Science1 publisher3 min readPublished
Sudan's cancer patients travel hundreds of miles to a hospital that has no oncologist
The U.N. counts 205 attacks on Sudanese health facilities since 2023, and the WHO puts 37 percent of health centers destroyed. Neither number says how much cancer treatment is left, or where a patient can still get chemotherapy.
The Scientist · Science desk
What happened
- The United Nations has documented 205 attacks on health care facilities in Sudan since the civil war began in 2023, when two rival factions fought for control of the country's military.
- The World Health Organization reports that some 37 percent of Sudan's health care centers have been destroyed by fighting, with frequent attacks on civilian doctors, clinics and ambulances.
- Fatouma Mahdi Ahmed Saeed, diagnosed with cervical cancer by a private doctor in Nyala, travelled hundreds of miles to Mother of Mercy hospital in central Sudan, a hospital with no oncologist on staff.
- Tom Catena, who trained in family medicine, is the only permanent surgeon in the Nuba Mountains, a territory the size of Austria, and has run its largest hospital for more than a decade.
- On the day STAT visited earlier this year, Catena and his staff gave some 15 doses of chemotherapy to patients who had nowhere else to go.
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Why it matters
- constraint The hospital cannot read its own biopsies, so every cancer diagnosis it makes depends on a tissue shipment leaving a war zone for a laboratory in the United States.
- exposure With Nyala's hospitals destroyed or badly damaged, a diagnosis there now comes from a private doctor. The first step of cancer care has become a cash purchase for the household.
- cost Doctors Without Borders puts aid cuts alongside the fighting as a cause of collapse. The surviving mission hospitals absorb the patients the funded system no longer reaches.
- decision Funders weighing trauma capacity against chronic disease are looking at a procurement problem: a caseload that needs cytotoxic drugs, pathology and repeat visits.
The U.N.'s tally dates from the start of the fighting in 2023, and STAT published its report on Sept. 18, 2026 [1][2][3]. The span is between roughly 32 and 45 months, depending on which month of 2023 the war began. The rate is between about 4.6 and 6.3 attacks on a health facility a month, no fewer than about one a week [4]. Both sides have been accused of indiscriminately targeting hospitals and clinics [6].
A count of attacks and a count of surviving facilities are different measurements. Repeat strikes on one hospital raise the first number without changing the second, and a national referral center and a rural dispensary each add one. The WHO's 37 percent has the mirror-image limitation, because a share of centers weights every center alike [5]. Cancer treatment was never spread evenly across them. "If there was peace, they would have gotten treated in Khartoum, Darfur, or El Obeid. Now those hospitals are gone," Catena said [7].
The figure a health planner needs is how many patients require chemotherapy and how many places can still give it. There are no recent numbers for cancer deaths in Sudan [11]. The nearest available measure is continental and predates most of the war: the WHO recorded 560,000 cancer deaths across Africa in 2022 [12]. Against that, the U.N. counts 13 million people driven from their homes in what it calls the world's largest displacement crisis [22]. Catena calls the cancer patients in his crowded wards "indirect casualties of war" [23], and of other conflicts he said "all those sick people are still there" [24].
Mother of Mercy has no equipment to review biopsies, so tissue samples go to the United States [14]. Chemotherapy medication and other essential drugs are hard to come by, and conflict has disrupted normal supply chains, according to a 2025 paper in the journal Global Oncology, which also records that Sudan was once a regional leader in cancer care [15]. Doctors Without Borders said this month that international aid cuts are "forcing the collapse of an already fragile health care system" [16]. Essential services have been slow to return even with support from international health charities [26].
Saeed sold one of her calves and asked her family for money to pay the private doctor who diagnosed her [18]. She traveled first from Darfur into South Sudan with her sister and son, eating meals cooked from flour, stopped at checkpoints, with drones overhead [19]. Turned away, the family went on to the Nuba Mountains.
"I was in a lot of pain and desperate to get treatment," she said. "The journey was very difficult, but I was not scared. I kept going. I know my day will come when God decides." [20]
She has since returned for a follow-up, gone home to Darfur, and come back for another round of chemotherapy. Catena does not know if he will be able to cure her [21].
What to watch
- Whether the U.N. or the WHO breaks its attack count down by facility type, so planners can see whether referral hospitals or village clinics took the hits.
- Any Sudan-specific cancer incidence or mortality estimate produced during the war, which would replace a continental 2022 figure as the planning baseline.
- Whether the drug scarcity described in the 2025 Global Oncology paper eases if aid funding is restored.