What Lies Ahead for Ukraine’s Contested Zaporizhzhia Nuclear Power Plant?https://english.aawsat.com/features/5223621-what-lies-ahead-ukraine%E2%80%99s-contested-zaporizhzhia-nuclear-power-plant
What Lies Ahead for Ukraine’s Contested Zaporizhzhia Nuclear Power Plant?
A Russian service member stands guard at a checkpoint near the Zaporizhzhia Nuclear Power Plant before the arrival of the International Atomic Energy Agency (IAEA) expert mission in the course of Russia-Ukraine conflict outside Enerhodar in the Zaporizhzhia region, Russian-controlled Ukraine, June 15, 2023. (Reuters)
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What Lies Ahead for Ukraine’s Contested Zaporizhzhia Nuclear Power Plant?
A Russian service member stands guard at a checkpoint near the Zaporizhzhia Nuclear Power Plant before the arrival of the International Atomic Energy Agency (IAEA) expert mission in the course of Russia-Ukraine conflict outside Enerhodar in the Zaporizhzhia region, Russian-controlled Ukraine, June 15, 2023. (Reuters)
The Zaporizhzhia nuclear power plant, Europe's largest, is one of the main sticking points in US President Donald Trump's peace plan to end the nearly four-year war between Russia and Ukraine. The issue is one of 20 points laid out by Ukrainian President Volodymyr Zelenskiy in a framework peace proposal.
Here are some of the issues regarding the facility:
WHAT ROLE MAY THE US PLAY?
Russia took control of the plant in March 2022 and announced plans to connect it to its power grid. Almost all countries consider that it belongs to Ukraine but Russia says it is owned by Russia and a unit of Russia's state-owned Rosatom nuclear corporation runs the plant.
Zelenskiy stated at the end of December that the US side had proposed joint trilateral operation of the nuclear power plant with an American chief manager.
Zelenskiy said the Ukrainian proposal envisages Ukrainian-American use of the plant, with the US itself determining how to use 50% of the energy produced.
Russia has considered joint Russian-US use of the plant, according to the Kommersant newspaper.
WHAT IS ITS CURRENT STATUS?
The plant is located in Enerhodar on the banks of the Dnipro River and the Kakhovka Reservoir, 550 km (342 miles) southeast of the capital Kyiv.
The Zaporizhzhia nuclear power plant has six Soviet-designed reactors. They were all built in the 1980s, although the sixth only came online in the mid-1990s after the collapse of the Soviet Union. It has a total capacity of 5.7 gigawatts, according to an International Atomic Energy Agency (IAEA) database.
Four of the six reactors no longer use Russian nuclear fuel, having switched to fuel produced by then-US nuclear equipment supplier Westinghouse.
After Russia took control of the station, it shut down five of its six reactors and the last reactor ceased to produce electricity in September 2022. Rosatom said in 2025 that it was ready to return the US fuel to the United States.
According to the Russian management of the plant, all six reactors are in "cold shutdown."
Both Russia and Ukraine have accused each other of striking the nuclear plant and of severing power lines to the plant.
The plant's equipment is powered by electricity supplied from Ukraine. Over the past four years these supplies have been interrupted at least eleven times due to breaks in power lines, forcing the plant to switch to emergency diesel generators.
Emergency generators on site can supply electricity to keep the reactors cool if external power lines are cut.
IAEA Director General Rafael Grossi says that fighting a war around a nuclear plant has put nuclear safety and security in constant jeopardy.
WHY DOES RUSSIA WANT ZAPORIZHZHIA PLANT?
Russia has been preparing to restart the station but says that doing so will depend on the situation in the area. Rosatom chief Alexei Likhachev has not ruled out the supply of electricity produced there to parts of Ukraine.
Oleksandr Kharchenko, director of the Energy Research Center in Kyiv, said Moscow intended to use the plant to cover a significant energy deficit in Russia's south.
"That's why they are fighting so hard for this station," he said.
In December 2025, Russia's Federal Service for Environmental, Technological and Nuclear Supervision issued a license for the operation of reactor No. 1, a key step towards restarting the reactor.
Ukraine's energy ministry called the move illegal and irresponsible, risking a nuclear accident.
WHY DOES UKRAINE NEED THE PLANT?
Russia has been pummeling Ukraine's energy infrastructure for months and some areas have had blackouts during winter.
In recent months, Russia has sharply increased both the scale and intensity of its attacks on Ukraine's energy sector, plunging entire regions into darkness.
Analysts say Ukraine's generation capacity deficit is about 4 gigawatts, or the equivalent of four Zaporizhzhia reactors.
Kharchenko says it would take Ukraine five to seven years to build the generating capacity to compensate for the loss of the Zaporizhzhia plant.
Kharchenko said that if Kyiv regained control of the plant, it would take at least two to three years to understand what condition it was in and another three years to restore the equipment and return it to full operations.
Both Ukrainian state nuclear operator Energoatom and Kharchenko said that Ukraine did not know the real condition of the nuclear power plant today.
WHAT ABOUT COOLING FUEL AT THE PLANT?
In the long term, there is the unresolved problem of the lack of water resources to cool the reactors after the vast Kakhovka hydro-electric dam was blown up in 2023, destroying the reservoir that supplied water to the plant.
Besides the reactors, there are also spent fuel pools at each reactor site used to cool down used nuclear fuel. Without water supply to the pools, the water evaporates and the temperatures increase, risking fire.
An emission of hydrogen from a spent fuel pool caused an explosion in Japan's Fukushima nuclear disaster in 2011.
Energoatom said the level of the Zaporizhzhia power plant cooling pond had dropped by more than 15%, or 3 meters, since the destruction of the dam, and continued to fall.
Ukrainian officials previously said the available water reserves may be sufficient to operate one or, at most, two nuclear reactors.
Trump Shattered Canada’s Old US Relationship. Carney is Building a New One in Europehttps://english.aawsat.com/features/5320726-trump-shattered-canada%E2%80%99s-old-us-relationship-carney-building-new-one-europe
FILE- Canada's Prime Minister Mark Carney, front left, speaks with European Commission President Ursula von der Leyen at the European Parliament in Strasbourg, eastern France, Thursday, Sept 17, 2026. (AP Photo/Pascal Bastien, File)
Trump Shattered Canada’s Old US Relationship. Carney is Building a New One in Europe
FILE- Canada's Prime Minister Mark Carney, front left, speaks with European Commission President Ursula von der Leyen at the European Parliament in Strasbourg, eastern France, Thursday, Sept 17, 2026. (AP Photo/Pascal Bastien, File)
For nearly four decades, Canada built its economy around closer integration with the United States. President Donald Trump has turned that dependence into leverage, imposing tariffs, threatening Canada’s sovereignty and openly seeking to pull Canadian industrial production south.
Canadian Prime Minister Mark Carney has moved on. Rather than return to trade talks or wait for the next US president to restore the old relationship, he is urgently building a future in which Canada is less dependent on America, The Associated Press said.
Last week, Carney embraced the prospect of Canada becoming the European Union’s first associate member, not as a step toward full membership, but as a way to reduce Canada’s dependence on any single country without ceding control over its own decisions.
“There is now a price to be paid for access to the United States market,” Carney said Sunday, pointing to tariffs, US investment commitments and demands for domestic policy changes.
Carney told the European Parliament on Thursday that countries need enough economic strength to keep any one power from dictating their choices.
Building options beyond the US
He carried that argument into a meeting Sunday with French President Emmanuel Macron in Saint-Pierre-et-Miquelon, the French territory just off Newfoundland’s coast.
“Canada and Europe will build an alliance for the future that will strengthen our collective resilience so we can live our lives as we choose based on the values that we share,” Carney said while standing alongside Macron.
Carney’s relentless schedule reflects the urgency of his push to build alternatives to the United States.
He began last week in Toronto hosting some of the world’s biggest investors, flew to Strasbourg, France, for European Commission President Ursula von der Leyen’s State of the European Union address, raced to Liverpool, England, to meet Britain’s new prime minister and returned to Strasbourg to address the European Parliament.
He met Macron in Saint-Pierre-et-Miquelon before flying back to Ottawa to meet Norwegian Prime Minister Jonas Gahr Støre. On Monday, he is set to open a new session of Parliament before heading to New York for the United Nations General Assembly.
Europe becomes the alternative
Trump has suggested Canada’s closer relationship with the EU could amount to a “hostile act” and threatened “very heavy tariffs” on Europe if he judged the move unfriendly.
Canada could become a test case for other middle powers trying to avoid being pushed around by larger countries. In his speech at the World Economic Forum in Davos, Switzerland, in January, Carney argued that “middle powers must act together,” warning that “if you’re not at the table, you’re on the menu.”
Støre echoed Carney on Sunday, saying tariffs should not become “a weapon to be used against countries, because we will all end up losers.”
The next major step in shaping that proposed relationship is an Oct. 29-30 Canada-EU summit in Montreal.
Unwinding 40 years of dependence
For Canada, that means undoing some of the reliance developed over nearly 40 years.
The 1989 Canada-US Free Trade Agreement and later NAFTA deepened integration, creating cross-border supply chains in autos, energy and manufacturing. Roughly 70% of Canada’s exports went to the US Europe remains nowhere close to replacing the US market.
Carney walked away from trade negotiations in August rather than accept terms he said Ottawa could not live with. The talks remain suspended, and Carney said Friday that leaving the table was the right decision.
“It was easy business, but it meant we relied too much on one economic partner,” Carney said recently. “That time is over.”
Investment chair wants to ‘crank the non-US’
Dominic Barton, Carney’s pick to chair Invest in Canada and a former global head of McKinsey & Co., said diversification does not mean abandoning the United States.
“We can’t complacently count on it,” Barton said. “It’s not about, let’s not do stuff with the US It’s let’s crank the non-US Let’s be way more ambitious on that side.”
Barton, a former Canadian ambassador to China, said Canada has been too inward-looking.
“We are not very global,” he said, calling Trump’s pressure a “jolt” Canada should use to build more global companies.
Carney wants to double non-US trade over the next decade and aims for a free-trade deal with India by year’s end. He said Canada’s tariff-free access to 1.5 billion consumers could double within six months.
Canada sells the trust America is losing
Carney is trying to turn growing doubts about the US as a predictable place to invest into a Canadian advantage. His pitch to global capital is increasingly clear: where Trump’s America uses tariffs and uncertainty as leverage, Canada offers stability, rule of law and reliability.
“The most sought after commodity today is trust,” Finance Minister François-Philippe Champagne said. “The world has changed and America has changed. And I think the world has taken notice.”
Trump may ultimately have done Canada a favor by forcing the country to confront its dependence, Barton said.
“Maybe in 20 years, we’ll thank Trump for shaking us out of our complacency,” Barton said. “Let’s use the moment.”
The ambition has limits. EU “associate membership” does not yet exist, and Europe cannot quickly replace a US market that buys nearly three-quarters of Canadian exports.
But Carney is hardly alone in concluding that Canada must rely less on the United States.
Former Conservative Prime Minister Stephen Harper, from the opposition Conservatives, said the government “had no choice but to take this path.”
That conclusion was particularly difficult for Harper as “one who has long been and known to be a great admirer of America” and who regarded Canada’s close relationship with the US as “among this country’s most precious assets.”
The current US administration now views the countries’ economic integration as incompatible with Canada maintaining its sovereignty, he said.
“Thus, to maintain that sovereignty, we must pursue diminished reliance on the United States,” Harper said. “I do find this all very sad, just as equally necessary.”
Voluntary Return or Pushed Out Against their Will? Migrants in Tunisia Go Homehttps://english.aawsat.com/features/5320317-voluntary-return-or-pushed-out-against-their-will-migrants-tunisia-go-home
Voluntary Return or Pushed Out Against their Will? Migrants in Tunisia Go Home
African migrants during a protest demanding to be repatriated because of the harsh conditions they are living under in Tunisia (AFP)
Less than a year after arriving in Tunisia, Michael Oppona had not planned to return to Ghana.
But, faced with increasingly harsh pressure from local authorities, he is among thousands of sub-Saharan migrants seeking to head home.
Many, like Oppona, have registered for a free return to their countries of origin.
But humanitarians say many migrants and refugees are being pushed out against their will.
Oppona, 37, had crossed the Sahara with his wife and two toddlers before arriving in Tunis but Europe proved out of reach after a 2023 deal with Tunis to curb migrant departures.
"The people here, the government... they treat us like we're not human," said Oppona, waiting for a "voluntary return" appointment near the International Organization for Migration headquarters in Tunis.
Many sub-Saharan migrants in Tunisia face increasingly harsh conditions following a speech by President Kais Saied in 2023 in which he said "hordes of illegal migrants" were posing a demographic threat.
The IOM told AFP it had helped 4,965 migrants return to their countries of origin from January 1 to August 31.
The IOM's program is separate from a namesake program run by the Tunisian government, and operates a major "return hub" near the city of Sfax.
Authorities did not respond to several requests by AFP for interviews and a visit the center.
In June, a Tunisian National Guard official told AFP that nearly 5,000 migrants had been sent to their home countries in the preceding 12 months and that "near-daily" return flights were now scheduled.
But humanitarian sources say these returns should not be considered "voluntary", arguing that socio-economic and political pressures including racism were deliberately forcing migrants to leave Tunisia.
"These are clearly expulsions," one source said.
Humanitarian sources also said migrants were at times coerced to leave even when it was unsafe for them in their home country.
"Authorities say that migrants stay at the so-called 'return hubs' for about two weeks, whereas we know that that process can take months, especially with people without documentation," one said.
The sources also said the conditions in which migrants were held were unclear, adding that some might have been sent to the wrong country.
"We've seen that more people have been arriving in Libya lately," one said.
UN experts in July said they were alarmed by an "alleged system of mass detention, expulsion and trafficking" at the Tunisia-Libya border.
Neither Tunisian nor Libyan authorities have commented on the allegations.
The humanitarian sources to whom AFP spoke also raised concerns over the lack of official information regarding the government's return program.
"We don't know how the authorities have been repatriating people who hold no documents, for example," one source said.
More than 40 global NGOs have said that refugees and migrants in Tunisia faced harsh mistreatment, including rape, according to testimonies they gathered.
In a joint statement in July, the NGOs -- including Human Rights Watch and Amnesty International -- said "refugees, asylum seekers and migrants have faced racist violence" in Tunisia, added to "arbitrary detention, collective expulsions, abuse, torture and other ill-treatment".
Their statement marked the three-year anniversary of a controversial deal the European Union signed with Tunisia to provide Tunis with financing, equipment and training to stop irregular departures.
The groups said the deal came at "a significant cost to human rights and dignity" and called the EU "complicit".
Campaigners say Tunisia's crackdown on organizations that supported migrants, compounded by the suspension of the UN refugee agency's operations in 2024, have barred thousands from receiving help.
Using pseudonyms, 24-year-old Moussa and 22-year-old Karim from Guinea also waited for an IOM "voluntary return" appointment in Tunis.
The two friends said they came to Tunis three years ago with one aim: to cross to Europe.
"But it's impossible to go now, and impossible to stay," said Karim.
Moussa said there was "more pressure now", his voice shaking.
"You're not free. The police prevent you from going anywhere -- to work or get something to eat," he said.
"So why not go back home?"
Can Sudan's Health Sector Rise from the Rubble?https://english.aawsat.com/features/5319449-can-sudans-health-sector-rise-rubble
Entrance to the Trauma and Emergency Complex at Omdurman Hospital (Asharq Al-Awsat)
Between hospitals that have reopened after being destroyed and looted, and facilities still struggling with shortages of electricity, equipment, medicines, and staff, two contrasting pictures of Sudan's health system are emerging after more than three years of devastating war.
In Khartoum, major referral hospitals have begun gradually resuming operations as residents return and fighting recedes from large parts of the capital. Elsewhere, however, the picture is much bleaker in Darfur, Kordofan, and other areas, where ongoing fighting, funding shortages, and difficulties accessing facilities continue to deny large segments of the population access to healthcare.
Data from the World Health Organization indicates that around 37 percent of health facilities in Sudan are not functioning, while around 21 million people need medical services, amid shortages of medicines and rising costs of accessing treatment.
At the same time, the organization is monitoring improvements in some states as early recovery efforts and the rehabilitation of facilities begin. This contradiction makes the question more complex: "Has Sudan's health system actually begun to recover, or is what is happening merely a partial restoration of services in areas where the war has receded?"
Hospitals Recovering
At Omdurman Teaching Hospital, one of the capital's largest referral hospitals, signs of a return to activity are evident. Its Director General, Abdel Moneim Ali Al-Qasim, told Asharq Al-Awsat that the hospital suffered extensive wartime destruction affecting its infrastructure, equipment, electrical networks, cables, and generators. In 2024, rehabilitation began on the emergency department to allow it to receive patients, while other parts of the hospital remained destroyed.
With support from the King Salman Humanitarian Aid and Relief Centre and its national partner, Kafaat Organization, the hospital received a 730-kilovolt-ampere generator in July 2025, along with intensive care, emergency, and laboratory equipment. Al-Qasim said the support was worth around $1 million.
According to Al-Qasim, the stabilization of the electricity supply had a direct impact on services. The waiting time for laboratory test results fell from four to six hours to around one hour and 15 minutes. Around 500 surgical procedures were performed during the first month of the support, before the number rose to between 1,000 and 1,500 procedures per month, averaging between 40 and 50 procedures a day.
The hospital currently receives around 600 patients a day. Eleven of its 15 intensive care beds are now operational, while the remaining four are being prepared for service.
The hospital also received an integrated oxygen production unit and opened a prosthetics center with a production capacity of up to 50 prosthetic limbs per month during a single shift. That capacity can be doubled by operating two shifts.
But the return of activity does not mean the problems are over. According to its director, the hospital still suffers from a shortage of wards and a need for fuel, in addition to unstable electricity. The return of residents is also increasing pressure on facilities that have resumed operations.
Buildings Have Returned... But Shortages Remain
The same picture is repeated at Bahri Teaching Hospital, which was rebuilt and reopened after suffering extensive destruction during the war. Its Director General, Ahmed Al-Bashir, told Asharq Al-Awsat that the hospital, with a capacity of 640 beds and 20 operating rooms, still needs intensive care equipment to increase its capacity to handle cases around the clock, as well as a backup power source.
The hospital also needs to complete its sewage system and connect it to the public network, or provide tankers to dispose of wastewater. Meanwhile, the administration is seeking to convert the emergency complex into a continuing vocational training center to make up for some of the staff the hospital lost during the war.
These details reveal one of the major challenges of rebuilding the health system: repairing a building and reopening its doors does not necessarily mean restoring its full capacity to provide services.
A Bleaker Picture Outside Major Hospitals
A short distance from the major referral hospitals that have begun to resume operations, the picture can be very different, even within Khartoum State itself. In Fattasha, west of Omdurman, Eman waited for three days while her son suffered from a high fever and worsening cough because the nearest health facility could not provide the services he needed.
Eman said in testimony published by the United Nations Children's Fund, UNICEF, in December 2025 that the area's only health center had just one health worker and offered no vaccination, nutrition, medicines, pharmacy, or laboratory services. The mother had no choice but to wait for a UNICEF-supported mobile clinic that visits the area twice a month. Despite the time that has passed since that testimony, the same hardship continues, revealing the wide gap between the return of major hospitals in the heart of the capital and those on the outskirts of the state.
The gap becomes even clearer outside Khartoum. At Al-Thawra Health Center in New Halfa locality, Kassala State, Noor, who is pregnant with her eighth child, says she previously had to buy the iron supplements prescribed by doctors during pregnancy. At times, however, she stopped taking them because she could not afford them.
In testimony published by UNICEF in July 2025, Noor said that the free provision of medicines had become a major relief for the family after the cost of treatment had prevented her from obtaining the medication.
At the same center, Aisha, a mother who received medicines for her children, said that receiving treatment for free represented significant assistance given the economic circumstances facing families.
In White Nile State, families face another problem: distance. In January 2026, UNICEF documented the journey of Zahra and her nine-month-old daughter, Amina, to obtain vaccinations.
Zahra takes around two hours to reach the nearest health facility from her home. Previously, she had been forced to travel to the city of Al-Jabalain in search of the service.
In the same area, another mother named Amina arrived with her two-year-old daughter, Aisha, after the child developed severe diarrhea and vomiting and became so weak that she could no longer walk. After being admitted to a stabilization center and receiving treatment and therapeutic milk, the girl began to regain her strength.
El Fasher... Giving Birth Under a Tree
The hardship reaches its most severe levels in areas affected by war and displacement. Amani, a displaced mother from North Darfur, recounted how she was forced to move with her family to escape fighting in El Fasher while she was in the final months of pregnancy.
In testimony published by UNICEF in August 2025, she said the family went days without food or water or anyone to help them. During their displacement journey between Sharika and Tawila, she went into labor, with no hospital or health workers nearby.
Amani gave birth to her daughter by the roadside, under a tree and on a small mat, with the help of her mother and some local residents. She said that during the delivery she did not know whether she would live or die, or what would happen to her children if she died.
After giving birth, she was too weak to carry her newborn or continue the journey. She was forced to stop for about a week before she was able to reach Tawila with her family.
Her experience represents the exact opposite of the picture presented by hospitals resuming activity in Khartoum. In areas affected by war, the issue is not simply the quality of services or the availability of equipment, but whether a health facility exists at all.
Disagreement Over the Definition of "Collapse"
These disparities lie at the heart of the disagreement over how to characterize the condition of the sector. Médecins Sans Frontières has warned that cuts to aid funding are pushing more health facilities to close and depriving millions of Sudanese of essential care.
The organization says the Sudan Humanitarian Response Plan, which amounts to $2.87 billion, had received only around 41 percent of the required funding as of August 11.
Sudanese Health Minister Haitham Mohamed Ibrahim, however, believes the Médecins Sans Frontières report focuses largely on the organization's activities and working conditions. He told Asharq Al-Awsat that it "does not by itself reflect the reality of the health sector in the country."
Omdurman Hospital Director Abdel Moneim Al-Qasim likewise rejects describing the system as "on the verge of collapse." He says the sector is indeed suffering from a major shortage of resources, but has begun to recover gradually as a result of efforts by the state and national, regional, and international organizations.
Bahri Hospital Director Ahmed Al-Bashir agrees that "the description of collapse is inaccurate," while acknowledging at the same time the need to expand support for referral hospitals and provide specialized equipment and medical specialties.
Health workers inside Omdurman Teaching Hospital (Asharq Al-Awsat)
Cancer Patient Searches for Medicine
For patients, recovery is not measured solely by the number of hospitals that have reopened, but by whether they can find the treatment they need when they reach them. In July 2026, Naela Hamad, who has cervical cancer, was receiving chemotherapy at Khartoum Oncology Hospital, known as "Al-Dhura," while her daughter, Ithar Al-Sir, was searching outside the hospital for a medicine needed alongside the treatment that was not available there.
Ithar said in testimony documented by Reuters that the family found the medicine outside the hospital for around 180,000 Sudanese pounds, or about $45 at the time, at the prevailing market price. Her mother needs it with each chemotherapy dose every 21 days.
The costs do not end with the medicine. She said she also pays 40,000 pounds for the bed where her mother receives her dose, asking how the family can afford these expenses when there is no work or income.
Naela says the family had previously struggled to afford food and is now struggling to obtain both food and medicine, while her home was destroyed and she was forced to stay with neighbors.
Reuters quoted Mona Abdel Rahman, head of pharmacy at Khartoum Oncology Hospital, as saying that some patients' doses had been delayed by two weeks or more after the free provision of some medicines stopped because they could not afford to buy them themselves.
The economic crisis is also affecting diagnostic services. Medical laboratory specialist Al-Tayeb Youssef told Asharq Al-Awsat that the rise in the price of the dollar has directly affected the sector, given laboratories' reliance on imported reagents and supplies purchased in foreign currency.
He added that many laboratory owners who returned to Khartoum had been forced to start "from scratch" after losing their premises and equipment and having to face the costs of maintenance, rent, and purchasing equipment again.
The high costs have prompted some laboratory owners to purchase equipment through partnerships and pool it at a single location rather than having each laboratory maintain its own equipment. This is viewed as a temporary solution that helps keep services running.
Expensive Medicine and Factories on the Road to Recovery
The situation in the pharmaceutical market is not very different. Pharmacist Mahmoud Al-Naeem told Asharq Al-Awsat that rising prices and complaints from citizens have worsened since the war, as a result of the destruction of several local pharmaceutical factories, disruptions to external supply chains, and the reliance on imports requiring foreign currency.
He noted that the National Medicines and Poisons Board has begun encouraging the registration of new pharmaceutical products and companies, considering that increased competition could help lower prices.
Some factories in Khartoum have begun returning to production, although they are operating below full capacity. This opens the door to gradual relief if local production and supply chains stabilize.
Epidemics... A Risk That Has Not Gone Away
Alongside destruction, funding shortages, and the high cost of treatment, the health system faces the threat of epidemic diseases. The director of Omdurman Hospital says rates of watery diarrhea, malaria, and dengue fever among the cases treated at the hospital have declined, with epidemic-control campaigns continuing and an isolation center established to handle cases of cholera, dengue fever, and other diseases.
The director of Bahri Hospital says malaria, as an endemic disease in Sudan, cannot be tackled by hospitals alone. It requires coordination among the federal health system, states, localities, and communities, from awareness, prevention, and vector control to diagnosis and treatment.
These risks remain more severe in areas affected by displacement and fighting, where disease and malnutrition coincide with weak water and sanitation services and difficulties accessing health facilities.
Thus, the current picture may not show a sector that has completely collapsed, but neither does it show a health system that has overcome the effects of the war. In Khartoum, hospitals have returned to service, surgeries and intensive care and laboratory services have resumed, and rehabilitation and oxygen production projects have begun. In Kassala and White Nile, there are examples of facilities that have regained their ability to provide free services or services closer to local populations.
But Eman is still waiting for the mobile clinic to treat her son, Zahra still travels two hours to reach a health center, Amani gave birth to her daughter under a tree while fleeing the war, and Naela reached one of the capital's largest cancer treatment centers only to find that the medicine she needed was unavailable.
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