Waiting for life: Kidney dialysis in Darfur, Kordofan a journey through illness and poverty

Inside the dialysis unit at the Specialist Hospital of Nyala, capital of South Darfur, 14-year-old Sanaa Adam Ibrahim (not her real name) lies quietly as kidney failure steadily weakens her small body. Standing beside her, her parents are exhausted after an arduous journey from North Darfur, clinging to the hope of saving their daughter’s life.

The family had to leave their five other children at home without a caregiver and travel to Nyala, where they have neither relatives nor anywhere to stay. The hospital corridors have become their temporary shelter.

Now, with their savings exhausted, they can no longer afford the cost of dialysis, which is around SDG 360,000 (about USD 100) per session, excluding tests and medication. Any delay in treatment poses a direct threat to Sanaa’s life.

Four machines serving two regions

Sanaa’s story is far from unique. It reflects the reality facing hundreds of kidney patients arriving from the Darfur and Kordofan regions.

The dialysis centre once operated 12 machines, but nine have fallen out of service after long periods without maintenance. Only four remain operational, placing enormous pressure on the unit and forcing many patients to wait longer for life-saving treatment.

The shortage of equipment is only part of the crisis.

Patients are now expected to meet much of the cost of their own treatment, including dialysis supplies and contributions towards keeping the service running. Families must pay for everything from catheters and dialysis materials to fuel and water, even though dialysis is supposed to be provided free of charge. For many, treatment has become financially impossible.

Infection fears and staff shortages

The problems extend well beyond a lack of equipment.

According to sources inside the centre, shortages have forced staff to use the same dialysis machines for patients with kidney failure and for others suffering from different illnesses. They say a number of kidney patients have contracted hepatitis and HIV, raising fears that inadequate sterilisation and shortages of medical supplies are increasing the risk of infection.

The same sources told Radio Dabanga that 35 patients died during May and June, an average of one death every two days. Two of those who died had contracted hepatitis C. They also say the centre currently has neither a specialist nor a general doctor to supervise patients’ treatment.

The head of the centre, engineer Tibi Hamid Musa, said the decline in services has been driven by broken dialysis machines, problems with the water purification system, fuel shortages, the need for a solar power system, and inadequate financial incentives for staff.

The centre was also badly affected by fighting in Nyala during 2023. Maintenance and supply chains were disrupted, operational infrastructure was damaged, medical supplies and fuel became scarce, and a number of healthcare workers left the area, reducing the centre’s ability to provide treatment.

Government pledges support

In an effort to address the crisis, the head of South Darfur’s Civil Administration, Yousif Idris Yousif, announced SDG 50 mln in support for the centre.

The funding includes repairs to five dialysis machines, fuel for generators, SDG 5 mln in staff incentives, and measures to ensure a more reliable water supply. During a visit to the centre on Sunday, he said other outstanding needs would be discussed with the Federal Ministry of Health under the Peace Government.

His visit followed repeated appeals by activists calling for the dialysis unit to be rehabilitated and for urgent action to save patients’ lives.

South Darfur’s Director General of Health, Abbas Hassan, said the five repaired machines should return to service within the coming weeks, increasing the centre’s operating capacity to eight machines.

He added that the next priority would be securing dialysis fluids and other medical supplies in coordination with the Federal Ministry of Health, with the aim of easing the financial burden on patients and making dialysis sessions free of charge.

But until those promises become reality, kidney patients in Nyala – including young Sanaa – remain locked in a daily race against time, where every delayed dialysis session can mean the difference between life and death.