The situation in MSF clinics where MSF is operating is very overwhelming and crowded because it is the only functioning clinic in the town – the whole town of about nearly one million population. And it is the only clinic functioning in El Fasher South. There are so many people and patients coming and we had to prioritise some cases with life [threatening] conditions and emergency cases rather than looking for all cases and some cold cases. And we are trying gradually to set up a proper triage system to avoid this crowd and to put [a] better crowd control system in place. But it is [the] only clinic known in the town that [is] receiving all types of cases… like wounded patients, obstructed labours, people with other chronic diseases, morbidities and so on.
The health care system in the whole town was almost collapsed during that 3 or 4 days of ongoing fighting. But for now, gradually the Ministry of Health is trying to reopen some health clinics in the periphery area of the town and other residential areas, but still remaining that the hospital supported by MSF is the main referral hospital where also people are doing surgery, receiving also delivery cases, caesarean sections, operating [on] wounded people. And most of the injuries related to the conflict are gunshots and stab wounds, and also some other people [have] different type of wounds [from] sharp items and people also fall down trying to run from the shooting whenever it happens.
We are receiving most of the cases in the hospital. There are about almost 40 plus patients with fractures. Most of them are [from] gunshots. And nowadays we start to receive [a] few stab wounds due to criminality in the town. And about people with other health conditions – like diabetics, like also asthmatics and other cases – they are suffering to cope with these conditions, as all the pharmacies remain closed completely. And also life [threatening] conditions at night, they cannot move because of the insecurity and also so many checkpoints, and also [the] security situation is not so calm, [so] people are afraid to access [care]. In addition to that, there is lack of also public transportation. So there are some mortalities increased among the community and especially also children with people with special cases and conditions due to lack of access to health care.
Some people [are] telling us some stories that, for example, when they're trying to access the hospital, they pass through several checkpoints while also shooting [is happening] and … suddenly they’re trapped into a situation that [means] they cannot reach the hospital, neither go back to their homes. So they had to take shelter or refuge in the nearby neighborhoods, and also trying to seek for services. And for some time I had an experience of one person coming from the far end of the town around eight kilometres all the way to reach to the hospital. And then he has no money because nowadays banks are also closed. There is no activity and there is no also business working. And then he was like, come to the hospital and his wife was operated [on] – a caesarean section – and delivered safely. And he was so grateful. And even he cried and trying to show said I'm worthless how to thank MSF [I don’t know how to thank MSF] for the great job that they did for them.

Another population are also complaining [about the] shortage of water. There is no water and there is also no electricity and also no market. And the main big shops remain closed. The basic commodities – prices [have] increased, are rocketing high, due to lack of supplies. And also communities are complaining [about] children with malnutrition problems. They were left with no supplies and there is not any nutrition programme running. And all the other health activities and health clinics were shut down. And another fear from the population, seeing that all the humanitarian actors – especially the international community – have left. Evacuated the town. So they felt like there is a fear, [about a] lack of protection and [a] lack of hope. And this raised great concern of the community, the feeling that they were left alone in this kind of dire and very critical situation.