Study reports on destruction at medical schools in Sudan

During a three-month period of warfare in Sudan, just over half of the medical schools in three of the worst hit conflict zones were attacked, looted and even turned into military bases.

This highlighted the vulnerability of these institutions during the war and sent a message to the country’s Ministry of Higher Education, calling for urgent interventions to provide leadership, support, and oversight of the educational process in medical schools across Sudan.

This was reported in a study, ‘War and education: The attacks on medical schools amidst ongoing armed conflict, Sudan 2023’ published in Conflict and Health recently.

The authors are Esra Mahgoub and Hala Kamal of the International University of Africa, Amna Khairy of the Eastern Mediterranean Region network for public health, Samar Osman of the National University, Khartoum, Musab Haga of the National Ribat University, Khartoum, Sarah Osman and Abubker Abbu Hassan of University of Khartoum, and Ayia Babiker of the Imperial College London, Royal Hospital for Children and Young People, Edinburgh, Scotland.

The armed conflict, involving the Sudanese Armed Forces and the paramilitary Rapid Support Forces, erupted in mid-April 2023.

Study outcome

A cross-sectional study was conducted across 58 medical schools located in the states of Khartoum, Darfur, and Kordofan. Data on attacks between 15 April and 15 July 2023 were collected using an online data collection form.

The study indicated that more than half (58.6%) of all medical schools in conflict areas were attacked. Private institutions, constituting the majority of the study sample, were the most frequently attacked (70.6%). Of these, 52.9% were located in Sudan’s capital, Khartoum city.

The study showed that more than one form of attack was reported in 64.7% of the affected schools. Looting occurred in 73.5% of the attacked faculties, while 67.6% of them were converted into military bases.

Despite these challenges, 60.3% of the schools in the conflict zone managed to restore some educational processes through online learning and collaboration with other universities both within and outside the country.

Re-establishing medical education

To address the situation effectively, the study recommended that the ministry conduct a comprehensive on-ground assessment to determine the extent of the damage and estimate the cost needed to rebuild the medical education system.

“This would be a first step towards re-establishing the national educational landscape, ensuring the continuity of medical training, and minimising the adverse impact of warfare on the healthcare system,” the authors concluded.

Adil Mohamed Ali, the head of the institutional development programme at the Sudanese Environment Conservation Society, and a coordinator with the United Nations Development Programme, or UNDP, told University World News that, besides a post-conflict assessment of the medical schools, Sudan’s Ministry of Higher Education should also re-examine the status of the medical schools and their capacities to function again in a satisfactory manner as there were high levels of human resource depletion.

“It is far better to have fewer medical institutions that provide high-quality education,” Ali stressed.

Sudan has 51 public medical schools, according to The World Directory of Medical Schools. The study sample looked at public and private institutions in three states only.

“A national and international campaign should be launched for the rehabilitation of the affected medical higher education institutions,” Ali suggested.

Post-war medical schools recovery

Professor Mohamed Hassan, the president of the Sudanese National Academy of Sciences and the World Academy of Sciences in Italy, told University World News: “After the war ends, a thorough evaluation of the severe effects of the conflict in Sudan on the infrastructure, as well as the research and education facilities within medical faculties and schools in conflict zones will ascertain the magnitude of destruction and, therefore, help in formulating both an immediate and extended plan … [to] restore the operational standards of medical schools.

“It is also important to devise a strategy to facilitate the return of displaced faculty members and students from medical institutions, many of whom have sought refuge in neighbouring countries,” Hassan added.

A 2023 study, ‘The impact of the 2023 armed conflict on Sudan’s healthcare system’, stated: “The deployment and distribution of the health workforce have become challenging and may lead to a further brain drain of healthcare professionals.”

According to Hassan, rebuilding endeavours will necessitate significant efforts to secure the required funding to reconstruct the facilities and equip them with modern medical equipment essential for education and research.

“Additionally, enhancing the capabilities of medical schools in contemporary digital technologies, especially artificial intelligence and its applications in medical research and education, is crucial,” Hassan said.

“Toward this objective, it is critical for medical schools to establish partnerships and twinning programmes with counterparts across the globe, both from developed and developing regions, to assist in the revitalisation of infrastructure, teaching, and research activities.

“This collaborative approach will not only expedite the recovery process, but also ensure the integration of global best practices and innovations in medical education and research within the recovering institutions,” Hassan added.

Hassan’s views align with the 2023 study entitled, ‘Consolidating Medical Education in Sudan During War’, which stated that implementing collaborative strategies and innovative approaches will help Sudanese medical schools “overcome challenges during armed conflicts and maintain quality medical education”.

Similarly, a 2024 study, ‘The implications of the Sudan war on healthcare workers and facilities: A health system tragedy’, stated that international collaboration and sufficient financial support are crucial to restore the healthcare system in Sudan.