Months of a siege on the western city of El Fasher had left many children grossly malnourished, stalling their growth, Lin, an anaesthetist who was deployed to the war-torn country by Doctors Without Borders (MSF), said.
“Many families arrived in the city in critical health condition,” the Taiwan native said at a dialogue with potential Malaysian donors before a media briefing yesterday.
“If I had not known their ages, I would have thought that a three- or four-year-old was actually just aged one or two,” she said.
The civil war between the Sudanese Armed Forces and the rebel Rapid Support Forces (RSF), now in its second year, has displaced more than 15 million people and shattered what remains of the healthcare system.
Lin was posted to Tawila, a remote town about 60km away from El Fasher. Getting there itself was a challenge. The overland journey of barely 250km to 300km from neighbouring Chad took three days.
Lin had her first shock on arrival in Tawila – there was a hospital, but it did not have an X-ray machine, a laboratory, or even consistent power supply.
“Of all the places I’ve been to on such missions, Sudan is the most austere I have ever seen,” she said.
Adults have not been spared by the 18-month siege of El Fasher. “Even young men had haemoglobin (levels) of only five or six. The normal is above 12,” she said. In simple terms, their blood was far too weak to carry enough oxygen.
Small cuts often became large abscesses because patients’ immune systems had collapsed from starvation and lack of clean water, she added.
When El Fasher fell to the RSF on Oct 26, Tawila saw a sudden surge in the arrival of displaced families.
“We used to have six to eight surgeries a day. After the fall (of El Fasher), it jumped to 24 surgeries a day for almost two weeks,” she said.
With only two operating theatres, MSF put up a tent to accommodate two more. Even then, the team regularly worked from morning until midnight, often skipping meals.
Power cuts added to the risk. Lin recalled a case when the lights went out midway through a laparotomy. “We had to switch the ventilator to manual mode (and worked) in the dark,” she said.
With no specialists left in the region, Lin had to work outside her area of expertise. She once removed a piece of okra from a nine-month-old baby’s oesophagus, a procedure usually done by an ear, nose and throat surgeon.
“The baby boy had been vomiting for more than a day, so we had no choice (but to go ahead with the procedure),” she said.
One case that still haunts her is that of a mother of 10 who collapsed during a C-section. The team managed to get her heart beating again, but without imaging or blood tests, they could not determine what went wrong.
“She never woke up. That day, 10 children lost their mother,” Lin said.
The emotional toll on the Sudanese staff is just as heavy. “Sometimes nurses came to the operating theatre crying because their relatives had been killed,” she said.
“The men told me, ‘Muslim men don’t cry’, but I could feel they were grieving inside.”
MSF Asia-Pacific communications chief Polly Cunanan said Sudan remains one of the world’s most neglected humanitarian crises.
“There are very few organisations left on the ground. MSF is one of the only international groups still running a hospital in these areas,” she said.
Cunanan urged Malaysians to help by staying in touch with events and offering aid in cash and kind.
“MSF relies mostly on individual supporters. Even small contributions help us buy fuel, emergency supplies and essential medicines,” she said.