A surge in deaths in Sudan camps points to coronavirus’ invisible spread

CAIRO  —  In the sprawling refugee camps of Darfur, the war-scarred western region of Sudan, officials say the elderly are falling sick and dying at astonishing rates.

In North Darfur’s provincial capital of El Fasher, some say they scroll through a dozen death announcements each day: another old friend, a relative, a community leader lost with dizzying speed.

Doctors in the region’s few functioning hospitals report an influx of patients with symptoms such as a lost sense of taste, breathing troubles and fevers. The official causes of their untimely deaths remain “unknown.”

Humanitarian workers and medical personnel believe the coronavirus is spreading unchecked and untracked through Sudan’s most marginalized territory, where medical facilities are few and far between and where years of conflict have left some 1.6 million people crammed into refugee camps.

Nationwide, Sudan has officially reported 6,879 coronavirus infections and 433 deaths, according to the Health Ministry. Of those, 193 cases and 54 fatalities have been confirmed across Darfur — a figure experts believe is a vast undercount.

Since the beginning of the pandemic, public health officials have sounded the alarm that the coronavirus will take a disastrous toll on the world’s most vulnerable regions, particularly refugee camps, where social distancing, even hand washing, prove impossible.

“People in the camps are suffocating, they can’t breathe,” said Mohamed Hassan Adam, director of the Abushouk displacement camp in North Darfur. Just a corner of the camp saw 64 unexplained deaths in one month, he said. His four neighbors, all in their 60s, grew feeble and vanished one by one.

“They get exhausted then they die. There is no way to tell what happened,” he said.

Authorities are scrambling to curb the spread of contagion amid a fragile democratic transition after massive protests last year toppled longtime autocrat Omar Hassan Ahmed Bashir.

“We are in the eye of the storm,” said Ashraf Issa, spokesman for the U.N.-African Union peacekeeping force in Darfur, referring to the country’s exponential surge in infections.

Sudan’s healthcare system is in disarray after years of war and sanctions. Dire shortages of protective equipment and staff nationwide have prompted strikes by medical workers as infections rise in their ranks. A drastic undersupply of drugs and hard currency forces the sick to purchase essential medicine out of pocket. A lack of fuel has made it increasingly difficult for doctors and patients to reach hospitals.

“These are the problems that Sudan faces everywhere, but in Darfur it is more severe,” said Dr. Babikir El Magboul, director of the Health Ministry’s Emergency and Epidemiology Department. “It’s like a separate continent.”

Many in Darfur’s camps are undernourished and weakened by infectious diseases, including malaria and acute diarrhea. At the Abushouk camp, each bathroom is shared by dozens of people. Around the territory, markets and mosques — along with a growing number of funerals — continue to draw crowds.

Darfur, with a population of 9 million, has only about 600 health facilities, or one per 15,000 people. With facilities scattered over an area the size of Spain, residents in rural areas must travel long distances to reach one. Doctors say quarantine centers have no more than a few dozen beds, two or three ventilators and cheap gowns and surgical masks for protection equipment.

Before a new testing center opened this month in Nyala, South Darfur, testing was centralized in one laboratory in the capital, Khartoum, which processes only about 270 samples each day. Health workers in Darfur say that results can take a week to come through.

To fill the gap, some local doctors are working to grasp the virus’ toll.

When El Fasher saw a surge of more than 200 “mysterious” fatalities in just two weeks, officials launched an investigation. Dr. Taher Ahmed, deputy dean of El Fasher University’s medical college, attributed about 50 fatalities to COVID-19, but said it was still probably an undercount. Doctors in West and Central Darfur provinces also reported an unusual increase in deaths.

Dr. Abdullah Adam, a radiologist, said he knew of 47 acquaintances who died in the last month after showing coronavirus symptoms in villages around Kabkabiya, near El Fasher. Among them were two of his uncles, he said. One family he knew lost a brother and sister in the same week.

Some camps in the north saw 10 to 15 people a day dying in the last week, compared with the normal rate of five to 10 a month, said Adam Regal, spokesman for a local organization that runs some camps.

“We’re losing a whole generation,” said Gamal Abdulkarim Abdullah, director of the Zam Zam camp. He said he documented 70 dead in the last week.

“The sharp mortality increase in Darfur is mostly linked to COVID-19, although not purely,” said El Magboul. Amid the pandemic, people with other illnesses are struggling to find treatment. Yousef Saleh, the 70-year-old leader of El Fasher’s Great Mosque, died this month because he couldn’t receive his usual diabetes care.

Darfur’s violent past has bred distrust that further corrodes government health efforts.

Conflict flared in the territory when African minority rebels launched a revolt in 2003 over oppression by Bashir’s Arab-dominated government. Bashir waged a brutal counterinsurgency campaign, including mass rapes and killings. The trauma remains even after Bashir’s fall.

Camp residents think the coronavirus is a conspiracy to “keep people in their homes where the old regime can come and kill them,” said Abdullah, Zam Zam’s director.

Hassan Adam of Abushouk scoffed when asked whether people call the government hotline to report suspected cases. “The government barely knows we exist,” he said.

It hasn’t helped that local authorities have clamped down on reporting. After two female journalists published an article about the high mortality rate and lack of protective equipment for doctors in El Fasher, they were promptly harassed and threatened with arrest by a military officer, according to the Darfur Journalist Assn.

Many saw the incident as an ominous sign.

“When people are in the dark, they don’t take things seriously,” Dr. Abdullah Adam said. “I fear the worst is yet to come.”