Ill-health and health-care in Khartoum/Omdurman

Medical geographies of Third World cities are particularly affected by lack of data of sufficient detail and spatial resolution to allow proper analyses of intra-urban patterns of variation. Rapid rates of population growth fuelled both by natural increase and migration compound the problem of demographic accounting. Khartoum/Omdurman, the major urban complex in the Sudan is no exception to this situation and although some available statistical information from official sources is used to portray some of the characteristics of urban ill health, greater reliance is placed upon data collected during a social survey of seven contrasted residential areas. Whilst the extent of under-reporting of disease and the typical patterns of ill-health become apparent, it is also clear that there are very large differences among the different types of residential area. The gap between rich and poor, manifest in many criteria of social well-being, is also no less acute in terms of vulnerability to disease. It is also evident that although quality of services is generally problematic, something resembling an 'inverse-care' situation seems to exist which further exacerbates the disadvantage of poor urban dwellers.