On most days, I don’t feel as though the daily debates or the deadlines set in Washington affect me much. Who’s up and who’s down, and who tweeted what at whom, just aren’t on my radar. But July 12 — the day by which the United States must decide whether to lift sanctions against the government of Sudan — is a day that I’ll be watching closely because it will affect me and the people I serve.

For the better part of the past 10 years, I’ve been the only doctor permanently based in the Nuba Mountains of Sudan. As the lone surgeon in the region, I help to run the only referral hospital that serves 750,000 citizens. Every day I treat an average of 500 patients with injuries and ailments ranging from malnutrition and tuberculosis and leprosy, to amputations and trauma — many of which are direct or indirect byproducts of the conflict.

From my vantage point here in the Nuba Mountains, there has been no improvement in the humanitarian situation. The fact of the matter is that things are now as bad as they have ever been in Sudan.

Last year’s harvest was extremely poor due to a lack of rain and the fighting in key agricultural areas. Not a single grain of food or tablet of medicine has arrived from any of the usual large humanitarian organizations. We are forced to make do with antiquated equipment and limited supplies. People here are hungry, and there is simply not enough food to go around. We are expecting rampant malnutrition in the next year, and all the associated negative health effects that go with it, including reduced physical growth, increased morbidity and mortality (particularly with infants and children), and a corresponding reduction in cognitive development and a decrease in production and physical work capacity.

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