The two Sudanese women believed they had malaria and were taking their prescribed treatment, but a catastrophic turn of events ensued. Both individuals reported of a severe headache and fever that did not respond to antimalarial medication.
As per VOA News, Raqiya Abdsalam had entered a coma by the time she was diagnosed with dengue fever. “I went into a coma shortly after they checked me three months ago,” she stated, recalling her ordeal. Both women have now healed and returned to their homes in the central province of North Kordofan’s city of El Obeid.
For decades, Sudan’s impoverished public health sector has failed to efficiently diagnose and treat patients, while major government spending flowed to the country’s extensive security agencies. A recent increase in mosquito-borne diseases, like as dengue fever and malaria, has highlighted the fragility of the African nation’s health system, portending future difficulties caused by climate change.
The best-equipped hospitals in Sudan are centered in the capital, Khartoum, leaving those in remote districts dependent on assistance initiatives. However, many of those have vanished.
General Abdel-Fattah Burhan, the main military figure in Sudan, conducted a coup that halted the country’s brief democratic transition in October 2021. The United Nations Office for the Coordination of Humanitarian Affairs said that funding levels for 2021 and 2022 decreased to less than fifty percent of the required amount.
Burhan, along with his ruling generals and a number of other political forces, committed to form a new civilian administration in December. However, political squabbling is preventing a final agreement, and it is unknown when — or if — donor financing will return to its old levels.
In late autumn, a young doctor in a hospital in North Kordofan believed she was witnessing a new malaria outbreak. Patients admitted to her facility exhibited malaria-like symptoms, including high temperature, bodily tiredness, and headaches resembling migraines.
However, once blood samples were tested in a laboratory in Khartoum, an alarming picture emerged. Some patients had malaria, which is caused by a parasite, while others had dengue fever, which has similar symptoms but is caused by a virus. Dengue fever can cause organ failure and death if severe and left untreated.
The young physician stated that the hospital lacked the necessary resources to combat the outbreak. She stated that patients were required to either sleep on the floor or bring their own beds to the hospital.
While malaria is prevalent in the central and southern regions of Sudan, significant dengue outbreaks are uncommon. According to Sudan’s Ministry of Health, dengue fever spread to 12 of the country’s 18 regions last fall and winter, killing at least 36 people and infecting more than 5,200. Given the constraints of testing, the true numbers are certainly greater.
Most hospitals outside of Khartoum are not connected to the Ministry of Health database, according to Alaaeldin Awad Mohamed Nogoud, a famous pro-democracy campaigner and liver and transplant surgeon.
According to the World Health Organization, various factors contributed to the dengue outbreak, including a lack of disease surveillance infrastructure and severe autumn flooding. The stagnant water allowed mosquitoes to flourish, which contributed to the disease’s spread.
Experts in the field of public health are particularly concerned that climate change-induced mosquito migration could spark new outbreaks of dengue fever and other tropical diseases generally found beyond Sudan’s southern borders. Aedes aegypti, a mosquito with long legs whose population is increasing in Sudan and which can transmit the dengue virus, is of special concern.
According to Anne Wilson, an epidemiologist at the Liverpool School of Tropical Medicine, it is difficult to prevent the spread of disease by the Aedes aegypti mosquito since it primarily attacks during the day, making insecticide-treated nets less effective.
Public hospitals in Sudan are state-run, although patients frequently must pay for medications and diagnostics. Rural hospitals are the most bare, supplied with little more than metal beds and physicians.
Some believe the virus went uncontrolled for months in North Kordofan, the location of the recent dengue outbreak, due to a widespread lack of blood testing equipment. Abdsalam and Amany Adris, two ladies from El Obeid, reported that multiple physicians had incorrectly diagnosed them with malaria.
After the Ministry of Health formally acknowledged the outbreak in November, dengue fever sufferers were offered free testing and treatment, according to officials. North Kordofan was proclaimed free of dengue fever by January.
However, despite this pronouncement, the young doctor from the province stated that she was treating questionable cases. She said that few patients can afford to pay for the blood tests themselves.
Both Nogoud and the young physician stated that severe drug shortages are pushing physicians to purchase essential medications, such as paracetamol IV infusions to treat fever, on the black market.
Sudan has been in an economic catastrophe for years, with annual inflation exceeding 100 percent in most months. Since 2018, the Sudanese pound has lost more than 95 percent of its value versus the dollar, making it difficult to import drugs and medical equipment.
By the end of the previous year, the National Medical Supplies Fund of Sudan, which is responsible for acquiring medicines, reported that cancer drugs were available at 48% of the required level, while other emergency medications were available at 68%. Due to low salary and poor working circumstances, doctors have frequently gone on strike.
Critics accuse the nation’s authorities of not investing more in the health sector. On the government’s website, the federal budget for 2021 said that the health ministry would receive less than half of what would be given to the Sudanese Armed Forces and the Rapid Support Forces, the largest paramilitary organization in the country. The military spokesperson declined to comment in response to AP’s request.
Due to a lack of funds, the Ministry of Health has turned to social media videos to encourage people to cover standing water sources and install window nets.
Few view this as a sustainable option. “The entire country is in disarray,” said Nada Fadul, a physician specializing in infectious diseases and a member of the Sudanese non-governmental organization NexGen. Fadul stated, “health care may not become the first concern for survival.”