As the lead obstetrician at Al-Saudi Maternity Hospital in El Fasher, Sudan, Safa Ali faces extraordinary challenges daily, but one case stands out. Last August, she treated a pregnant woman shot during the country’s brutal civil war. A bullet had pierced the woman’s abdomen, injuring her unborn baby. Remarkably, both survived.
“It was one of the most challenging cases I’ve worked on,” says Ali, 45, who was recently named to the BBC’s annual list of 100 inspiring women.
Drawn to obstetrics as a student, Ali found joy in helping bring new life into the world. However, the chaos of Sudan’s ongoing conflict has made her work increasingly difficult. Sudan was named the country most likely to face an escalating humanitarian crisis in 2025 by the International Rescue Committee. Violence has displaced over 11 million people, more than half of them women and girls, with devastating consequences for maternal and infant health.
South Darfur is experiencing one of the worst maternal and child health crises globally, according to Médecins Sans Frontières. Nationwide, hospitals have been damaged or destroyed, with nearly a quarter of facilities offering emergency obstetric care no longer operational, reports the United Nations Population Fund (UNFPA).
El Fasher has endured months of siege, with violent clashes between the Sudanese Armed Forces and the Rapid Support Forces (RSF) damaging all but one of the city’s eight hospitals. Al-Saudi remains partly functional but faces severe shortages of medical supplies, including antibiotics, sutures, and anesthesia.
“The conflict makes everything unpredictable,” says Ali. “The airstrikes, shelling, and clashes put us all at risk.”
Like most doctors in Sudan, Ali has not received a government salary since the conflict escalated in April 2023. Despite these hardships, she continues to serve, often forced to improvise with limited resources.
“It’s heartbreaking and frustrating to prioritize care when there’s not enough to go around,” she says.
UNFPA is working to improve access to reproductive health services by deploying mobile health teams and midwives. Meanwhile, efforts to repair Al-Saudi Hospital are underway. Ali is also training new obstetricians, hoping the next generation will strengthen Sudan’s fragile healthcare system.
Despite the risks and hardships, Ali remains committed to her work. “My role here feels more important than ever,” she says.