For three years, Dr Jamal Eltaeb faced an unimaginable dilemma: who among the wounded would live, and who might die? Should he operate without essential medicines if it offered a glimmer of hope? How would he even secure the fuel to keep the hospital’s lights on?
As Sudan’s brutal conflict raged around him, only one decision remained clear: he would keep working.
The orthopaedic surgeon was at the helm of Al Nao hospital in Omdurman, on the outskirts of the capital, Khartoum, as control of the urban area swung between the Sudanese army and paramilitary forces. With the front line drawing ever closer and the hospital overflowing with casualties, many of his colleagues lost their resolve and fled.
Dr Eltaeb, soft-spoken yet resolute, was one of the rare surgeons who remained. He stayed even as the hospital endured multiple bombings and as most medical supplies dwindled to nothing.
“I weighed the options of staying here, and taking care of your patients and helping other people that need you as a skilled surgeon, rather than choose your own safety,” he told The Associated Press.
He stands as one of countless Sudanese citizens who have stepped up to help, even as the world’s attention is largely diverted by conflicts in the Middle East and Ukraine.
Dr Eltaeb has witnessed first-hand the human cost behind the estimates of tens of thousands killed, and the daily, excruciating reality of a health system that the United Nations warns is on the brink of collapse.
Nearly 40 per cent of Sudan’s hospitals are now non-functional, many having been stripped for parts or repurposed as bases by armed groups. Al Nao, now that Sudan’s army has retaken the capital, remains one of the area’s few operational health centres.
Walking through the hospital complex, the 54-year-old surgeon showed AP journalists the scars of some of the most challenging months of his life. He pointed to a window struck by shelling, which killed a patient’s relative, and to the last remaining tent in the courtyard, one of many erected during the conflict’s peak to manage mass casualties.
“We were working everywhere, in tents, outside, on the floor, doing everything to save patients’ lives,” he recounted.
His unwavering dedication earned Dr Eltaeb the $1m Aurora Prize for Awakening Humanity, an award that recognises individuals who risk their lives to save others. He has since donated a portion of the prize money to medical and humanitarian organisations globally.
Before the war, Al Nao was a quiet facility, its nearly 100 beds often empty. But when fighting erupted in Khartoum in April 2023 and the paramilitary Rapid Support Forces (RSF) seized swathes of the city, patients began to pour in. Dr Eltaeb’s own hospital elsewhere closed shortly after the conflict began, prompting his move to Al Nao. By July, most of the staff had fled, leaving him in charge.
He, along with a handful of employees and volunteers, struggled to keep the facility running. Electricity was cut for weeks, with the hospital relying on the army to supply fuel for its generators. Essential medicines, including antibiotics and painkillers, quickly ran out.
In August, just a month after Dr Eltaeb took charge, the hospital was hit for the first time. “From that moment, we knew that we are a target… And from that time, they didn’t stop targeting us,” he said. The RSF subsequently struck the hospital three more times.
Normality had completely crumbled. A father of three, Dr Eltaeb would sit in his office, offering sweets to a constant stream of patients and staff vying for his attention. Decisions became almost impossible.
On one particularly harrowing day in late 2024, he and his team frantically triaged over 100 wounded people after a strike hit a nearby market. Eight of them died.
“You choose… as if you can choose who is going to live and who is going to die,” he reflected.
The day only worsened as Dr Eltaeb faced the grim choice of whether to amputate on children without full anaesthetic, as they were bleeding heavily and there was no time to move them to an operating theatre.
Using only local anaesthetic, he removed an arm and a leg from a nine-year-old boy, and a leg from his 11-year-old sister. He now scrolls through photographs of such surgeries on his phone, attempting to convey a horror few can truly grasp.
The hospital’s survival also depended heavily on volunteers who ensured supplies kept flowing. They would post their needs on social media, prompting pharmacists to provide keys to their long-closed shops, allowing volunteers to collect medicines and other items for free.
One volunteer, Nazar Mohamed, spent months cycling around Omdurman, often under the sound of explosions, delivering vital supplies. Further donations arrived from organisations and individuals abroad, while a network of Sudanese doctors overseas offered remote advice on managing mass casualties or coping with dwindling supplies of antibiotics and anaesthetics.
The remaining hospital staff became resourceful, crafting beds and crutches from wood and using clothes as makeshift splints in place of gauze.
As the fighting has shifted away from the Khartoum area, some funding-strained organisations that once supported Al Nao are now redirecting their aid to more acutely needy locations.
Dr Eltaeb confirmed that the hospital has sufficient funds to cover salaries and generator fuel until June, but will require approximately $40,000 (£31,500) per month to remain operational thereafter.
While some countries have pledged support for Sudan’s reconstruction, there is growing concern that the war in Iran might divert international attention and resources, particularly from Gulf countries that had vowed to assist the nation’s recovery.
Many hospitals, far more severely damaged than Al Nao, lie in ruins and require significantly greater assistance. Across town, Dr Osman Ismail Osman, director of Al Shaabi hospital, stated that the several hundred thousand dollars provided by the government is merely a “drop in the bucket”.
His hospital was occupied by the RSF during the war, leaving behind piles of dusty, broken medical equipment worth millions and concrete chunks scattered among metal beds.
The goal of reopening the badly damaged Al Shaabi hospital for emergency referrals within weeks is ambitious, yet medical professionals like Dr Eltaeb have become adept at confronting the impossible.
“I believe I did my best as a doctor as a Sudanese,” the surgeon concluded.
