The October coup had an impact on the healthcare industry. Patients at Khartoum’s Ibrahim Malek hospital wake up during surgery because anaesthetics are so scarce. Medical supplies have not arrived, according to staff, since Sudan’s military coup on October 25.
“We give them extra anaesthesia as they’re about to wake up,” said Dr. Ali Shaker, general manager of Ibrahim Malek, one of the country’s highest traffic public hospitals. “It would be a disaster if the Health ministry did not provide us with these materials at no cost.”
The unregulated black market is where Ibrahim Malik Hospital purchases equipment and drugs, but doctors have no idea whether they are safe or even effective. Because anaesthetics wear off quickly, surgeons must give multiple dose to keep patients asleep during surgery.
An untrustworthy industry
Sudan’s healthcare system has had a trying 3 years. In April 2019, protests deposed former tyrant Omar al-Bashir, and a civilian-military coalition took control. The military took power 4 months ago. Al-Bashir had spent decades privatising Sudan’s healthcare system prior to the coup. While wealthy Sudanese sought treatment elsewhere, his administration undermined public health care and syphoned off funds.
Former health officials claim that former Prime Minister Abdallah Hamdok improved the situation during the country’s brief democratic transition. As a result of IMF-recommended austerity policies, many treatments have become prohibitively expensive. Things deteriorated during military rule. As nationwide protests against the coup continue, the sector is collapsing. Following the coup, Bashir-era allies were appointed as hospital directors and health officials, many of whom were embroiled in corruption scandals.
According to doctors and former medical personnel, this has led to a shortage of medicine and medical equipment, as well as an increase in public medical bills.
Former health ministry adviser Asil Sidahmed believes the coup paved the way for high-level corruption. She also stated that the World Bank Global Fund and Gavi, a public-private partnership that provides vaccines to developing countries, should provide the Ministry of Health with the majority of its funding.
Sidahmed was concerned that restoring ministry aid would fund the military instead of patients.
“We require a mechanism that directs funding to healthcare facilities,” she told Al Jazeera. It should be distributed to the directors of primary care clinics and the hospitals in charge. “Money ought to be spent there.”
Dr. Shaker claims that his hospital lacks basic equipment despite relying heavily on international and local aid organisations. He indicates a few boxes of surgical gloves in the hospital’s storage area, indicating that they will be the only ones available for at least the next month. Prior to surgery, Dr. Shaker advises patients to purchase gloves and syringes. “We keep them on hand in case something happens.”
Al Jazeera was unable to confirm the number of fired medical personnel and healthcare officials.
Dr. Khaled Badr was one of three people fired one week after the coup. “We were fired at the federal level,” he explained, “but many of us were fired at the state level.” If Dr. Shaker is fired, the heads of all 27 Ibrahim Malik departments have threatened to go on strike.
According to Sudan’s Professional Pharmacists Association spokesperson Samahir Mubarak, doctors and medical workers like Dr. Badr were critical in the 2019 protests that toppled al-Bashir. The Sudanese Professionals Association led anti-regime protests. She expects al-National Bashir’s Congress Party (NCP) to settle scores. “The NCP is coming back with a vengeance,” she predicted. “They’re returning with power and an army.”
Since taking over at Ibrahim Malik Hospital in April 2021, Dr. Shaker has waived all medical fees for anyone who is unable to pay. According to the pharmacists’ union and some doctors, the government raised healthcare rates across the board on February 19.
A hospital stay costs $4.49, but X-rays and malaria tests are four times as expensive. Between 220 and 7,000 Sudanese pounds ($0.45 to $16), hospital admissions increased by 3,000 to 5,000 percent.
Sudan’s health minister, Dr. Haythem Mohamad Ibrahim, told Al Jazeera that international funding is lacking. The government is looking into ways to help low-income residents, such as expanding national health coverage so that insurance companies can cover a portion of the cost. “The Ministry of Finance is not adequately funding hospitals,” he said via WhatsApp. This year, medical costs are expected to more than fivefold.
These exorbitant prices are out of reach for Ahmed Baqar. Baqar, a day labourer earning $11.22/month, brought his young son to Ibrahim Malik before the price increases. “I brought [my son] here because he was having breathing difficulties…but I had no idea each service would cost 4,000 or 5,000 Sudanese pounds,” he continued. I was terrified of having to return my son to his mother.
Unlike most hospitals, Ibrahim Malik will not raise his prices
Dr. Shaker requested that the hikes be halted until a study was completed. The government granted his request the next day, but he is concerned that prices will not be frozen indefinitely and hopes that the administration will increase sector support. “If the [military] wants to govern, they should pay for people’s healthcare in the same way that they pay for security forces,” he told Al Jazeera. The government has money, but it isn’t for healthcare.