been attacked in the capital, which has borne the brunt of the fighting, and are fast running out of supplies.
On Wednesday, the World Health Organization (WHO) reported that only 16% of health facilities in Khartoum were operating normally, with 24,000 pregnant women unable to access maternal care.
Eisa says that his organization is updating a list of pharmacies across the city that are operating at sporadic hours of the day and secretly, to avoid looting.
"I personally know people who had medical emergencies like chest pains or hypoglycemic and diabetes comas because they couldn't find a hospital to take them," Eisa says.
"My colleague was forced to take a patient off a ventilator because the electricity was cut and there was no gasoline to power the generator," he recounts. "They continued manually using an Ambu bag [a device to manually pump air into someone's lungs], taking turns between himself and the nurses for 24 hours. They were hoping for a miracle. Then they just had to stop." The patient died, he says.
On Friday, the Sudanese army and paramilitary Rapid Support Forces (RSF) agreed to extend a ceasefire for another 72 hours. Despite the supposed pause, heavy fighting has been reported in Khartoum and the western region of Darfur. The true death toll is likely to be much higher as civilians struggle to find health facilities.
Fierce clashes have also been reported in the city Omdurman, adjacent to the capital, where Eisa says SAPA operates a hospital offering pediatric care.
"On one day we received five babies transferred from facilities that had been shut down. One set of parents had been looking for an incubator for their sick newborn for three days. By the time they made it to the hospital, it was too late."
The charity Médecins Sans Frontières said on Thursday that they had managed to deliver supplies to three health facilities in Khartoum despite coming under shelling.
On April 25, tragedy struck Eisa personally as his close friend and colleague Dr. Bushra Sulieman was killed. Sulieman traveled regularly to the United States to see family and perform surgery but had moved back to Sudan years ago to help train doctors. He taught at the University of Khartoum's faculty of medicine and was a director at the Sudanese American Medical Association (SAMA).
"It was a sad day for Sudan given his impact on the medical profession. His death was a turning point. It's not Bushra that died, a nation died."
Eisa says that when war struck, Sulieman was moving his father from different hospitals to seek dialysis. Eisa told Sulieman that he was heading to Port Sudan, an eastern city on the Red Sea from where evacuation ships to Saudi Arabia depart, and that he should do likewise.
"Eventually I convinced him to leave Khartoum for a safe place. He was getting ready but then he was attacked," Eisa says.
Sulieman was killed outside his home while taking his father to an appointment. SAPA members say it's believed Sulieman was stabbed to death during a robbery attempt amid the turmoil. U.S. White House national security spokesman John Kirby on Wednesday confirmed that two Americans had died in the violence since April 15. Sulieman was likely one of the two deaths, even though he was not named.
In the meantime, Eisa had to embark on a perilous journey to escape the city with dozens of his family members.
"The van driver wouldn't come to our street as we live in one of the hot zones near the airport road so the night before we had to sneak between small streets to a different neighborhood."
Though the distance to Port Sudan is nearly 600 miles, Eisa said that the hardest part was leaving Khartoum amid constant bombardment.
"The drive to the bus station was only 45 minutes, but it was the longest journey of my life. We crossed many checkpoints manned by RSF soldiers and were stopped and searched numerous times. We never knew what might happen – would they open fire? Would the army fire missiles at them? As we made it to the bus station, we saw dead bodies in the streets and in civilian cars surrounded by unexploded missiles."
After exiting Khartoum, Eisa says the journey was relatively straightforward.
A.K.M. Musha was also evacuating around the same time. He's the country director for the international nonprofit group Concern Worldwide, and his team reached Port Sudan on April 24 after joining a U.N. convoy out of Khartoum.
"We were 80 vehicles of eight or nine hundred people," he told NPR. "It took 34 hours over 900 kilometers [about 600 miles]. The convoy had to stop many times due to security checks, checkpoints, refueling, flat tires and other logistics. When one car stopped, everyone had to stop. It was painful and difficult, particularly for children."
Musha said that his organization's international staff were leaving the country but providing remote support, hoping to return when hostilities cease.
"Sixteen million people in Sudan were dependent on humanitarian support before the war," he says. "Now that need has increased. What about the people we are leaving behind?"
Meanwhile, Eisa is waiting for an evacuation ship to the Saudi port of Jeddah and plans to return to his family in Pittsburgh. He is relieved to be in the relative safety of Port Sudan but is wary about the deteriorating humanitarian situation as supplies dwindle while more internally displaced Sudanese arrive.
"The situation is a mess. Thousands and thousands of people lying on the streets, kids everywhere, it's a very sad picture. There are no commercial ships coming in and the people of Port Sudan are starting to worry about that. The prices are rising. Everybody is looking for food, water and shelter. Even if they are not seeing bullets, they are looking at an economic crisis."
Andrew Connelly is a British freelance journalist focusing on politics, migration and conflict.
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