Louise Donovan
As the lead obstetrician in a hospital in the Sudanese city of Omdurman, Safa Ali helps dozens of patients a day. But there’s one she won’t easily forget.
Last August, a pregnant woman walked into the Al-Saudi Maternity Hospital drenched in blood. The latest to be caught up in the country’s brutal civil war, she had been shot. A bullet pierced her abdomen, injuring her unborn baby.
“It was one of the most challenging cases I’ve worked on,” says the 45-year-old, who made the BBC’s annual list of 100 inspiring women last month. “But they both survived.”
As a student, Ali was immediately drawn to obstetrics. You start with one patient, and you leave with two — what could be more joyful? Yet as the chaos and destruction of war shows no sign of abating, it’s become increasingly difficult to keep doing her work.
In December the International Rescue Committee named Sudan the country most likely to face an escalating humanitarian crisis in 2025, the second year the country has topped the annual list. Nationwide, the violence has displaced more than 11 million people, more than half of them women and girls.
The war has also taken a devastating toll on maternal and infant health. Newborn babies, pregnant women and new mothers are dying in “shocking” numbers in South Darfur, according to Médecins Sans Frontières, which described the situation as “one of the worst” maternal and child health emergencies in the world.
Hospitals have been attacked or damaged. Nearly a quarter of those offering emergency obstetric and newborn care no longer operate, according to Sufian Abdulmouty from the United Nations Population Fund (UNFPA) in Sudan.
“The conflict makes everything unpredictable,” says Ali. “The airstrikes, shelling and clashes put us all at risk.”
Like most doctors in Sudan, she has received no salary from the government since the start of the latest conflict in April 2023. Medical supplies have also been hit. Along with struggling to maintain basics like clean water and electricity, Al-Saudi is facing shortages of antibiotics, sutures, anesthesia and blood supplies, says Ali. This has a huge impact — surgeries are delayed and staff are forced to improvise with limited resources.
As Ali walks the hospital’s corridors, checking in on patients or preparing to perform cesarean sections, she’s aware staff often can’t provide the care a patient needs.
“It’s heartbreaking and frustrating to have to make decisions about prioritizing care when there’s just not enough to go around,” she says. “The stress takes its toll.”
Pregnant women urgently need better access to reproductive health services, says UNFPA’s Abdulmouty. The U.N. agency is investing in mobile health teams and midwives to bring essential care close to those in need.
Earlier in the conflict, shelling severely damaged the Al-Saudi hospital, says Ali, forcing her and her colleagues to relocate to a safer location. As the only functioning maternity hospital in the province, it was essential their services continue.
But work to fix the damage is underway. Ali is also training students in obstetrics to help mitigate the shortage of medical staff — knowing the next generation of doctors will continue this work brings her hope.
Despite the risk, she’s never thought about leaving. Not in any serious way, at least. Her patients and the country’s healthcare system — which is on the verge of collapse — need her.
“My role here feels more important than ever.”
Editor’s Note: This newsletter has been amended since publication. Ali works in the Al-Saudi hospital in Omdurman, not El Fasher.
