All but a few hospitals in Sudan’s capital, Khartoum, have closed down because of the conflict raging there. Those that remain open often run out of power, making giving birth an even more stressful experience than usual for both the women and the healthcare workers trying to help them – especially if surgery is needed.
“We’re relying on lights from mobile phones to perform a Caesarean,” obstetrician Dr Howaida Ahmed al-Hassan said on a video shared with the BBC.
She recorded the footage as she was operating on a mother-to-be.
Her gloved hands can be seen applying pressure to the patient’s chest and stomach as the Caesarean takes place.
The medics present – all women – surround Dr Hassan and hold their phones up to illuminate the area where an incision has been made.
Dr Hassan was one of the handful of obstetricians who remained at Alban Jadeed Hospital, in the north of Sudan’s capital, Khartoum, for three consecutive weeks after heavy fighting erupted between military factions in April.
In the video she sent to the BBC, she showed wards with nurses assisting mothers giving birth under extremely tough conditions.
“The situation is really bad. We’ve stayed in the hospital for days and days. We’ve completely lost any sense of time. We don’t know if it’s day or night,” Dr Hassan said.
“There is minimum medical staffing in the hospital, and in many cases the electricity cuts out and we have no gasoline to operate the generators for Caesareans.”
She said the maternity ward in her hospital was packed with women in dire need of emergency obstetric care, many requiring Caesareans.
“We have taken high risks performing these Caesareans in dimly lit operating theatres. We do not have enough resources.
“We work in the absence of general anaesthesia consultants and specialists. We’ve had to discharge women only 10 hours after each Caesarean delivery.”
In April, the UN Population Fund estimated 219,000 pregnant women were believed to be at risk, as heavy fighting raged around Khartoum, interspersed by fragile and failed ceasefires.
Near the beginning of the fighting it said that around 24,000 would give birth “in the coming weeks”.