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As I stood there with an emergency kit full of lifesaving supplies, the bombardments still echoed through the trauma section of Alnau Hospital. Amongst the chaos, family members and volunteers hurried in, carrying a middle-aged woman who had catastrophic injuries: shrapnel had crushed and severed half of her arm, her fingers were crushed too, and her leg had deep, probably fatal wounds. While some medical staff, including myself, stood around her, she would fall in and out of consciousness. In one moment of lucidity, she said: "Do not cut me apart, let me die whole." Her statement lingers in my memory to date, reminding me of the depth of desperation a disabled person is subjected to by stigma and the struggle to live a whole life in Sudan to the extent that some individuals would believe the situation is so grim that being dead is better than staying alive.
Disabilities Within the Conflict History of Sudan
Continuous armed wars in Sudan result in disastrous effects, exacerbating lives for persons with disabilities. According to the 2008 census in Sudan, there were 1,854,985 individuals with disabilities, representing 4.8% of the total population. However, according to The Swedish International Development Cooperation Agency report, worldwide estimates show that the number of disabled people in Sudan could stand at any figure between 1.9 and 3.8 million, that is, 10-15% of the total population. Contributing factors for increased disabilities in the country are the poverty level, poor healthcare facilities, and most importantly, armed conflict.
Sudan has ratified the United Nations Convention on the Rights of Persons with Disabilities and its optional protocol in 2009, among other legislative and regulatory initiatives, but there are still gaps in addressing the issues that persons with disabilities face.
War intensifies disability rates, particularly through injuries from bullets, artillery, and bombings that civilians in conflict zones suffer from. These attacks cause severe physical harm, such as amputations, burns, and fractures, often leaving victims with lifelong disabilities. The destruction of infrastructure and healthcare systems, combined with displacement and ongoing violence, prevents many from accessing necessary medical treatment and rehabilitation. As a result, victims of war injuries face not only physical impairments but also social isolation and limited opportunities for recovery. The continued conflict further exacerbates their suffering, making it difficult for them to regain independence or receive the care they need.
Fragments of War, Fragments of Resilience
In the trauma department of Alnau Hospital, amidst the relentless echoes of bombings, I encountered humanity at its most broken and resilient. Weekly, 3-7 amputations visited the department —men, women, children, and even infants just months old, arriving with severed limbs. In moments of heavy bombardment, the hospital overflowed with the wounded. Blood stained the floors, beds were scarce, and we often had to skip over patients lying on the ground to reach others in need of first aid.
One unforgettable moment was the arrival of a 2-month-old baby, his limbs were severed because of an injury caused by the war. His cries punctured the din of suffering. As I stood holding an emergency kit by the child’s bed, I recalled a heated debate on X (formerly Twitter) I’d seen the night before, arguing the necessity of war for a political resolution. Staring at the mutilated baby, I thought: Have these people witnessed this destruction? What politics justifies cutting a child apart before he can even utter “mama”?
Amidst relentless bombardment in Omdurman, Tarig Abuzaid became an icon of bravery: He was volunteering to run a communal kitchen when a bomb exploded near his neighbor's home. Checking on people, Tarig sprinted out into the chaos, guiding them to safety, and returning in time to pluck a stranded old lady from death. As he was about to plunge again into the fray seeking whom he could help, another blast in the neighborhood shattered his leg.
Watch the full Interview with Tariq Abu Zeid - Working People
His wounds were beyond Alnau Hospital's capacity so he was sent to the River Nile state. After recovering from his injuries, he went back to Omdurman and got back to serving in the communal kitchen despite his traumatic experience. Tarig says: “I could have died, but I will aid the most vulnerable people as long as I live. Have you seen the women and children who have been displaced from Bahri and they have nothing to eat? There are people more vulnerable than me.”
Tarig’s story captures resilience at its purest—a man who, even with profound loss, chose to uplift others in their darkest hour. His life is a defiant stand against the ravages of war, embodying the unbreakable spirit of humanity.
Pre-War Efforts for Disability Inclusion in Sudan
Before the outbreak of war, the Sudan Disability Movement was formed and was working on the needs of persons with disability in Sudan. Eng. Ashraf the founder and managing director of Nayla Prosthetics and Dr. Arwa who used to work at Nyla Prosthetics were both part of these efforts. They both worked towards making sure that persons with disabilities were involved in developing prosthetics that would work in Sudan. Nayla Prosthetics tried to make prosthetics lightweight and culturally appropriate for persons with disability.
Watch an Interview with one of the beneficiaries of Nayla
A key group of individuals targeted by these initiatives were those affected by mycetoma, which is a chronic infection caused by fungi or bacteria, leading to painful lumps, abscesses, and draining sinuses, often affecting the skin, muscles, and bones. It is common in rural and agricultural areas, especially in tropical regions. The disease typically spreads through trauma or injury when microorganisms from contaminated soil, plants, or animal waste enter the body. In Sudan, it is common in Western Sudan, Blue Nile state and Sinnar state regions. Farmers, who are most vulnerable due to their work, often require amputations as a result of severe infections, when the infection can no longer be controlled with antibiotics or antifungal treatment. For these individuals, financial inclusion became a key part of their recovery, as it allowed them to regain mobility and access to job opportunities. Nayla Prosthetics aimed to address this by developing prosthetics that could help individuals return to work and support their families.
Eng. Ashraf, the founder and managing director of Nayla Prosthetics, has identified several important parties who were key actors in advocating and working for the benefit of people with disabilities. These include, among others: the Ministry of Social Welfare, Neelain University, the General Authority for Prosthetics, the National Council for Persons with Disabilities, NGOs both local and international, the International Committee of the Red Cross, and the Mycetoma Center. Consequently, the company collaborated with most of these groups to offer insightful information and services through research.
According to Dr. Arwa most of the interviews they conducted in the research highlighted the fact that differently abled people in Sudan desired to be given equal treatment. Most of them needed and wanted to work and contribute to the market. One notable case involved a man who had lost his hand in a bus accident. Despite his qualifications and determination, he faced significant discrimination when applying for jobs. Even after obtaining a master’s degree, he was still unable to find employment. His story highlights the challenges faced by people with disabilities in Sudan’s labor market, where societal discrimination often overrides legal protections.
The Intersection of Disability and Gender Roles in Care Labour
A Sudanese feminist activist, who requested anonymity, described how war worsens the marginalization of disabled individuals in Sudan, forcing hard choices during displacement and overburdening women caregivers. She shares her family's struggle to navigate stigma and bureaucratic hurdles to secure safety for her disabled uncle and reflects on systemic failures. She says: "During the war, this marginalization becomes even starker. In our neighborhood, basic essentials like water, sanitary pads, and diapers for people with disabilities and the elderly were completely unavailable. Families were forced to make heartbreaking decisions about who could flee for safety and who had to stay behind, often based on who was capable of providing for the family”.
For women, particularly those without disabilities, the weight of care labor is immense. They often bear the responsibility of looking after family members with disabilities, even in a crisis. From what I’ve seen, nearly every family in conflict zones now includes someone with a disability, yet these individuals are frequently left behind, and treated as less capable or less deserving of protection. This harsh reality underscores the devastating intersections of inequality and social inclusion including disability, war, and societal norms.
In Sudan, the battle to get documentation for people with disabilities often starts at birth because most families do not fully accept these children. My uncle also suffered from a severe physical disability caused by meningitis, which was a challenge in life. In the case of my uncle, amid repeated displacements, we lost his basic identification documents. Replacing them required a Sharia-based witness testimony, where only male relatives could vouch for him. Yet my mom although she was his primary caregiver from 2002 until now, her testimony was dismissed solely because she is a woman.
Later, new bureaucratic hurdles emerged, such as a national ID number being required for passports. We secured an emergency travel document for my uncle and that travel document, following a long and arduous journey through the states of Sudan, one marked by displacement and obstacles, was eventually accepted by an African country. I am extremely grateful that he and my family now have safety there.
I have been faced with several obstacles trying to reunite with my uncle in the country where I live. The government refused to accept his emergency travel document, and the Sudanese embassy presented no help or support. Despite these challenges, my uncle's resilience and my sisters' firmness, enduring the caregiving responsibilities even when others failed, is something that stands out in their courageous determination.
This story reveals a deep intersectionality between disability, gender, and societal expectations during wartime. It underlines that systemic barriers, such as stigma, cultural attitudes, and physical infrastructural inaccessibility, have more disparate impacts on people with disabilities and their caregivers, who, most often, are females who bear the brunt of care labor amidst crisis.
Added to this marginalization are legal and bureaucratic hurdles that make access to essential documents and services almost impossible, and humanitarian aid often neglects specific needs. Despite these, the resilience and agency of individuals and families come through loud and clear, demonstrating their will to survive and adapt against insurmountable odds.
These are matters that call for inclusive policies, accessibility in both aid and infrastructure and a changed attitude toward the contributions and rights of persons with disabilities. This means not just looking at them as victims but also as integral members of society who have agency and autonomy.
While I was writing this essay, one of my friends called and shared with me how her neighbor, while delivering groceries to the families, lost her leg from shrapnel. Citizens are always at risk, as can be understood in the above situation. At Alnau Hospital, with which my colleagues are engaged, there has been an unending stream of serious casualties that makes the work of hospitals tough and keeps the medical workers weary.
These incidents reveal the deeper impact of violence on successive generations, including family disintegration, loss of livelihoods, and long-term trauma that impacts not only the present but also the future of Sudan.
Lessons from Somalia: Disability Inclusion in Conflict Zones
When it comes to assisting disabled people in wartime, Sudan could learn a thing or two from Somalia. The government of Somalia has done much to address this issue, despite the country being wracked by violence for decades.
With the establishment of the National Disability Agency (NDA) and recent accession to the UN Convention on the Rights of Persons with Disabilities by Somalia, the country is on the move to ensure full inclusion of persons with disabilities into society. The National Disability Act provides for the establishment of vocational training facilities, and the distribution of assistive gadgets, it also advocates for disabled persons to have access to financial and entrepreneurial opportunities. Somalia has also taken steps to improve the educational opportunities for disabled youngsters.
Somalia is an example of how the presence of laws and strong protection of the rights of persons with disabilities would protect citizens from being left behind when there is war. Local actions are important, especially in availing of inclusive education and employment opportunities.
Conclusion and Recommendations
Rehabilitation efforts in Sudan after the war should shift to include the protection of civilians, including (PWD). Access to health care, food, and other services must be ensured under international humanitarian rules, particularly in areas directly affected by violence. Prevention of future incapacity and protection of internally displaced persons is highly imperative in locations experiencing high levels of conflict. While postwar rehabilitation is necessary, early intervention during the ongoing conflict is equally relevant. Some recommendations include:
*Protecting people with disabilities by ensuring access to hospitals and humanitarian supplies, particularly in areas of conflict.
*Humanitarian corridors should be established to ensure that the provision of basic services is equitably distributed.
*Even amid a crisis, it is critical to prioritize the provision of emergency rehabilitation services, such as physical therapy, assistive gadgets, and basic prostheses, to those who have been hurt and have equal access
*Continuing and increased cooperation is needed in the areas of accessible health, rehabilitation, assistive technology, and social support by international organizations, NGOs, and Sudanese authorities.
*More attention to inclusive education, vocational training, and economic empowerment programs needs to be addressed for persons with disabilities.
*Rehabilitative therapies and prosthetics must be made available immediately after the disaster. These prosthetics should be culturally applicable, lightweight, and made from material that will withstand the rigorous climate in Sudan. This will enable patients to resume ambulation and assist in the rehabilitation effort within their communities.
*In addition, the creation of financial inclusion programs, offering vocational training, small business grants, and inclusive employment opportunities, can help people with disabilities regain their independence and contribute toward economic recovery.
*Anti-discrimination policies, focusing on implementing public awareness campaigns and enforcement of policies, especially in the field of employment.
*Building legal frameworks that guarantee the rights of persons with disabilities and strengthening them through the enforcement of legislation, with consideration to ensuring equal access to healthcare, education, and employment.
*A multi-sectoral approach should be inclusive of the needs of PWDs, through which the government, local and international NGOs, the private sector, and disabled people's groups work in unison for recovery. This is necessary to create an inclusive society after a conflict.
