Children are dying in droves at an orphanage in Khartoum as a direct result of the Sudanese civil war.
On April 15, the army chief and the paramilitary Rapid Support Forces (RSF) went to war in Khartoum.
After the fighting broke out in Khartoum, Dr. Abeer Abdullah hurried from room to room at Sudan’s largest orphanage, trying to care for hundreds of infants and toddlers who had been abandoned by their families. She reported that loud gunfire rocked the area while children’s cries echoed through the vast edifice.
And then there were death waves. Mygoma, the state-run orphanage, had floors dedicated to housing infants. The doctor indicated that they died of severe hunger and dehydration since there wasn’t enough staff to care for them. Some of the already vulnerable neonates in her medical clinic on the ground floor developed a high fever and died, she claimed.
They required three hourly feedings. When I called the orphanage, Abdullah remarked, “There was no one there,” with the sobs of crying babies audible in the background. We attempted intravenous therapy, but the kids were usually beyond help.
Abdullah reported that the number of daily fatalities had risen to “two, three, four, and higher.” According to Abdullah, the orphanage has lost at least 50 children, including at least two dozen infants, in the six weeks since the violence broke out in mid-April. She reported that on Friday, May 26th, at least 13 infants had died.
A top administrator at the orphanage corroborated those numbers, and a surgeon who volunteered at the facility during the war reported that many dozen orphans had perished there. A majority of the victims, they both agreed, were infants and little children younger than a year old. Malnutrition, dehydration, and infections were highlighted by all three experts.
This last weekend had many more fatalities than usual. Heba Abdullah, a former orphan turned caregiver, provided Reuters with copies of seven death certificates dated Saturday and Sunday. Death was attributed to circulatory failure in every case, with fever, malnutrition, or sepsis mentioned in all but one cases.
Infants found dead in their cots have been “terrifying,” as described by Abdullah. “It hurts like hell.”
According to Reuters’ interviews, eight additional people have been to the orphanage since the conflict broke out, or have been in contact with those who have. Conditions have worsened drastically, and the death toll has increased.
Among them is Siddig Frini, general manager of the ministry of social development in the state of Khartoum, which is responsible for the financial and human resources management of care facilities. There have been more deaths at Mygoma, he admitted, but he blamed the uptick on personnel shortages and frequent power outages due to the conflict. Ceiling fans and air conditioners that don’t function are useless in the oppressive heat of Khartoum in May, and the lack of electricity makes it difficult to sterilize medical equipment.
When asked about the number of fatalities, Frini and Zeinab Jouda, the orphanage’s director, deferred to Abdullah, Mygoma’s medical head. Jouda told Reuters she knew of more than 40 deaths; she blamed the fighting for the absence of nannies and other staff during the conflict’s earliest days. She stated on Friday, May 26 that plans to evacuate children from Khartoum are still being discussed.
The head of emergency operations for Sudan’s health ministry, Mohammed Abdel Rahman, has stated that a team is looking into the situation in Mygoma and that the findings will be made public once they are complete.
The neighborhood is still risky. Abdullah, a doctor, and two others claim that the area around Mygoma was hit by warplanes and artillery late last week. Heba Abdullah, a caretaker at the orphanage, reported that she had to evacuate infants from one of the rooms because of an explosion in a nearby building.
Invisible casualties of a greater conflict
The murdered infants of Mygoma are among the unseen casualties of the conflict in Sudan, the third-largest country in Africa. The United Nations estimates that over 700 people have been killed and thousands more injured as a result of the violence, and that at least 1.3 million people have been forced to flee their homes in Sudan or neighboring countries.
The actual number of fatalities is almost certainly higher. Many government and medical facilities in Khartoum, where fighting has been fiercest, have shut down and are no longer able to keep tabs on casualties. The city of El Geneina in Darfur region, where violence has also erupted, has seen hundreds of deaths, according to the Sudanese health ministry.
On April 15, fighting broke out in Khartoum between army leader Abdel Fattah al-Burhan and Mohamed Hamdan Dagalo, also known as Hemedti, the commander of the paramilitary Rapid Support Forces (RSF). They were getting ready to endorse a new political transition to elections run by a civilian government. In a coordinated coup in October of 2021, they were able to overthrow a civilian administration.
Humanitarian aid could be delivered after both parties agreed to a seven-day ceasefire on May 20. The agreement reduced fighting in the Sudanese capital, but it did not significantly enhance aid.
Requests for comment from the army and RSF were not returned.
The roughly 49 million people who call Sudan home live in one of the world’s poorest nations. Healthcare and other facilities, like as hospitals and airports, were already at capacity before the combat began. Prior to the conflict, about sixteen million people were in need of humanitarian aid. The United Nations reports that number has increased to 25 million. According to the World Health Organization, over two-thirds of hospitals in conflict zones are closed.
The battle forced the personnel of al-Dayat, Sudan’s largest maternity hospital, to evacuate in late April, according to general manager Emad Abdel Moneim. He explained that many patients were transferred, but those who required ventilators or incubators had to be left behind. In order to safely evacuate them, high-quality ambulances would have been required. He estimated that nine infants had passed away, in addition to an unknown number of adults who had been in the ICU. Two more individuals corroborated that patients were abandoned, although they reported knowing nothing about any fatalities.
Abdel Rahman, an official with the national health ministry, denied knowing anything about any deaths at the maternity facility, expressed skepticism that any patients had been abandoned, and declined to provide any other information.
According to care worker Radwan Ali Nouri, deaths have also occurred at an aged care center in Khartoum, highlighting the impact on the health of Sudanese of all ages. He reported that five of the old people living at the al-Daw Hajoj center had just passed away from malnutrition and neglect. Nouri showed a single snapshot of what he claimed to be the deceased resident’s wrapped body.
Frini, an official with Khartoum’s state department of social development, claimed that the number of recorded deaths at the retirement home was within the “normal rate,” and he also refuted rumors that any of the inmates had died of starvation.
Attia Abdullah, secretary general of the Sudanese Doctors’ Syndicate, a doctors’ union, indicated that the number of deaths due to violence was a small fraction of the total number of deaths. Every day, the health situation gets worse, he claimed.
Lost and forgotten kids
The orphanage is located in a three-story structure in the heart of Khartoum, and its official name is The Orphan’s Care Centre, Mygoma. You can hear the gunfire from here. Employees and volunteers report hearing gunfire inside the structure. One doctor mentioned that newborns used to sleep on the floor, far from any windows.
The international medical charity Doctors Without Borders (MSF) reports that since its founding in 1961, Mygoma has cared for hundreds of newborns annually. Having a child outside of wedlock is frowned upon in the mostly Muslim country of Sudan.
Mygoma was a troubled place even before the war. About 400 youngsters, many of them infants, lived there. The orphans are housed in overcrowded conditions; according to the orphanage director and MSF nurses who worked at Mygoma in 2016, there are an average of roughly 25 children per room, and babies often lie two or three to a crib. They stated that many children are in bad health upon arrival.
There have been periods of increased mortality at the orphanage. Hygiene issues, low wages, staffing gaps, and insufficient funding for healthcare have plagued the region, as reported by MSF.
According to MSF, the orphanage’s mortality rate in Mygoma reached nearly 75% in 2003. Authorities told Reuters in 2007 that 77 children had died at Mygoma in September of that year; a charity involved with the orphanage at the time speculated that this was due to an influx of sick infants.
After the monthly death toll averaged roughly 12, MSF says it stepped in to help again in 2021 and 2022, providing additional funding to compensate caretakers and refer unwell children to hospitals. According to MSF, the death toll dropped by around half at that time.
The majority of the orphanage’s staff stayed at home when the war broke out. Doaa Ibrahim, the orphanage’s doctor, said that there were only about 20 nannies to care for the roughly 400 kids at Mygoma. A one-to-twenty ratio, to be exact. She and others estimated that the typical ratio was somewhere around one to five.
“I worked as a nanny, nurse, and doctor, feeding one baby, giving antibiotics to some, and changing diapers for others,” Dr. Ibrahim explained. While resting, she worried about “how many I would find dead when I woke up.”
Ibrahim claimed that four days into the fight, she had to leave Mygoma because she had fallen from weariness and a fever. And she finished by saying, “God forgive us if we didn’t do our best.”
Everyday infant mortality”
More kids were brought into the orphanage, which only made things harder. Dr. Abdullah reports that during the first week of the conflict, two care centers sent scores of older girls and boys to Mygoma, and hospitals returned roughly 10 babies who had been sent out for treatment by the orphanage’s medical staff.
Surgeon Abdullah Adam volunteered at the orphanage for the first five weeks of the conflict. Dr. Adam made a public call for volunteers to come help him feed the infants in the first week. There were a few takers, but he said no pediatricians among them.
Adam warned that as long as the conflict persisted, resources would be limited and employees would be hesitant to return for fear of being caught in the crossfire. On May 10th, he was speaking with Reuters and held out his phone to record the sound of shelling.
Nothing less than a militarized zone exists in Khartoum, he declared.
The orphanage official and Dr. Ibrahim both reported that the babies were left in dirty diapers without enough caregivers, making them vulnerable to skin rashes, infections, and fever. The severe heat of Khartoum, which has reached about 43 degrees Celsius (110 degrees Fahrenheit) this month, is adding to the children’s discomfort.
“We are losing babies daily,” reads a May 16 Facebook post by Hadhreen, a non-governmental organization assisting to raise funds for Mygoma’s staff and supplies. Aged between six and eighteen months. These symptoms are identical. Very high temperature. After four hours, God, who is more generous than any of us, takes the souls of the innocent away.
Both Dr. Ibrahim and the orphanage’s official indicated that the deceased children’s bodies are washed and wrapped in white fabric in a room close to the orphanage’s gates.
The conflict follows the kids even after they die. Marine Alneel, who has been working at Mygoma for the past few weeks, said that orphans were formerly buried in a cemetery to the west of the city, but that it is now too hazardous to travel there. The orphanage official stated that the staff had begun using a new cemetery located to the northeast of the facility.
Dr. Abdullah stated Thursday over the phone that transporting the dead there has also become risky. She revealed that two infants who had passed away the day before were not interred at the orphanage but rather in a city square nearby. The doctor also noted that six civilians had been killed in adjacent shelling.
