Sudanese people feel "worthless" amid fighting that has "annihilated" so much, a volunteer doctor working in one of only five operational hospitals in Omdurman told The National.
Dr Rashid Mukhtar is volunteering with an international humanitarian group as the head of Al Naw Hospital.
The situation in Omdurman is becoming worse, he said, as fighting continues between Sudan's paramilitary Rapid Support Forces (RSF) and the army for a fourth month.
"I often wake up to my alarm or the sound of shelling at dawn," said the British-Sudanese general physician, who travelled from the UK to Sudan with the group Project HOPE.
After months in Omdurman, Dr Mukhtar said he no longer drives his car to work because petrol has become so expensive and difficult to find outside the black market.
He now walks for an hour to work.
When he's not at the hospital, Dr Mukhtar goes house to house to see what people need.
"We feel terribly helpless, tens of people due under our watch," he said of a "terrifying" shortage of supplies and medical equipment, particularly for dialysis, diabetes and patients with high blood pressure.
Some, including the elderly, are dying as a result of being unable to reach hospitals because of the worsening security situation, he said.
"The Sudanese people feel that their lives are worthless", amid looting, sexual violence, killing and a dire humanitarian situation, Dr Mukhtar told The National. "You can count the number of working hospitals in Omdurman on one hand."
"There was an older woman with inflammation who needed an intravenous infusion and antibiotics. We were unable to find her some or take her to the hospital due to ongoing violence. Two days later, she passed away. May God have mercy on her."
A recent round-up by a local group of doctors found 70 per cent of hospitals in conflict zones were out of service.
These include 14 in Omdurman, where only five are still working, including one that has completely shifted operations to the Al Naw base.
"Mohammad Ali Fadl is the only hospital in Omdurman with a birthing section. Six weeks ago it came under attack, which killed one of its security guards," Dr Mukhtar said.
"This caused the hospital administration to move all the staff and equipment to Al Naw hospital, which now shares the operating rooms and overall space."
The others "were closed down due to security issues or taken over by the RSF", Dr Mukhtar said.
Situation worse in Khartoum
Shaza Mohamed, executive direct of Project HOPE's partner, Nada Elazhar for Disaster Prevention and Sustainable Development, herself had to flee her home in Sudan.
Ms Mohamed is using her network to help support medical staff in Sudan. She said in Khartoum, 90 per cent of hospitals are out of service.
"We have friends, relatives and neighbours passing away on a daily basis due to fighting, bombing, lack of food and lack of access to health services and medication," she said.
"In most residential areas of Khartoum, people have been living without power for four months – people who need insulin are dying simply because they can’t put their medicine in the refrigerator.
"Women are struggling to get to hospital to deliver their babies. They need vaccinations and urgent care for their kids. They can't reach hospitals because they're closed, roads are closed or fighting is blocking their access."
Sudan's Health Ministry said in June at least 3,000 people had been killed. But doctors say these numbers are far below the true figures since a lack of access makes it difficult to arrive at an accurate tally.