South Darfur hospital closure leaves pregnant women dying on road to care

By Abdelmoneim Madibu for Radio Dabanga

The journey taken by three women from Rahad Al-Bardi locality in South Darfur to the state capital of Nyala was not simply a trip for medical treatment. It became a race against time that ended in death after they suffered obstructed labour and their families were forced to take them to Nyala, amid the near-total suspension of medical services at the locality’s hospital, which has been out of service for more than two weeks following the departure of its only doctor.

According to a representative of the hospital’s board of directors, all three women died while being referred to Nyala, in circumstances linked to the difficulty of dealing with obstructed labour cases within the locality, the absence of specialised medical services following the hospital’s closure, as well as poor road conditions and the long journey during the rainy season.

The deaths expose one aspect of the health crisis facing residents of Rahad Al-Bardi, where patients requiring urgent medical intervention are now forced to travel long distances to Nyala, while the locality’s main government hospital suffers from a severe shortage of staff, medicines, medical supplies, and equipment, to the point that it has stopped operating altogether.

Residents of the locality are facing a worsening health crisis as the hospital has ceased providing basic medical services, coinciding with the rainy season, the spread of seasonal diseases, and the difficulty of transporting patients and ambulances along the roads.

As the Rahad Al-Bardi locality humanitarian response room appeals to aid organisations, government bodies, and donors for urgent intervention, the local community has launched an initiative to collect donations and establish a fund to support the hospital, in an attempt to get it operating again and create an environment that will attract medical staff.

Deaths from obstructed labour

Abdel Aziz Ibrahim Adam Brosh, a representative of the Rahad Al-Bardi Hospital board, said the locality’s hospital had been completely out of service for more than two weeks because the only doctor working there had left. His departure brought the hospital’s medical services to a halt, while patients arriving at the facility found themselves having to seek limited alternatives within the locality or be referred elsewhere.

Brosh told Radio Dabanga that the hospital’s closure had had a serious impact on cases requiring urgent medical intervention, particularly women experiencing complications during childbirth. He said more than three women from Rahad Al-Bardi locality had died in recent weeks after suffering obstructed labour and being referred to Nyala.

A journey that cannot tolerate delay

According to the hospital board representative, one of the cases involved a woman who was referred from Jamaa Health Centre in Rahad Al-Bardi after suffering obstructed labour, but died before reaching Nyala.

The other two women were referred by midwives from neighbourhoods in the city after also suffering childbirth-related complications, but died on the way.

The cases highlight the dangers posed by the absence of maternal, obstetric, and emergency services in the locality. Cases of obstructed labour often require rapid medical intervention and may require caesarean sections, blood transfusions, and emergency care, none of which is currently available in Rahad Al-Bardi.

The risks increase during the rainy season, when poor road conditions and difficult travel make the journey to Nyala long and arduous, particularly for women experiencing obstetric emergencies.

The deaths indicate that the problem is not simply one of patients reaching hospital, but of the local health system’s ability to provide appropriate intervention at the right time, before transporting a patient over long distances becomes the only option available.

Shortages of medicines and equipment

Brosh added that the hospital lacked the medical staff needed to operate its departments, as well as medicines, medical supplies, and equipment. He said patients had in some cases come to rely on medical assistants or the limited services available outside the hospital, while the more complicated cases were referred to Nyala. He stressed that the continuation of the current situation posed major risks to residents of the locality, particularly women, children, emergency patients, and those requiring urgent surgery.

The executive director of Rahad Al-Bardi locality, Ahmed Mohammed al-Fahl, said the local authorities were making continuous efforts to find a qualified doctor and reopen the hospital. He said the doctor’s departure came amid a broader crisis affecting health institutions across the state, including an acute shortage of doctors, unpaid or inadequate salaries, and the recruitment of medical staff by humanitarian organisations offering higher salaries, better contracts, and improved working conditions.

Al-Fahl told Radio Dabanga that the hospital was a major health facility in western South Darfur, serving residents of Rahad Al-Bardi locality and its administrative units, as well as receiving patients from neighbouring localities and areas, including Kabum, Um Dafuq, and areas close to the border.

He added that the hospital had played an important role in providing surgical services, including caesarean sections and minor operations, as well as treating people injured and wounded during events and clashes in neighbouring areas.

Efforts to save the hospital

To address the situation, Rahad Al-Bardi executive director Ahmed Mohammed al-Fahl said Médecins Sans Frontières had previously provided support to the hospital, including renovating the operating theatre, installing a solar power system, and improving water and electricity services. However, he said, interventions by humanitarian organisations were generally linked to emergencies and limited periods of no more than three months at most.

Al-Fahl told Radio Dabanga that a community meeting had been held in Rahad Al-Bardi to discuss the possibility of residents contributing to support the hospital, improving working conditions, and providing for the doctor’s needs, with the aim of making the locality more attractive to medical staff. Meanwhile, the local government continues to work with the Ministry of Health, state authorities, and health organisations to find a doctor and restore services at the hospital as quickly as possible.

He said the continued closure of the hospital represented a major challenge, given the large geographical area it serves and the need of residents, including patients from neighbouring areas and localities, for its medical and surgical services.

Meanwhile, the locality’s humanitarian response room has issued an urgent appeal to all relevant authorities, humanitarian organisations, UN agencies, donors, and people from the area to intervene and support the hospital.

Following a meeting with the hospital board to discuss the challenges and urgent needs, the response room said the facility was suffering from a severe shortage of medical and health workers, as well as medicines, medical supplies, equipment, and essential devices. It called for medical and health staff in various specialities, essential medicines and medical supplies, and the equipment needed to operate the departments, particularly emergency care, surgery, obstetrics and gynaecology, paediatrics, and the laboratory.

Five million Sudanese pounds offered to find a doctor

While in Nyala, the locality’s executive director made several attempts to find a doctor for the hospital. He said he had met officials at the state Ministry of Health to discuss providing a doctor, but the ministry told him it was itself suffering from a severe shortage of medical staff.

The locality offered a monthly salary of 5m Sudanese pounds to any doctor willing to work at Rahad Al-Bardi Hospital. Several doctors were also contacted, including people from the area working in Nyala, but most declined because of professional or personal commitments. Al-Fahl added that some doctors had expressed a willingness to work in the locality in the future, but no agreement had yet been reached with a doctor who could move there urgently.

He stressed that the locality was not simply looking for any doctor, but one with the experience and training required to deal with the type of services provided by the hospital, particularly caesarean sections, and emergency surgery, given that it receives patients from a wide rural area.

Community mobilisation to save the facility

Alongside the government’s efforts, the local community has refused to stand by as the crisis, which affects it directly, worsens. It has launched an initiative to establish a hospital support fund, aimed at mobilising popular and official support and helping to create working conditions that can attract and retain health workers.

Under an order issued by the locality’s executive director and seen by Radio Dabanga, a finance committee has been formed comprising representatives of the local community, traditional administration, government institutions, security agencies, the chamber of commerce, the media, and popular committees.

The committee will coordinate with neighbourhood heads, government institutions, traditional administration, community elders, and benefactors to raise donations, as well as with the hospital board to improve working conditions for staff. As part of the community fundraising plan, residents have agreed to collect 1,000 Sudanese pounds a month from every household in the neighbourhoods of Rahad Al-Bardi.

The initiative reflects an attempt to draw on community resources amid weak funding for health services, while also seeking support from the government, humanitarian organisations, and people from the area living inside and outside Sudan.

In the latest developments, Ahmed Awad, secretary of the community committee supporting the hospital, said efforts were accelerating to restore services gradually. He said that, following a meeting with the locality’s executive director, medical assistant Musa Ali al-Tijani had been appointed temporary medical director of the hospital until a doctor arrived from the state. Laboratory technician Mohammed Nour had also been instructed to resume work, despite continuing shortages of some essential supplies, particularly medical fluids.

Awad told Radio Dabanga that emergency medicines sent from the state were on their way to the locality, in a move that could help resume some urgent services. Meanwhile, hospital board representative Abdel Aziz Brosh said the locality’s executive director was currently in Nyala seeking a doctor who could be brought to Rahad Al-Bardi.

A crisis that goes beyond the absence of a doctor

The crisis at Rahad Al-Bardi Hospital reveals a problem greater than the departure of its only doctor. It reflects the limited ability of peripheral health facilities to attract and retain medical staff, as well as shortages of funding, equipment, medicines, and incentives.

Community initiatives may help provide some urgent supplies, but they do not appear sufficient on their own to guarantee sustainable healthcare, particularly at a facility serving residents of the locality and neighbouring areas.

The deaths of the three women during their referral journeys, after suffering obstructed labour, make the crisis all the more urgent. Every delay in treating a woman experiencing obstructed labour can turn the distance between Rahad Al-Bardi and Nyala from a journey for medical treatment into a journey the patient does not survive.

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Editor’s note: This article has been translated from Arabic with the assistance of artificial intelligence, and subsequently reviewed and adapted by a human editor before publication.