The impact of armed conflict on Sudan’s surgical services and training: collapse, resilience, and strategic recovery

The April 2023 armed conflict in Sudan severely disrupted healthcare delivery, surgical services, and training. Hostilities systematically dismantled infrastructure, closing most public hospitals in Khartoum and forcing nationwide facilities to cease operations. Synthesizing 25 peer-reviewed publications (2023–2026), this narrative review provides a comprehensive assessment of the resulting structural collapse, subspecialty vulnerabilities, and frontline adaptations within Sudan’s surgical ecosystem. This institutional failure caused widespread personnel displacement, sharp declines in case diversity, and escalating trauma cases in understaffed peripheral regions. This work contributes to global surgery and disaster medicine fields by establishing an evidence-based blueprint for crisis recovery and institutional resilience in fragile environments. This review demonstrates how localized, low-resource innovations such as mobile telemedicine and decentralized training can preserve lifesaving education and clinical care when centralized systems fail, offering universal strategies essential for future global humanitarian responses.