Sudan has been afflicted by recurring conflict for the latter half of the twentieth century, causing millions of deaths, casualties, and refugees. Sudan was the largest state in Africa until 2011, when the people of South Sudan voted for independence and Sudan split into two countries. Despite recent improvements, armed conflicts and poverty continue to threaten the health of the country’s people.

EMERGENCY first responded to the needs of the people in Sudan in 2004 by rebuilding and equipping the Emergency Surgery Department in the main hospital in Al Fashir (North Darfur). The following year, EMERGENCY opened the Pediatric Center in the Mayo refugee camp, a few kilometers from the capital, Khartoum, to provide free medical care to children up to 14 years of age.

Mayo Pediatric Center

Program Data

Start of clinical activities: December 2005
Activities:Pediatrics, health education, prenatal care, immunization and nutrition services
Inpatient: 6-bed observation ward
Outpatient: 2 pediatric clinics, obstetrics clinic
Support Services: pharmacy, laboratory, health education and outdoor play areas
Number of beds: 6 (day hospital)
National staff: 32, including doctors, nurses and health personnel, Community Health Promoters (CHP), administration and ancillary services staff
Admissions (day hospital): 15,971
Outpatient consultations: 189,273
Patients referred to hospital: 9,399
Beneficiaries of integrated outreach activities: 37,073
Prenatal care consultations: 9,069
(Data correct as of December 31st, 2015)

The Mayo refugee camp, on the outskirts of Khartoum, was opened twenty years ago for refugees fleeing the war between Sudan and South Sudan. Over the years the camp has expanded and is now home to 400,000 people. The only health facility providing free treatment for the population is EMERGENCY’s Pediatric Center, which opened in December 2005.

Every day, around a hundred mothers and children come to the Center: the EMERGENCY staff begin by triaging the children to understand which patients need to be examined first. Children with serious illness can be observed in a 6-bed ward, or transferred by ambulance to a public hospital where EMERGENCY staff continue to monitor their condition until they are discharged. All children who need it receive medication entirely free of charge.

To help as many children as possible, our doctors, nurses and health promoters organize health education courses, screening sessions for malnutrition, and immunization services. Mothers can receive prenatal care to help ensure the birth of healthy children.

Port Sudan Pediatric Center

Program Data

Start of clinical activities:December 2011
Activities: Pediatrics, vaccination program, community health education
Inpatient: inpatient ward, sub-intensive care unit
Outpatient: 2 pediatric clinics, cardiology clinic
Support Services: ultrasound room, radiology room, pharmacy, laboratory
Number of beds: 18
National staff: 100, including doctors, nurses and medical staff, administration and ancillary services
Admissions: 4,141
Outpatient consultations: 88,658
Cardiac screening and follow-up visits: 472
Preventive medicine program examinations: 10,753
(Data correct as of 31st December 2015).

EMERGENCY began working in Port Sudan in 2011 to provide pediatric care in an impoverished area, where there are no free health facilities for a population of 800,000.

The Port Sudan Pediatric Center provides free inpatient and outpatient healthcare to children up to 14 years of age. Common illnesses affecting children include malaria, diarrhea, and pneumonia. The majority of hospitalized children (85%) are less than the age of 5.

EMERGENCY implemented a preventive medicine program to improve the general health of children in the communities. Each week, health promoters visit the various communities to provide health education. They give advice about vaccinations, how to minimize the risk of getting malaria and other infections, and the importance of a healthy diet. They also monitor the condition of sick children receiving treatment.

The Salam Center for Cardiac Surgery

Program Data

Open Heart Trailer
Bed capacity: 63
National staff: 359 medical and non-medical staff
Outpatients: 60,330
Cardiology examinations: 53,560
Patients admitted: 7,214
Surgical interventions: 6,273
Cath Lab procedures: 1,287
Patients from outside Sudan: 1,021
(Data correct as of 31st December 2015)

The Salam Center for Cardiac Surgery is the only specialized hospital in Africa that provides entirely free open heart surgery.

Over 300,000 people living in Africa die from cardiac disease every year, and roughly one million people are estimated to need cardiac surgery in the next 5 to 20 years. Surgery remains unattainable for most who need it.

Rheumatic heart disease (RHD) is the most common cardiac disease in children in developing countries. RHD is a result of poverty and the lack of basic healthcare, such as facilities to provide adequate treatment for the common strep throat infection. According to the World Heart Federation, "Africa has the largest number of children with (RHD): in sub-Saharan Africa, where there is little access to the treatment that could enable them to survive and lead normal lives, over a million children are estimated to suffer from the debilitating and often fatal condition."

The Salam Center for Cardiac Surgery has operated on over 6,000 patients, and performed cardiac screenings on more than 50,000 patients, since it opened in 2007. As a part of the African Network of Medical Excellence (ANME), the Salam Center has treated people from over 25 countries.

The Salam Center is the core of our heart surgery program: international cardiologists carry out screening sessions at the Pediatric Centers in Sudan, the Central African Republic, and Sierra Leone, at the Rehabilitation Center in Iraq, and in the Surgical Centers in Afghanistan, identifying patients who need to be transferred to Sudan for heart surgery and guaranteeing the necessary follow-up for patients who have already been operated on. Where there is no EMERGENCY facility, screening is carried out in cooperation with the authorities of the host country.

The Center was constructed using innovative solutions to minimize the use of electricity and fossil fuels to cool the building, including the use of vegetation for heat mitigation, sunscreen panels inspired by traditional techniques, and a 1,000-square-metres of solar panels. The Salam Center has won numerous architecture awards, including the prestigious Aga Khan Award for Architecture, for innovative buildings that combine architectural excellence with a positive impact on the quality of life of the surrounding communities.

News from the Field

2012 Gold Medal for Italian Architecture
Salam Center's Ingenious Container Houses Recognized

October 16th, 2012: In assigning Gold Medals for Italian Architectural Design, the Milan Triennale recognized EMERGENCY's Salam Center for Cardiac Surgery with an award in the special category “Architecture and Emergencies.” In receiving this honorable mention, the Salam Center’s innovative Medical Housing Compound will be featured with other finalists in an exhibition at the Triennale that will run until November 18th.

The Compound houses the international personnel who work at the Salam Center, while also hosting family members who travel to accompany patients treated at the facility. With efficient use of available resources, the architect, Raul Pantaleo of Studio Tamassociati, recycled used shipping containers at the Salam Center building site to create elegant and functional living quarters. The Compound is located next to the surgical hospital, not far from the banks of the Nile River. A beautiful and central focus of the compound is giant mango trees. Each lodging is comprised of 1.5 shipping containers and includes a bedroom, bathroom and small courtyard veranda.

Not only are the starting materials inventive, the insulating system is especially inspired and energy-saving as, through engineering, the system counters the effects of the region’s frequently exaggerated high temperatures. A “layer system” insulates each residence. Five-centimeter panels are installed inside each container. Outside, each roof is insulated, and each face shielded from the sun by a bamboo brise-soleil panel system. The sun never actually hits the shipping containers and cooler temperatures are maintained. Solar panels efficiently supply hot water to the residents.

Other information available on this project:

Link here for a video highlight of the Container Houses An Architectural Article on the project More information about the Gold Medal Honorable Mention An Architectural Article on the project

Democratic Republic of the Congo:

An EMERGENCY team in the hospitals of the capital city

A Growing Network

A mission is in the works in Kinshasa to set up follow-up care for patients who have undergone surgery at the Salam Center for Cardiac Surgery in Khartoum, Sudan and to perform cardiac screenings on new patients, as well as to begin defining the terms of participation in the Regional Program of Cardiac Surgery.

We first met Dida in December 2006, during our first cardiac screening mission in the Democratic Republic of the Congo. 32-year-old Dida was among the first non-Sudanese patients to undergo surgery at the Salam Center for Cardiac Surgery in Khartoum because she needed a new mitral valve. Now, we see her again at the diocesan hospital of St. Joseph, one of the hospitals hosting the screening missions carried out by EMERGENCY cardiologists in Kinshasa. Doctor Josephine says that the patient is doing well, and that she comes to all her appointments for monitoring of the anticoagulant which she will be taking for the rest of her life.

Debora, our tiny but energetic cardiologist confirmed that 10 months after surgery, Dida's heart works perfectly. We would have guessed as much judging by the radiant smile she gave us when we arrived at the hospital. She still needs to resolve some practical problems - not having a job, for one thing - but she can now face life with renewed energy. And, she can finally play with her 8-year-old little girl.

In addition to seeing Dida, our cardiologist visited the other five Congolese patients who have undergone surgery at the Salam Center, and found them all to be in good condition. We gave them the medication they would need for the next six months. We brought it with us from Khartoum because it is extremely expensive in Kinshasa. When we had to buy medications there due to required treatment changes for a couple of patients, we spent over $200 for a 2-month supply.

New patients to be transferred to the Salam Center - a partnership to be expanded

Debora has also been devoted to the screening of new patients at St. Joseph's hospital and at the hospital of Monkole, in the hills surrounding Kinshasa. Cooperation with local doctors, Dr. Josephine and Dr. René, proved invaluable in ascertaining the medical history of patients and ensuring proper communication. Out of 36 screened patients, one third require surgery. However, all diagnoses will be considered by the Salam Center team. The first patients to undergo surgery will be transferred in autumn.

During our visit we began to define the terms of a formal agreement with the Department of Health for the participation of the Democratic Republic of the Congo in the Regional Program for Cardiac Surgery. In the meantime, the Minister of Health and the Secretary General expressed their most sincere satisfaction regarding cooperation with EMERGENCY, and put forward a new and challenging request: to extend the mission of screenings to other regions of this vast country. In Congo the needs are enormous and largely neglected, and not just in terms of cardiac surgery.

Translated by Giorgio Bonafede