In Sudan, where a war that has caused the world’s biggest humanitarian disaster is in its second year, Dr Javid Abdelmoneim has his own daily struggles, trying to save lives in a place where the health system has all but collapsed.
Rockets and bullets have an immediate effect on people caught in the crossfire, but the wider consequences of war are wreaking havoc on the population’s health.
“It’s always the most vulnerable people who are impacted negatively by conflict,” says Abdelmoneim, a medical team leader at Médecins Sans Frontières (MSF), who is based in Sudan’s capital, Khartoum, after working in Gaza last year.
They are often overlooked, as official figures of lives lost don’t include “the newborns who died because they were underweight because the mother was malnourished”, he says, or “the woman who died from a haemorrhage [in childbirth] because there weren’t the right instruments, and she had a complicated delivery because she didn’t have the right antenatal care”.
Then, he says, there is the person who fell into a diabetic coma and died because of a lack of insulin; the one who didn’t get their kidney dialysis and died a horrible death; the person who had a stroke; and the one who had a heart attack.
“All those are not in any death figures for Sudan,” he says. “Conflict is devastating for a population. You have unborn children affected by war. If they are born at all, they’re underweight, the mother can’t breastfeed them, they’re more at risk of infection, they’re not going to get their vaccinations.”
MSF is one of three beneficiaries of the 2024 Guardian and Observer charity appeal, along with War Child and Parallel Histories. The appeal, which closes at midnight on 12 January, has so far raised over £1.5m.
The civil war in Sudan has perpetuated a mass famine and forced 12 million people from their homes, according to UN estimates. Both sides of the conflict have been accused of war crimes, with one, the paramilitary group Rapid Support Forces, last week accused of genocide by the US for its role in “systematic atrocities”.
The scale of need in Sudan is immense, says Abdelmoneim. “What is happening in Sudan is more than 10 times bigger than what is happening in Gaza and there is far less response here.”
He adds: “Sudan is not on people’s agendas and has not received the attention it needs from the entire global system, be it governmental, non-governmental, diplomatic, humanitarian or otherwise. It’s an enormous emergency when you look at the number of people suffering, food insecurity, malnutrition, famine, conflict, violence and the collapse of the healthcare system.”
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The conflict is driving a maternal and child health crisis as people are displaced and subjected to violence. Pregnant women, mothers and newborns are dying at alarming rates from preventable and treatable health complications. In one hospital in Darfur, supported by MSF, one out of every 30 women died from complications in pregnancy or childbirth in July 2024. Women are not able to access antenatal care, says Abdelmoneim, and there are no follow-ups to identify at-risk deliveries: if the baby is in a breech position, for example, or there are twins. The team sees high rates of malnutrition in pregnant women, which causes premature deliveries, low birth weights and higher infant mortality. Women experience complications during labour and if they make it to hospital at all, they often turn up too late to be helped, with infections and sepsis. Many die at home.
Abdelmoneim, 45, has worked in crisis zones across the world with MSF after he first became involved with the charity during his second year at university. Three years ago, he left his job in the NHS in the UK, where he trained and worked in emergency medicine, to work for MSF full time.
This latest mission is personal. His father is Sudanese and Abdelmoneim lived in the country as a child.
“It’s hard, to be honest, but I’m glad to do it,” he says. He was in Sudan with MSF on a previous mission at the start of the war, entering the country the day after his father left it. “I came at the beginning of the war and the government here is very restrictive,” he says. “There are a lot of bureaucratic impediments, regulations and permits, and parts of the country are restricted because they are active conflict zones.”
There were also the reports of destruction of places familiar to him. “In meetings people talk about a neighbourhood or a bridge that’s been blown up and in other countries I’ve been, it’s abstract. But here it was like, ‘Oh God, that’s where my auntie lives. I know that street. It was hard. It’s a special burn.”
For now, though, “the hope is on that patient at the bedside, that patient we saved today who is walking out smiling. There are plenty of those.”
