Sudan: “It was clear they were terrified to lose him”

After 11 days with a high temperature, eight-year-old Samir* started to experience pain in his abdomen. He was living in one of Tawila’s refugee camps with his mum, aunt and grandmother. Concerned that he was seriously unwell, Samir’s family brought him to the MSF-run hospital – the only secondary healthcare facility in the remote Sudanese town.

At the emergency room at the hospital, we assessed him quickly: he was hypothermic, much colder than he should be. We sometimes see this in babies or very young malnourished patients, but rarely in a non-malnourished eight-year-old. 

We also noticed that he was bradycardic, which means his heart rate was slower than it should be. Finally, I noticed his abdomen was swollen and tender. All the signs pointed to typhoid, a life-threatening bacterial infection.

On top of that, he was in septic shock, which can happen when an infection has become so severe and overwhelming that the patient is at risk of multiple organ failure. 

I immediately called over the surgeon and anaesthetist to review Samir, who agreed that it could be typhoid or appendicitis. In either case, Samir needed urgent care, so the team rushed him to the operating theatre for emergency surgery. 

Evolving healthcare provision 

To begin with, we were the only international NGO on the ground, working with the community to gain their trust, fully understand the needs and build a healthcare facility to address those needs and requirements.  

It was an intense but immensely rewarding experience, as we could observe the daily improvements in the hospital.  

When I returned to Tawila in the spring of 2026, the evolution of the project was astounding to witness. The team had tripled the number of beds and, along with the paediatric intensive care unit which we set up before, expanded the neonatal unit from seven beds to 20. The paediatric ward now incorporated a dedicated maternity unit, improving flow and collaborative working.  

There are now dedicated spaces for antenatal care and for survivors of sexual and gender-based violence, significantly improving the experience for these women who require privacy and dignity.

Samir’s vital surgery

As a paediatrician, I oversaw the care of our youngest patients and their families. After he was taken into surgery, Samir’s family were distraught. They knew that he was unwell, but at this point they started to fear the worse. The women stood outside the operating theatre, crying, waiting for it to finish. 

Samir was the last remaining male family member—all the men in his family had been killed in El Fasher. Speaking to his mum, aunt and grandmother, it was clear that they doted on their child and were terrified to lose him too. 

Fortunately, the surgery went well. The team was able to confirm the diagnosis of typhoid and close the perforations in Samir’s bowel. Afterwards, we closely monitored Samir in the paediatric intensive care unit (ICU). Alongside the surgical management, he also needed antibiotics and fluids to recover from sepsis. 

Day-by-day his condition improved and the joy on the faces of his relatives is something I will never forget. Before, he was so quiet and in pain, but it was wonderful to see his smile return. When he started playing games on his aunt’s phone and eating biscuits, we knew he must be feeling better. After two weeks, he was recovered enough to be discharged and return home.

MSF’s crucial role 

If MSF were not in Tawila operating a hospital with surgical and ICU capabilities, Samir and other children like him would not survive.

This experience showed to me just how crucial MSF is in Tawila; as one of the only secondary healthcare facilities in the wider area, we take referrals from other NGOs and deliver essential care to an ever-growing population with significant need. 

Leaving Tawila for a second time, I felt proud to work with MSF. 

*Name has been changed