The civil war in Sudan has brought to country's health system to its knees. UN mobile health teams are attempting to plug the gaps, crossing conflict zones to help pregnant women to give birth in safety.
Under shelling and gunfire, Esraa cradled her newborn son. As the war in Sudan broke out in April 2023, she was trying to reach a health clinic for treatment for her baby, who had been struggling with infections and breathing difficulties. But with the roads blocked by fighting, the young mother never made it to the clinic; her son died in her arms.
When she became pregnant again in August last year, she was haunted by the fear of losing another child. "There's only one functioning maternal hospital left in Khartoum," said Esraa. "It's incredibly dangerous to move around the city - one of our neighbours died on her way to the hospital."
Throughout the war, Esraa and her family have been forced to move repeatedly as areas that were safe one day became lethal the next. They eventually found refuge in a crowded shelter with other displaced people from Khartoum.
'It was like moving from one grave to another'
Once the largest city in Sudan, Khartoum now has vast areas that resemble ghost towns. In shelters set up for people forced from their homes, conditions are dire: Overcrowding is rampant and basic hygiene essentials mostly missing. Food is also increasingly scarce, leaving many battling severe hunger as Sudan faces the worst levels of acute food insecurity ever recorded in the country.
As the crisis deepens and diseases like polio and cholera spread, accessing health care has become one of the most critical challenges for the people of Khartoum. Most medical facilities have been forced out of service due to destruction and a severe lack of supplies.
"I was five months pregnant when I arrived at the shelter," said Esraa. "For me, it was like moving from one grave to another. We were constantly expecting something bad to happen. Hope had no place in our hearts."
Roving responders
Amid these dire conditions, a mobile health team supported by UNFPA arrived at the shelter to provide reproductive health and protection services to the women and girls living there. "The mobile health teams play a crucial role in preventing maternal deaths, offering a comprehensive range of medical services in war-affected areas of Sudan," explained Mohamed Hasan Nahat, coordinator of the team.
Esraa received antenatal care and micronutrients from the team, who made regular visits to care for her and the other women and girls in the shelter. "They not only helped me with medical care but also gave me a sense of safety and hope that I hadn't felt in months," she said.
Four months later, Esraa gave birth to a healthy baby boy, assisted by the mobile team. "I gave birth in the shelter. They took care of me and the baby - I even named him Mohamed after the doctor who helped me."
UNFPA has deployed 56 mobile health teams across 11 states in Sudan, which provide sexual and reproductive health services and gender-based violence protection and response. Since the war began, the teams - including doctors, pharmacists, lab technicians, psychologists and midwives - have conducted over 150,000 medical consultations.
Although they are saving lives and providing the only medical assistance many have received, humanitarians like social worker Nisreen Kamal Abdulla felt there was still more they wanted to do for these communities.
"The time available at the clinic was not enough to treat everyone - we should visit every community more frequently to reach more people and provide consistent care," she told UNFPA. "Most of the women we met who have psychological issues have stopped their treatment because they can't afford the medicine."
Reaching remote communities
The mobility of the teams is crucial for increasing access to vital services in remote areas, preventing maternal deaths due to unsafe childbirth and high-risk pregnancies. Too often a lack of transportation means many simply cannot get to a health centre in time - or at all.
On average, a team will cover three different locations per week, spending one to two days in each, based on the community's size and needs.
"Even though I did not leave Khartoum during the war and continued working in its hospitals, this experience was different," explained Dr. Nahat.
"I reached far-away areas and connected with people I had not been able to reach before. It was a great morale boost for them to know there are organizations that care about them and are not leaving them behind."
