In Sudan, attacks on hospitals force patients to make dangerous journeys

For more than a decade, medical missionary Tom Catena has run the largest hospital in the Nuba Mountains, a rugged territory the size of Austria, most recently during a brutal civil war. There is no oncologist on staff at Mother of Mercy, but as the war destroys much of Sudan's health care system, patients like Fatouma Mahdi Ahmed Saeed, who has cervical cancer, keep turning up at his door. Saeed was diagnosed last year by a private doctor in Nyala, the capital of South Darfur, and had no choice but to make a dangerous trip of hundreds of miles to Catena's hospital in central Sudan; she said she was in a lot of pain and desperate for treatment, that the journey was very difficult but she was not scared, and that she kept going because she knows her day will come when God decides.

Sudan's civil war began in 2023, as two rival factions clashed for control of the nation's military. Some 13 million people have been forced to flee their homes, according to the United Nations, in what is currently the world's largest displacement crisis. Both sides have been accused of indiscriminately targeting hospitals and health clinics, with 205 attacks on health care facilities since the start of the war, according to the U.N. International aid cuts have added to these challenges, forcing the collapse of an already fragile health care system, Doctors Without Borders said in a statement this month. As a result, people with cancer and other long-term illnesses now struggle to receive treatment that was once readily available.

Catena described these cancer patients as indirect casualties of war, recovering alongside wounded civilians in his crowded wards. Originally trained in family medicine, he is now the only permanent surgeon in the Nuba Mountains. He said that if there was peace, these patients would have been treated in Khartoum, Darfur, or El Obeid, but those hospitals are now gone. There are no recent numbers available for cancer deaths in Sudan, but Catena said the situation is not unlike the challenges faced by patients with long-term illnesses living through other wars, citing Gaza and Ukraine and noting that all those sick people are still there.

Before the war, Nyala had good hospitals where Saeed could have been diagnosed and treated, but many have been destroyed or badly damaged in the fighting. Even with the support of international health charities such as Doctors Without Borders, essential services have been slow to return. When STAT visited Mother of Mercy hospital earlier this year, Catena and his staff had administered some 15 doses of chemotherapy in a single day to patients with nowhere else to go. Saeed said she had to sell one of her calves and seek help from her family to pay the private doctor for her cancer diagnosis, and she first travelled from Darfur to a neighboring area before continuing her journey.