Dr Mohja Khairallah is a family physician and palliative care specialist at the Khartoum Oncology Hospital in Sudan. She founded the Comboni Palliative Care Volunteers (CPCVs) and recently led palliative care trainings in Mauritania through Cairdeas Sahara. During this last week of April 2023, she shared her observations and reflections on the need of palliative care – and peace – in Sudan.

Note that accompanying photos are taken before 2023 during a time of peace in the Khartoum area.

Since 15th April (the first day of our social unrest) I've been locked in my small town 40 km south of Khartoum, Sudan where I live with my family, and we are all safe physically (thank God). I have cared for three patients with different neurological conditions at their home, with no resources, in this time. Unfortunately, I lost two of them because they couldn't get the hospital care (ICU) that they needed; we thank God the third one is stable and well. The current need for palliative care is the greatest ever.

1. For cancer patients:

Unfortunately, opioids have not been available for the last 4 months, and now even the access to the alternative available pain killers, cancer treatment, and face to face support are no longer possible, especially in the capital city.

2. For patients with medical emergencies, injuries, and chronic diseases:

Most of the hospitals are out of service or closed, due to lack of medicine, that the staff cannot reach the hospitals and insecurity. Death is everywhere, with very sick patients who have left the hospitals, HDUs & ICUs and have died in the community (homes).

3. The death of innocent people and the smelly dead bodies thrown in the streets cause a lot of pain and worries for families and communities. 

4. Lack of basic life needs (water, food, security) makes people terrified. Now, a lot of Sudanese are leaving the country to face a new suffering of becoming refugees.

5. Telemedicine is no longer an option to provide palliative/medical care since the networks and tele. companies have no /or interrupted services.

I've tried to help my people and wrote a letter to our local community and army leaders asking for their support, protection, and contribution in establishing a volunteer clinic for patients with chronic diseases (including cancer). This clinic would aim to provide simple palliative and medical care and follow-up services safely, while reducing the workload for the only functioning hospital in the area.

But as you know, a such process to set up a volunteer clinic can take time, especially in times of war. Yet I am waiting for their positive response.

Lately I have noticed in myself and most of my friends, that watching news on some channels have increased our sadness, tension, and fear.

After a while we discover that the news channels only amplify these feelings, so we have decided to engage the news of reality. That is, the news based on what we see with our eyes (the streets are clear) and what we hear from others. (I call my loved ones in different areas, and they reassure me about their wellbeing, their family, and their neighbourhood.)

Really, the news of reality is different.

And this is my wish to you: Keep your inner peace and mental safety. We will have a homeland tomorrow; we want to build Sudan.