Trigger Warning and Disclaimer: The following content includes personal and sensitive experiences. We encourage you to engage with the piece in whatever way feels right for you. You can read our full editorial notice here.

Breast Cancer Before April 2023

Before the outbreak of the war in April 2023, breast cancer rates among Sudanese women had reached alarming levels, at a time when the healthcare system was suffering from severe shortages in resources, equipment, and qualified personnel to provide treatment.

According to data from the International Agency for Research on Cancer (IARC), the total number of new cancer cases in Sudan in 2022 was approximately 28,586, of which 17,260 were women. Breast cancer was the most common cancer among Sudanese women, with 6,631 new cases recorded that year, accounting for 38.4% of all cancers in women. The number of deaths caused by breast cancer also increased, reaching 3,243 in 2022, equivalent to 17.5% of total cancer deaths in Sudan.

National survey estimates indicate that one in every eight Sudanese women is at risk of developing breast cancer, a figure that highlights the scale of the challenge amid weak awareness programs and a lack of specialized screening centers. Cases were often diagnosed at advanced stages due to the absence of routine screening and a limited culture of early detection, increasing the burden on patients and their families.

Together against breast cancer - Source: Dr. Rayan Ali

In addition, Sudan suffered from a severe shortage of diagnostic and treatment equipment, especially outside the capital. In 2023, the country had only three mammography units, all located in Khartoum, while most states relied on ultrasound machines, which are less accurate. Regarding treatment, Sudan had only two government-run radiotherapy units: one at Khartoum Oncology Hospital and another at the National Cancer Center near Wad Medani, in addition to two private radiotherapy centers.

The cost of chemotherapy doses rose dramatically, from around 50,000 Sudanese pounds before the war to more than 300,000 pounds, and most medications were no longer available in pharmacies. This forced many patients to turn to the black market for their medicines, risking counterfeit drugs and inflated prices.

These challenges reveal that Sudanese women’s battle with breast cancer was difficult even before the war, and that their healthcare reality was extremely fragile. The outbreak of war later compounded their suffering and complicated opportunities for diagnosis, treatment, and prevention. Nevertheless, these harsh conditions were not enough to extinguish their determination. Sudanese women faced the disease with rare courage, transforming pain into resilience. They supported one another, led awareness campaigns in neighborhoods and villages, and turned fear into knowledge and pain into hope. Despite limited resources, they proved that willpower is stronger than helplessness and that hope cannot be defeated, no matter how dire the crisis.

The Impact of the War on Cancer Treatment Services

With the outbreak of the Sudanese war on April 15, 2023, the healthcare sector suffered widespread damage, with cancer patients and women’s organizations bearing the burnt of the suffering.

An analysis published in The Lancet, based on World Health Organization (WHO) data, reported that the war disrupted 70% of hospitals in affected areas, resulting in approximately 12,000 deaths and leaving 11 million citizens in need of healthcare. 

This meant that thousands of patients began seeking treatment under extremely harsh conditions. A recent medical report confirmed that Sudan’s healthcare infrastructure, including Khartoum Oncology Hospital and regional cancer treatment centers, became nearly inoperative, depriving thousands of patients of essential treatments.

Specifically in Khartoum, all cancer treatment facilities completely halted operations, including Khartoum Oncology Hospital and the nonprofit Breast Care Center, the only center of its kind in Sudan, which together treated over 10,000 new patients annually. The closure of these centers due to the fighting meant the indefinite suspension of mammography, chemotherapy, and radiotherapy services.

Khartoum Oncology Hospital, Nuclear Medicine Department – Source: Lamia Mutwakil

This situation forced a mass displacement of patients toward less-affected regional centers. For example, a large number of cancer patients moved from Khartoum to the National Cancer Institute in Wad Medani, which was originally designed to accommodate 50 patients per day.

The influx caused patient numbers to exceed its capacity. Between April and June 2023, the institute recorded 2,217 new patients compared to 1,399 in the same period the previous year. This pressure exhausted treatment supplies: almost all chemotherapy drugs were used up, leaving only tamoxifen for breast cancer patients as the available hormonal therapy.

Additionally, one radiotherapy unit likely broke down due to intensive use, reducing the number of operational radiotherapy machines.

Healthcare facilities were subjected to violent attacks, further compounding the crisis. According to WHO, 88 attacks on health facilities were verified since the onset of the conflict, resulting in 55 deaths and 104 injuries among patients and staff.

In July 2024, WHO reported ongoing attacks on medical facilities and healthcare workers. A stark example of this destruction was seen at Al-Durra Hospital in Khartoum, which had numerous rooms destroyed, as shown in official photographs. In short, the medical treatment network was on the verge of collapse, with basic health services disrupted and 70% of hospitals in combat zones rendered nonfunctional.

The extent of the damage inflicted on the Radiation & Isotopes Centre Khartoum - Source: Lamia Mutawakkil

The continuous destruction and looting doubled the suffering. Oncology staff were displaced or killed, and pharmaceutical warehouses were ransacked. WHO described the healthcare crisis as a catastrophic collapse of the care system, leaving thousands of patients without access to treatment.

International organizations, such as the Red Cross, were called upon to evacuate many cancer patients, especially children, for treatment abroad, as had occurred in previous crises in Ukraine and Gaza. However, implementation remained limited compared to the widespread scale of the conflict.

Feminist Initiatives and Awareness Campaigns During the War

Amid this humanitarian crisis, Sudanese women have not only been patients; but have also spearheaded numerous feminist solidarity initiatives during and after the war. Since mid-2023, community support groups and independent women’s unions were formed, some of which were named 'Awareness' (Wa’y), Qulub (Hearts), and Ayadi (Hands).

These grassroots initiatives, led by local female volunteers, extend beyond cancer patients to include women affected by displacement, violence, and the loss of healthcare services, with a clear focus on health awareness and psychosocial support. These groups remained active through 2025, conducting breast cancer awareness campaigns in peripheral neighborhoods and providing psychological support sessions for survivors in collaboration with small local organizations.

In the same context, individual initiatives also made a wide impact. Notably, media activist Lamia Mutwakil transformed her personal battle with breast cancer into a platform for awareness and psychosocial support. She conducted workshops and field visits to universities and schools in Darfur, Kassala, and other states, promoting slogans such as “Through awareness, we fight cancer” and “Early detection… a life story.” Similarly, the Noor for Women Center launched the “Be Strong” initiative with support from the United Nations Population Fund, offering psychological support sessions and storytelling workshops at the Hope Oncology Center to instill hope among patients and emphasize the importance of early detection.

The broadcaster Lamia Mutwakil – Source: Lamia Mutwakil’s official page

Efforts also collaborated with official bodies and international organizations whenever possible. For instance, in 2025, the Ministry of Health in North Kordofan launched the Pink October breast cancer awareness program with participation from women’s organizations and healthcare partners. The Sudan Family Planning Association also conducted annual October awareness campaigns under the slogan “Early Detection”, including free screenings and lectures across various states. Some smaller organizations, such as Qadirat in the Kabkabiya area in North Darfur, continued to hold annual celebrations and workshops on World Breast Cancer Day to provide psychosocial support to patients.

Breast Cancer Awareness Campaign at Shikan College - Source: Kordofanioun Account

Awareness initiatives often combined psychological and community solidarity. An example is the Black October initiative launched in 2024, a Sudanese anti-war association that linked global silence on the fate of women in conflict zones to their struggle against breast cancer. This campaign, driven by activists on social media, reflected the understanding that raising awareness alone is insufficient as long as violence threatens their lives. It is a grassroots feminist movement advocating for breast cancer awareness and an end to violence threatening women’s existence.

Telecommunications company Zain also plays an important role in breast cancer awareness campaigns in Sudan through its corporate social responsibility programs and partnerships with feminist initiatives and local partners. Each year, Zain launches the Pink October campaign to raise awareness about the risks of breast cancer, in collaboration with women’s initiatives. The campaign includes media and field activities, such as community outreach in Omdurman and villages in El-Gezira and Nile states, free screening activities, awareness in peripheral neighborhoods, and the use of traditional and digital media to disseminate advice, instructional videos, and text messages to reinforce early detection and awareness concepts.

This year, a group of educated women from the Al-Halfaya area in Bahri launched an awareness campaign under the slogan “All of Us Against Breast Cancer”, aiming to spread knowledge among women and encourage them to perform early self-exams. The initiative operates voluntarily and systematically, with members visiting neighborhoods and health centers to hold educational sessions on how to conduct self-exams, identify warning signs, and correct misconceptions surrounding the disease.

The campaign goes beyond awareness to provide psychological and emotional support to patients and survivors through home visits and group sessions where survivors share their stories of courage and resilience, fostering hope and breaking the fear barrier around early screening. Participants emphasize that the campaign sends a clear message to every woman: You are not alone; we are all with you in your fight against cancer.

One of Zain Telecom's Pink October campaigns in Kassala - Source: Zain Sudan

Inspiring Real-Life Stories

The harsh reality has presented inspiring success stories from public figures whose impact has been highly motivational. Lamia Mutwakil is a prime example, having developed her personal story into a model for awareness. She stated that after her recovery, she was inspired to launch awareness initiatives through radio and television programs. Mutwakil appeared on TV channels and radio programs urging women and girls to bravely undergo regular breast examinations, emphasizing that awareness is especially urgent in rural areas for several reasons. She also documented her illness with photos during chemotherapy, when she lost her hair. She shared these images to challenge negative perceptions and inspire others to persevere in life.

Beyond the microphones, hundreds of patients and survivors participated in initiatives with symbolic names such as “Beautiful Despite the Pain”, “Coming Back Stronger”, and “Our Life Story”, lighting up social media with their experiences. For example, Mai, who holds a master’s degree in psychology, shared how she documented each patient’s suffering while providing psychological support, emphasizing that awareness is the most effective path to treatment. Despite security risks, some survivors continued to hold motivational workshops in displaced persons’ camps, such as the Shababiyat Against Breast Cancer campaign organized by girls in the Al-Jarif East neighborhood at the end of 2023.

Among these moving stories is that of Rashida, a university colleague, who discovered her breast cancer in September 2023 amid the chaos of war and the collapse of healthcare facilities. Living in Nyala, where most medical centers were closed and treatment had stopped entirely, she was forced to embark on a long, arduous journey to Chad for care. She left home with a small bag and her medical papers, crossing broken roads and checkpoints, exhausted by fear and hope at the same time.

Rashida recalls: “I was not only afraid for myself, but also for the girls I left behind, who could not afford travel or even the cost of screening.” In the medical center in Chad, she courageously received her first treatment doses, keeping a diary between pain and hope, sharing the stories of Sudanese patients who could not access care. Today, even as she continues her treatment journey, Rashida sends messages to encourage others to seek early screening, believing that disease does not mean the end, but a new beginning for life and determination.

“Early Detection is Life” – Source: Mohamed Al-Mukhtar’s account

Leading by Example

On October 2, I went for an early screening at a medical clinic in Khartoum Bahri, where I met Dr. Ruaa Al-Amin, who performed a simple clinical breast exam and recommended spreading self-exam steps to other girls to increase awareness among women.

The doctor explained that each woman can perform a self-exam once a month, a few days after her menstrual cycle, either in front of a mirror or during a shower, by:

1. Checking the shape of the breasts and noting any changes in size, color, skin texture, or nipple appearance.
2. Raising the arms and observing any skin dimpling or wrinkling.
3. Feeling the breasts with fingers in a gentle circular motion from outside to inside, searching for any unusual lumps or firm areas.
4. Checking under the armpits, as some lumps may also appear there.
5. Recording any new findings and consulting a doctor immediately if a lump, discharge, or persistent pain appears.

Self-examination steps – Source: Baheya Foundation, Egypt

She emphasized the importance of paying attention to several warning signs that require seeing a doctor, such as:

1. Abnormal nipple discharge.
2. Changes in nipple shape or inward retraction.
3. Redness or flaking of the breast skin.
4. Persistent pain or heaviness on one side without an obvious reason.

Common breast cancer symptoms - Source: World Health Organization

In the course of the conversation, I asked the doctor about cases of infection and recovery. She indicated that although the rate of breast cancer has increased in recent years, treatment is no longer impossible. She told me the story of a young woman who came for early screening last year and was diagnosed at an early stage; she fully recovered after receiving treatment in Egypt, due to the collapse of several hospitals in Sudan that used to receive such cases.

Dr. Roaa added that there is still hope, and that treatment has become more possible and easier than before thanks to advances in early diagnosis and treatment. She emphasized that awareness and regular checkups are the first line of defense against the disease.

Current Situation and Future Prospects

Despite the extensive destruction of the health infrastructure during the war, some signs of recovery have begun to emerge in Sudan’s cancer care landscape. In June 2025, the government issued a decision to rehabilitate and reopen damaged oncology and dialysis centers.

This decision revived hope among thousands of women who had lost access to care. The Ministry of Health also confirmed its commitment to reopening Khartoum Oncology Hospital and regional oncology centers once security conditions stabilize.

In the same context, the International Atomic Energy Agency (IAEA) carried out its first comprehensive cancer assessment mission in Sudan, at the request of the Federal Ministry of Health, to evaluate current capacities and identify needs for disease control under the Rays of Hope initiative. The report recommended supporting the modernization of radiotherapy services and developing a comprehensive national cancer strategy. This marks one of the clearest signs of renewed international attention to rebuilding Sudan’s oncology system.

On the ground, the administration of the Free Pediatric Cancer Hospital in Khartoum announced its move to a new building covering 6,000 square meters, in preparation for installing modern radiotherapy equipment after the old facility became unfit for use.

A new Breast Care and Early Detection Center was also inaugurated at Al-Mogran University Hospital, affiliated with Al-Neelain University, equipped with the latest screening and imaging technologies for early-stage diagnosis.

Despite these initiatives, challenges persist. The Radiation & Isotopes Centre Khartoum (RICK), suffers from a shortage of essential medications, such as hormonal therapy drugs and chemotherapy cytokines, while delays in maintaining radiotherapy machines have led to long patient waiting lists. Oncology centers in the states have also become overcrowded due to waves of displacement, placing heavy pressure on limited resources.

Nevertheless, signs of hope remain visible. The government has announced plans to gradually rehabilitate and reopen these centers, while international and local organizations are working to introduce new equipment and expand psychosocial and awareness programs. Training programs for midwives and village health workers in early detection techniques have also begun as part of a plan to expand geographic coverage and reduce mortality rates, according to officials from the Khartoum State Ministry of Health.

Although there is still a long road ahead to rebuild an integrated cancer care system, the joint efforts of the government, the World Health Organization (WHO), the International Atomic Energy Agency (IAEA), local organizations such as the Sudan Family Planning Association (SFPA), and civil society represent a true starting point toward a better future.

Get checked and Reassure Us (Breast Cancer Awareness Campaign) - Source: Mohamed El-Mokhtar's account

Conclusion

In conclusion, although the war has placed immense burdens on women battling cancer, their determination remains unbroken. As Dr. Roaa said, “We are not only seeking treatment, we need our voices to be heard.”

Many survivors and mothers have become advocates among other women, sharing stories of recovery and hope, drawing strength from the resilience shown by others. Through this shared struggle, whether via networks of women humanitarians or through online platforms, Sudanese women are proving that breast cancer does not defeat them. This determined fight has strengthened the values of solidarity and community awareness: widespread public consciousness and collective support for patients may one day form a lifeline that saves hundreds, even thousands, of women across Sudan.