How Sudan medical students used Covid to improve community health

One year into creating opportunities to fight Covid-19 in Sudan with medical students, a coalition of Sudanese doctors has taken the lessons learned while working with local communities and is applying them to healthcare for all.

Within six months, with the help of the Sudanese ministry of health, healthcare workers administered 20,000 doses of Covid-19 vaccine throughout the country, according to Dr Nada Fadul, one of the co-founders of Sudan’s community Medical Response Team (CMRT).

She first spoke to RFI one year ago about launching the Covid-19 awareness program with the help of medical students.

She admits there were a number of challenges, even some that were discovered on the ground.

“One of our students started talking to women who were standing in the bread line and one of the women brought up the concern that the vaccine clinics are far,“ says Fadul.

It was expensive to travel to the clinic, so it was more of an access issue than vaccine hesitancy. They discussed either driving people to the clinics, or bringing the clinics to the people.

Based at the University of Nebraska in the US, Fadul noticed that neighbourhood pop-up vaccine clinics worked well in an underserved area in Omaha, the largest city in the state.

Applying the same model with outreach in the community the day before the clinic was really positive, she says.

The medical students went to sports clubs, the mosque, the market, and youth groups to talk about vaccinations.

“We are trying to bring vaccines closer to people, so our motto right now is ‘meet them where they’re at’, especially people in remote areas and underserved areas,” she says.

The group has now expanded this to basic health care, not just vaccines, throughout the country, by using community members to promote more trust with healthcare providers.

Working in Darfur

One of the challenges of working in Sudan is the absence of a solid government structure after the military carried out a coup d’etat in October 2021.

But even with some setbacks, the CMRT program has now launched in all five states in the restive Darfur region in the west of the country.

“We’re still in the stage of needs assessment, to find out what are the needs in each state and locality in Darfur are, especially with internally displace communities and camps,” says Fadul.

“We are super excited because the needs there are tremendous and the ministry of health and non-profit organsations don’t have a presence in these areas,” she says.

The Covid-19 model is still partially the same, but instead of using medical students, who still play a role, the primary contacts are member of the community.

They’re part of the community, they’re trusted by the community. As you can imagine in Darfur, with all the hardship in place, there’s a lot of mistrust,” she adds.

Health and politics

Building trust with community members as part of providing healthcare means walking a fine line between the Sudanese government and the local community.

“The resistance committees became the most trusted there, so they’ll be our main partners,” she says, speaking of the grassroots neighborhood-organised civil disobedience campaigns that are the core of resistance in Sudan.

While she says the group is not always successful in creating programs in communities with the help of government, CMRT works regularly with the ministry of health.

“The officials that we have worked with thus far, because they are healthcare providers themselves, are still prioritizing the community over politics,” she says.

CMRT has also encouraged medical students to work outside their comfort zone, and not necessarily in the community they have always lived in, focusing on the underserved areas and neglected areas of the country.

“We’re hoping our next convoy to be in Kordofan, which is in western Sudan so some of these students will go to remote villages there and see how things are done down there,” she adds.

Community-oriented care

This custom approach to each community will help those on the ground to decide what is the most pertinent, or urgent needs, instead of taking cues from the central government or outsiders.

“With the rainy season starting, we’re expecting several outbreaks-- there’s always cholera, a malaria outbreak, there’s all sorts of mosquito-borne illnesses that are emerging during the season, so we’re prepping for that.”

By expanding their scope beyond Covid-19, their public health approach will be working towards sustainable health in the communities.

“We’re not going to just respond to an emergency and then move away,” she says.