Short-term aid or long-term gains? Harnessing Sudan’s humanitarian response for the resilience of its health system


Highlight of the week

Read the article published in the Lancet Global Health from Maisoon Elbukhari Ibrahim MBBS, Prof. Karl Blanchet and Dell D Saulnier PhD

By Maisoon Elbukhari Ibrahim MBBS

War is a harsh reality that many of us only hear about in the news or read about in history books. However, for the people of Sudan, as well as those in various Middle Eastern countries and Ukraine, it’s a lived experience. The conflict that escalated in Sudan on April 15, 2023, has tested the resilience of the human spirit. I was home for the holidays, planning to start my thesis work in Khartoum when the war broke out. On that fateful day in April, as gunfire shattered the peace of my morning coffee in Khartoum North, a journey of fear, displacement and a new identity began. I decided to leave home when my son asked me if he would die !. I also work for an international organization based in Geneva, and I had to return to work to be able to help my family and loved ones reach safe places and get what they need. This meant leaving my father, siblings, and nephews amidst the war, not to mention my memories and future too. When we left our home in Khartoum North, this was the start of a journey marked by uncertainty, and collective mourning for a homeland left behind. Despite being strangers, we the internally displaced found solace in shared glances, tears, and words of hope, whispering, “We will return to Sudan,” despite the deep wounds and sense of betrayal.

As a Ph.D. student researching health system resilience in Sudan,  I observed how the war has severely impacted Sudan’s health system, pushing it to the brink of collapse. I also observed how despite the devastation, our health system showed resilience. Healthcare workers stayed in the states under fire, working despite shortages of everything. They are the reason why our health system has not collapsed, even with open conflict in more than half of Sudan’s 18 states. Amidst this turmoil and my personal pain, and depression my knowledge of how health systems operate and the nature of “complex adaptive systems” gave me hope that people would find the needed medical services and that Sudan health system will show resilience. This proved true every day and at personal level when my aunt had a brain tumor operation in November 2023 in northern Sudan, and my uncle had a hip replacement last week in a city in northern Sudan.  It’s also important to acknowledge that survival hinges on the compassion of others; the Sudanese volunteers, neighborhood and resistance committees, unions and national and international humanitarian workers are the unsung heroes. Their relentless efforts bring courage and hope to those left behind. As a woman I will say that amidst the chaos, Sudanese women have emerged as pillars of hope and strength, juggling multiple roles as daughters, mothers, friends, and professionals. Our stories are not just about survival, but also about harnessing science and public health to combat inaction and make sense of the complexities of war.

This narrative extends beyond personal experiences; it’s a call to action for health system resilience, even during the most challenging humanitarian crises. In our paper published in Lancet Global Health, we share insights and expertise on how to harness health systems to withstand such shocks. The paper serves as an invitation to join a movement advocating for building resilient health systems especially in settings marred by fragility, conflict, and violence.

As the world witnesses the resilience of Sudan and its people, it becomes evident that together, we can make a difference. The call to action is clear: build and support health systems that not only survive but thrive, even amidst the ravages of crises.

This blog is one of the many ways of resistance; It’s a call to action for the world to stand with us, to learn from us, and to help us rebuild. Together, we can make a difference. Together, we can rise from the ashes of conflict and build a future that is stronger, brighter, and more resilient than ever before.