Mutwakil Ali was one step away from being able to work as a doctor in his homeland of Sudan.
After graduating medical school in 2022, Ali was awaiting a hospital placement to complete his intern year and become a licensed physician — then war erupted.
"We woke up from bombs being dropped on the military base two blocks away [from our home]," says Ali, adding that his medical school and many hospitals were also bombed. "I had to flee my home."
For over 600 days, civil war has ravaged Sudan. The violence has killed at least 60,000 people, according to a report issued in November by the London School of Hygiene and Tropical Medicine's Sudan Research Group, and more than half the country faces starvation.
Medical education, interrupted
Ali is one of 3 million people who have fled Sudan. He's in Saudi Arabia now — and his medical education is in limbo.
As people in Sudan continue to suffer the effects of what is sometimes described as a "forgotten war," the ongoing disruption of medical education is often overlooked.
The conflict is delaying training for thousands of medical students, likely leading to a worsening health care crisis for Sudan for years to come.
"Medical education is one of those forgotten parts of the humanitarian crisis," says Dr. Mazin Khalid, interventional cardiologist in the U.S. and director of career development at the Sudanese American Physicians Association, who worries about the future of healthcare in his home country.
"Education is impossible in the majority of the country due to the destruction of hospitals and medical schools," Habab Iraqi says. She's a Sudanese emergency medicine intern now based in Saudi Arabia. "Some residency programs and medical colleges have switched to online learning, while others have been forced to relocate to safer cities in Sudan."
A 2024 study published in the journal Conflict and Health revealed that between April and July of 2023, 34 of 58 medical schools in Khartoum, Darfur, and Kordofan were attacked. Some medical schools were looted while others were converted into military bases.
Hospitals and medical schools have been at the center of the attacks by the paramilitary group Rapid Support Forces (RSF), which is fighting the Sudanese army. It is not known whether hospitals are being targeted intentionally, according to a statement by Stéphane Doyon, head of Doctors Without Borders (MSF) emergency response in Sudan, but the attackers "are not taking any precautions to spare them."
"About 70% of medical schools are concentrated in the capital, where the war started," says Khalid. And the majority of those students had to flee the area and either pause their medical education, resort to online learning, or transfer to medical schools abroad.
Khalid fears that the ongoing obstacles to medical training will lead to a collapse of the Sudanese healthcare system as more people leave the country for better training opportunities.
"We are hemorrhaging specialists. We have a lot of specialists who had to leave the country and then found jobs in other countries, which pay much better and provides them the stability they need for their families."
These impacts of war are not unique to Sudan. More than two-thirds of medical students surveyed in Ukraine have had their education restricted during the war, according to a 2022 study. Similarly, medical students who underwent training under "hostile circumstances" during the Syrian crisis had lower test scores compared to those who began training after.
Iraqi also worries about the toll war has taken on her colleagues who have remained in Sudan. "The long-standing brain drain of medical professionals is made worse by the growing number of medical students and interns who decide to emigrate when faced with the decision between constant insecurity and fleeing," she writes.
"Part of the problem is the mental load on practicing doctors," adds Ali. "There are always people coming in with horrible stories, coming in with traumatic [injuries], women who were raped, malnourished children. And you can do nothing because there is nothing in your hands you can help with. That's part of the challenge faced by medical teams there."
As of November 2024, only 57% of the $2.7 billion the U.N. requested in humanitarian aid for Sudan had been funded, contributing to a growing shortage in medications, diagnostic tests, and other medical devices needed for medical education and medical care. The international president of MSF, Dr. Christos Christou, has called the support for Sudan "deeply inadequate." For comparison, three years into its war, Ukraine has received U.S. commitments of nearly $183 billion in funding, with $86.7 billion disbursed.
A shortage of medical supplies
But lack of funding is not the only issue. According to a statement by MSF, the Sudanese Armed Forces have blocked delivery of humanitarian aid across front lines, so medical supplies are not reaching some areas controlled by RSF.
Ali experienced the effects of medical shortages himself.
"I was working as a volunteer doctor in my hometown for the 3 months I stayed there [before fleeing in July 2023], and we had to reuse medical equipment multiple times — like IV sets for fluids had to be used multiple times," he says. "We had a lot of shortages of life-saving medicines and a lot of the technology used for diagnostics were not available."
The war has caused what the U.N. and others are calling the world's worst humanitarian crisis. Sudanese physicians are urging the international community to do more for medical trainees and patients.
"There is no doubt that Sudan's healthcare workforce is in danger," says Iraqi, the Sudanese medical intern living in Saudi Arabia. "As long as these attacks continue to infuriate us, we will not become desensitized to them. Nevertheless, action — not complacency — must follow fury."
And when the war ends, communities will need educated professionals to rebuild.
"Violence against healthcare has far-reaching implications that go well beyond attacks on hospitals and their immediate aftermath," he adds.
As for Ali, he's pursuing his physician's license outside of Sudan, currently studying for exams to apply to medical residencies in the U.S.
"I consider myself lucky because I had the chance to leave early," he says.
Ali wants more people to know about the crisis Sudan is facing. "This is the largest displacement crisis in the whole world right now. [I want] everyone to know how dire the situation is."
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