{'I cannot afford to save the two sisters': Sudan's conflict forced one mother with an impossible choice

Warning: This piece includes details that certain viewers may consider distressing

Touma hasn't eaten in days. She sits silently, her gaze distant as she stares aimlessly across the hospital ward.

Held close, still and severely undernourished, rests her three-year child, Masajed.

Touma appears numb to the cries of the other infants around her. "I hope she would cry," the 25-year-old mother explains us, looking at her daughter. "She has been silent in multiple days."

The medical center is among the last operational medical facilities in Sudan's capital, Khartoum, devastated by the internal conflict which has been ongoing since April 2023. Numerous families have travelled hours to arrive here for medical treatment.

The malnutrition ward is filled with young patients who are too weak to combat illness, their mothers by their side, powerless.

Distress calls here can't be soothed and every sound causes pain.

Touma and her family were compelled to escape after fighting between the national military and the paramilitary RSF approached their home about 200km southwest of Khartoum.

"They seized everything we owned - our savings and our livestock - directly out of our hands," she explains. "We fled with only our lives."

With no funds or food, Touma's children began to deteriorate.

She looks stunned as she recounts their previous existence. "Before the conflict, our home was filled with goodness. We had animals, milk and dates. But now we have nothing."

Crisis Situation

Sudan is currently facing one of the world's worst humanitarian crises.

Based on the United Nations, 3 million children under the age five are acutely undernourished. The hospitals that are left are overwhelmed.

The facility provides treatment and essential treatment without cost.

Nevertheless, the lifesaving drugs required by the children in the malnutrition unit must be purchased by their families.

Masajed is a twin, she and her twin Manahil were transported to the hospital simultaneously. But the household could only afford antibiotics for one child.

The mother had to face the devastating decision – she selected Manahil.

"I hope they could both heal and develop," her grief-stricken tone breaks, "so that I could see them walking and playing with each other as they did previously.

"I just want them together to recover," Touma states, cradling her dying daughter.

"I am alone. I have nothing. I have only God."

Chances of recovery here are low. For the families on this unit the conflict has stolen all they had. They have been left with nothing and no means to purchase the medicines that would preserve their offspring.

As we leave, the physician says not one of the patients in this ward will survive.

Throughout the whole of Khartoum, children's futures have been transformed by the internal conflict.

City Destruction

What started as an outbreak of fighting between forces supporting two generals – military commander the general and RSF leader Hemedti – soon engulfed the city.

During a two-year period – until last March when the army retook control - the capital was gripped by war as rival fighters fought.

Khartoum, once a hub of culture and business on the shores of the Nile River, became a war zone. Armored vehicles rolled into neighbourhoods. Fighter jets flew overhead. Non-combatants were caught between exchange of fire, shelling and drone strikes.

This occurs in this destroyed landscape, within the quiet of ruin, that the delicate sound of a child rises from the rubble.

12-year-old Zaher moves himself through the destruction, past burnt-out vehicles, tanks, broken homes and abandoned ammunition.

"I want to return home," he whispers softly to himself as his mobility device moves over shattered fragments and shrapnel. "I can no longer see my home. What happened to my residence?"

Personal Stories

His words, vulnerable but resolute, contains both a lament for what has been lost and a quiet hope that one day, he may ultimately return home.

In a building now being serving as a refuge, the boy's mother Habibah describes observers about what existence was like under RSF occupation.

"Conditions were extremely challenging," she says. "We couldn't switch on our lights at night - it seemed like we were thieves. We avoided making fires. We didn't move whatsoever at darkness."

She remains beside her child in a room containing sleeping arrangements.

"At any moment, whether you were sleeping or washing, upright or seated, you find them [the RSF] breathing down your neck."

Many fled the city, but the boy and his parent had no way to leave. To persist, they traded food items on the streets.

Subsequently a particular day, as they worked together, a aerial attacked.

"I looked at him and he was losing blood. There was the fluid everywhere," the mother says. "I began losing consciousness. I compelled myself to remain conscious because I understood if I passed out, I would lose him forever."

Zaher's legs were severely injured. After an extended period of agony, they made it medical care.

"I continued praying: 'I beg the divine, accept my existence instead of his limbs,'" she weeps.

But medical professionals could not save his legs. The two had to be amputated slightly under the knee.

"He would wake up and ask: 'Why did you allow them remove my legs?'" She looks down, her expression filled with remorse, "I had no response."

Both Habiba and her son cry, tormented by the recollection of what occurred to them. It is made worse by knowing that prosthetic limbs could provide the boy a chance at his old youth, but his mother cannot afford them.

Regarding the boy, the memory of what happened is too painful to talk about.

He mentions just one simple dream. "I hope I could have artificial limbs so I can play football with my friends like I did before. That is everything."

Lost Childhoods

Young people in Khartoum have been robbed not only of their childhoods but of safe places to enjoy and be young.

Educational institutions, football pitches and playgrounds are now shattered, with damaged reminders of a life stolen by conflict.

"It was quite pleasant here," says 16-year-old Ahmed looking around a destroyed funfair and recreation space.