Health Deserts and Conflict Hotspots in Four African Countries

2. Conflict Intensity and Population Overlap

In Sudan and the Democratic Republic of the Congo, the most severe conflict impacts, measured by fatalities, are highly concentrated and spatially clustered.

Several districts in Sudan record over 500 conflict-related deaths in 2025, with the most affected areas reaching a maximum of approximately 4,705 fatalities, reflecting the extreme intensity of ongoing violence. Similarly, parts of eastern Democratic Republic of the Congo exceed 500 fatalities, highlighting persistent and lethal insecurity.

These high-fatality hotspots closely overlap with densely populated areas, intensifying humanitarian vulnerability: communities already under demographic pressure face heightened exposure to violence while simultaneously experiencing severe disruption to essential healthcare access.

By contrast, Mali displays a markedly lower fatality concentration, with district-level peaks around 300 deaths, primarily in the northern and central regions. Chad remains the least affected among the four countries, with most districts recording fatality levels below 100, indicating comparatively lower conflict severity.

3. The Sudan-Chad Border: Refuge, Pressure, and Health Infrastructure

A striking pattern emerges along the Sudan-Chad border.

While many Sudanese conflict zones lack adequate healthcare facilities, a cluster of clinics and hospitals appears just across the border in Chad, especially near refugee reception areas.

(Only a few health facilities near the conflict zone in Sudan)

(While once crossing the border, there are quite a lot health facilities in Chad)

Reports by UNHCR and UNICEF indicate that the Sudan–Chad border region hosts hundreds of thousands of Sudanese refugees. Humanitarian sources suggest that in certain border districts or settlements, displaced people make up a major share of the population — in some areas, as many as one in two residents are refugees or internally displaced persons.

Despite its own poverty and limited infrastructure, Chad has kept its borders open, hosting hundreds of thousands of Sudanese refugees fleeing violence since 2023.

This humanitarian openness has turned border towns into critical health access points — not only for refugees but also for host communities.

4. The Northern Health Desert

Across northern Chad, Sudan, and Mali, the map shows vast areas with little to no health infrastructure. This is the Sahara Desert belt, where extremely low population density, harsh climate, and logistical barriers make facility construction and staffing difficult. These regions form what could be termed “health deserts” — large geographic zones with minimal formal access to medical care.

5. The Democratic Republic of the Congo: Dense Health Networks Amid Eastern Conflict

In contrast, the Democratic Republic of the Congo (especially around Kinshasa, population ~9.5 million) shows the densest concentration of health facilities among the four countries.

Interestingly, conflicts in the Democratic Republic of the Congo are concentrated in the east, near resource-rich zones, while the western capital region combines high population density with high healthcare access — a sharp contrast within the same country.

6. Mapping Key Takeaways

• Conflict hotspots and population density frequently overlap, heightening humanitarian risks.

• Border regions (Sudan–Chad) act as both pressure points and humanitarian buffers.

• Northern arid regions remain underserved, forming vast “health deserts.”

• Urban centers, particularly Kinshasa, demonstrate what well-developed facility networks can look like — but also highlight inequality across regions.