medicine

Hasanat al-Rashid, 48, has lived with diabetes for 15 years, and the three-and-a-half-year civil war between Sudan’s military and the Rapid Support Forces paramilitary group has worsened her situation. Finding the treatment she needs has become a daily struggle.

When the war broke out in April 2023, she was forced to flee south from her home in Haj Yousif in Khartoum North to Umm Daw Ban in Khartoum State.

During her displacement, she went for days without medication and was forced to eat foods unsuitable for her condition, such as asida, a traditional Sudanese porridge.

She underwent operations on her foot twice when she developed complications of diabetes, including a severe infection.

She moved between hospitals in Gezira State south of Khartoum, seeking treatment in Rufaa, Wad Madani and Al-Hasahisa. When fighting spread to these areas in December 2023, she fled again, arriving in Port Sudan, a city on the Red Sea that was less affected by the war.

Her condition has worsened to the point that she now has to use insulin every day and with this comes added costs, something that forces diabetes sufferers in Sudan to choose between medicine and other essentials, such as food.

“The doses vary depending on whether my blood sugar is high or low,” she told Al Jazeera.

The war has pushed income levels in Sudan back to those last seen in the 1990s, according to the United Nations Development Programme. This means Hasanat and other diabetes sufferers are struggling to afford the medicine they need to treat the condition.

Hasanat’s doctor recommended she use an insulin pen, a device used to inject insulin under the skin. She would need one or two of the devices a month, but the cost at 70,000 Sudanese pounds ($8) is more than she can afford up front, so she opts for a vial of insulin.

This is cheaper at 17,000 Sudanese pounds ($1.80), but there is the additional cost of buying ice every day to keep the insulin cool. She spends 180,000 pounds ($20) a month on ice to preserve the medicine. But she is able to spread these costs out through the month, making the vials her only viable option even if the overall costs are higher than an insulin pen.

“It may last a month or less, but the challenge is that I don’t have a refrigerator, so I struggle to store the insulin properly,” she said.

She also needs painkillers and vitamins on a regular basis to manage complications caused by the diabetes.

The rising cost of treatment

Fatima Adam, 75, is among the patients at Port Sudan Hospital struggling to afford the medicines she needs to manage her hypertension and a thyroid condition.

She was admitted to the hospital with complications caused by high blood pressure, which has started to impact her heart. Too unwell to speak to Al Jazeera herself, her daughter, Aisha, described how the rising cost of treatment has affected her whole family.

Before the war, Fatima received medicine through the National Health Insurance Fund. She paid a quarter of the cost while the fund covered the rest. But when the war started and the economy collapsed, the medicines she needed were no longer covered by the scheme.

“My mother takes six different medicines because hypertension has affected her heart in addition to her thyroid medication. The war has made things harder because the prices of these medicines have gone up,” Aisha told Al Jazeera.

The responsibility for paying for Fatima’s treatment and supporting her and her daughter falls on her son, who works as a casual worker. With no fixed income, he goes to the market every day in search of work but sometimes returns home empty without any luck.

“Sometimes, when my brother finds work, we buy enough medicine to last a month. Other times, we have to buy smaller quantities and take the medicines intermittently,” Aisha said.

She bought a month’s supply of her mother’s medication a few days ago for 160,000 Sudanese pounds ($17.80), a substantial expense for a family whose income depends on day labour but essential to treating Fatima’s condition.

War damage

The war has caused an estimated $500m in losses to medicine stocks, infrastructure and transport fleets, dealing a major blow to Sudan’s pharmaceutical supply system, the National Medical Supplies Fund told Al Jazeera.

The National Medicines and Poisons Board estimated that only eight of the 30 pharmaceutical factories in Khartoum that shut down during the conflict have resumed operations despite the security situation in the capital recently improving.

This has increased Sudan’s reliance on imported medicines, but the subsequent depreciation of the Sudanese pound has driven up the costs of pharmaceutical procurement and production.

Hossam al-Naeem, who works as a pharmacist in Port Sudan, said customers with diabetes and hypertension require regular painkillers and vitamins to help their overall condition.

“I feel deeply saddened when I see the expressions on some patients’ faces as they ask about the prices of medicines and discover how much they have increased because of the depreciation of the Sudanese pound,” Hossam told Al Jazeera.

The currency’s collapse has created added challenges for pharmacists. Before the war, a dollar traded for roughly 600 Sudanese pounds. Now black-market currency traders are quoting rates of 9,300 pounds to the dollar, meaning higher costs for most goods in Sudan.

Sometimes Hossam incurs losses himself when he finds that the prices of drugs have risen sharply, and keeping essential medicines stocked is becoming difficult.

“I used to sell a strip of cold and flu tablets for 6,000 Sudanese pounds [70 cents]. But when I went to buy new stock, I found that the supplier’s price was also 6,000 pounds per strip. That means I made no profit, not even enough to cover the pharmacy’s operating costs,” he said.

The struggle to afford heart medication

Huda Mahmoud, 58, lives in el-Obeid, the capital of North Kordofan state in south-central Sudan, where drone attacks and other violence remain a problem while the military is making advances towards the city.

Huda has lived with heart problems for more than 12 years and described the impacts of the war as being physical, financial and emotional.

“I take five different medicines. There was a time when they weren’t available, and I suffered a lot. Sometimes, I had to ask people in Wad Madani, Sennar or Port Sudan to send them to me,” she told Al Jazeera. “The medicines were extremely expensive, costing me 300,000 Sudanese pounds [$33.30] a month.”

Taking medication has become a carefully managed routine with each pill tied to a specific time of day.

“I’ve become tied to my pills: this one before eating, that one afterwards. If I forget one, my heart starts beating very fast,” she added.

In March, Huda was forced to travel from el-Obeid to Omdurman. Following her strict treatment regimen has become increasingly difficult during repeated periods of upheaval.

She has now returned home to el-Obeid, where her regular medicine is priced at 151,000 Sudanese pounds ($16.80) a month, something she can barely afford.

Her greatest fear is running out of medicine or being unable to afford her next supply, which would put her at risk of a blood clot.

“I’m afraid of becoming incapacitated. I used to be responsible for the whole household, but now I need help. I feel like I’ve become a burden on my family,” she said.

Tehran, Iran – Iranians are stocking up on food and medicines as fears grow that the country will face dire shortages as the United States tightens an embargo on the country.

The Iranian government had managed to keep household staples flowing during the early months of the war. But a US naval blockade and pivot to draconian sanctions have led to fears that imports will be limited.

More recently, the US announced a ban on Iranian airlines worldwide and is pressing other countries to cut trade ties with Iran in a bid to isolate the country.

Addressing the United Nations General Assembly last week, Iranian President Masoud Pezeshkian condemned Washington for its blockade on his country, saying it will prevent food and medicine from reaching the Iranian people.

On Saturday, US President Donald Trump rejected Iran’s offer for a seven-day truce that would see it reopen the Strait of Hormuz in exchange for economic relief and other conditions.

As the war enters its eighth month and hopes for a diplomatic solution dim, Al Jazeera looks at how some Iranians are faring under a US embargo.

Consumers

Tehran’s stores remain stocked, but shoppers are keeping an eye on shop shelves. Their anxiety has deepened since a flurry of social media posts urging people to ensure they have several days of food before a possible new round of fighting with the US.

At one shopping centre, Ali, 51, was loading a trolley packed with rice, flour, pasta, pulses, cooking oil and canned food.

He is stocking up because he is convinced that Iran’s adversary is seeking to “starve” the people to push them to turn on their government.

“This is not a war in the traditional sense. It targets the people to put pressure on the authorities,” he said.

With flights to some nearby countries suspended, imports of certain medicines and mobile phone headsets are hard to find. The prices of those still available in shops have been pushed up.

Haj Pasandideh, a 71-year-old grocer, said he believed warehouses were well-stocked with basic goods at the moment. But the problem lies in the daily price increases due to Iran’s weakening rial, prompting him to bulk-buy goods before the expected hikes.

He sometimes caps cooking oil at one bottle per sale to ensure as many customers can purchase the goods as possible.

Exporters crushed

Farmers are also on edge due to the embargo, unable to ship out their produce and forced to sell to local markets.

The war has worsened the economic situation, even after years of sanctions that have pushed the country from being a regional exporter of agricultural and food products to being one of the region’s main importers.

Mehran, an apple grower, told Al Jazeera that due to the difficulties of exporting, he had sold only a third of this year’s harvest, all of it inside Iran.

Some neighbouring countries have halted trade with Iran in recent months, he said, while trucks now spend days at crossings they once cleared in a day, causing fruit to spoil before it reaches buyers.

“The blockade has not only closed the sea and air but also the land routes but in an undeclared manner,” he said.

Pharmaceutical shortages

The war has also deepened an already-dire shortage of medications. Some pharmacies Al Jazeera visited in southern Tehran had run out of infant formula and dozens of other types of medications.

Although officials have assured Iranians that substitute products were available, pharmacy staff expressed concern about the increasing number of customers searching for infant formula in vain.

“Imported medicines are disappearing fast, and lately people have been coming in to buy certain items before they need them for fear they will run out in future,” Mahsa, a 23-year-old pharmacy assistant, told Al Jazeera.

She said the health authorities had introduced “smart systems” to track the quantity and type of medication each person buys.

Breaking the blockade

The prospect of a prolonged siege and deteriorating economic conditions have driven some Iranians to call for a military solution.

On Tehran’s main thoroughfare, several people told Al Jazeera that another round of fighting with the US was unavoidable. Some urged the government to break the blockade by force before it is tightened further.

Mohsen, a 23-year-old economics student, believes Washington’s goal is to strangle the Iranian economy and the cost will ultimately be felt by Iranian citizens.

Iran possesses many strong cards that it must use to break the air and sea blockade before they develop into a land blockade that would completely choke Tehran, he said.

Alireza Taghavinia, an Iranian international relations expert, told Al Jazeera that the gap between Washington and Tehran was too wide to be bridged. “The siege imposed by force will only be lifted by force,” he said.

In a worst-case scenario, falling living standards could bring protesters onto the streets, he added.

“The enemy is counting on stirring up chaos inside Iran because it believes no military strike will achieve its objectives without internal unrest,” he said.

Filming a broadcast television show can leave even the most seasoned actors feeling like they’ve lost sense of time. But by afternoon on a recent weekday, Josh Charles actually looks like he teleported to the past as he collapses into a seat inside his production trailer in upstate New York.

He’s in the throes of filming Season 2 of “Best Medicine,” the Fox dramedy he headlines that’s set in a small fishing village in Maine, and the reason he’s shed his character’s usual suit and tie for gaitered trousers and a navy coat with red facings eventually reveals itself: Port Wenn, the show’s fictional town, is putting on a Revolutionary War reenactment. And if you’re familiar with Martin Best, the curmudgeonly doctor with an almost permanently furrowed brow portrayed by Charles, the character’s willingness to don such a getup likely took some coaxing.

That’s the fun of it all for Charles.

He’s been a working actor since childhood — making his debut at 15 in John Waters’ cult classic “Hairspray,” followed soon after by his turn as Knox Overstreet in “Dead Poets Society” — and a fixture in TV and film ever since.

While best known for dramatic roles like high-powered lawyer Will Gardner in “The Good Wife,” Charles easily pivots to comedy — like the time he memorably played the triple-collared, snobby camp ringleader in “Wet Hot American Summer: First Day of Camp.” Now, “Best Medicine” lets Charles leans into the push and pull of the comedy and drama within his tightly wound alter ego.

Josh Charles as Martin Best in Fox’s “Best Medicine.”

(Francisco Roman / Fox)

Created by Liz Tuccillo (“How to Be Single,” “Sex and the City”), the series follows a brilliant but cranky heart surgeon who, after developing a crippling blood phobia spurred by a traumatic medical case, abandons his thriving career in Boston to become a general practitioner in the town where he spent summers as a child. Martin Best is a doc whose bedside manner could use some TLC, but he came to town hoping he can still practice medicine — that is, if the townspeople would actually do as he says.

“I have been really wanting to do more comedy lately and looking — especially if I was going to call a place home for a particular period of time, like you do in a television show — for something that was a little more lighter air than I had been networking in of late,” says Charles, whose recent credits include dystopian drama “The Handmaid’s Tale” and spy thriller “The Veil.”

The series is based on the beloved British dramedy “Doc Martin,” which starred Martin Clunes as a doctor with a similar storyline, that aired between 2004 and 2022. Tuccillo says Charles brought an elegance and depth to the fish-out-of-water dynamic his character navigates in the quirky town.

“He never hits a false note,” she says in a separate video call. “I knew the material would be in great hands in that he would always elevate it just by his artistry and being. I knew he was going to be able to play the gruffness, but any time that you’re doing a show, there is a question mark on so many things. To be honest, we were like, ‘But is he going to be super funny? Is he going to want to do pratfalls? Is he going to be game for the comedy part of it?’ When we started working, it was clear he was game for all the shenanigans … he likes to laugh. So I try to devise things that I think will amuse him.”

A special advance preview of the Season 2 premiere aired Sunday, but the show will move into its regular time slot Tuesday. Here are edited excerpts from the conversation with Charles.

Josh Charles poses for photos on the “Best Medicine” set in upstate New York. He says he was drawn to the Fox dramedy because it was “a little more lighter air” than the other work he had done recently.

(Ebru Yildiz / For The Times)

“Best Medicine” hit Netflix after its first season aired. Building an audience outside the traditional linear viewing has become such a key component of television today. How do you feel about it?

One of my dad’s best friends told me, “I’m watching the show on Netflix!” He’s like, “I just can’t watch shows with commercials anymore” — as people are programmed now. That is the new shift. You go into these platforms for periods of time, build your audience in a different way and hopefully keep growing that audience. [Television] keeps evolving and growing in a way that I don’t fully understand, but I do know that it’s a different world right now. Netflix has a great reach, and it’s great that we’re on there and that people are discovering it. And apparently we did very well.

Season 2 opens with Martin on probation and under review by the medical board. What is Martin in for this season?

When it starts off, he’s really in it. Eden [Martin’s ex-girlfriend played by Eliza Coupe] is now back in the picture. She’s coming from Boston every weekend, and she’s rubbed a lot of people in town the wrong way. And the progress that Martin made, we see him maybe take a few steps back in the way that he interacts with people. He’s with her and I think there’s feelings there, but I think their relationship feels very — I don’t know, it’s interesting. It doesn’t have the fire. But she doesn’t make him feel bad about himself. She respects him, and I think those things are important. And he’s around in this town where nobody’s listening to him half the time. People are just always mad at him about something, and she’s not. She puts him a little bit on a pedestal, and I think he really needs that.

All that presents an obstacle for the show’s slow burn: Martin and Louisa (Abigail Spencer). There’s been some discourse about the art of the slow burn and how the pacing has changed in an era of short episode orders and unpredictable renewals. You have experience in this department with “The Good Wife.”

Liz and I have talked about it a little bit. You don’t want to muck bait it and drag it out for the sake of dragging it out. I think they’ve done a good job of putting the obstacles in a way that still feels organic and genuine and not yet a reach. In the British show, things accelerated so much faster. They only made eight [episodes] a year. We want to also have it feel like it’s plausible. It is really fun to have Eliza Coupe here. It’s fun to play scenes with her and [see] the different side that brought out in Martin. That is the challenge because I don’t think we’re as interested in doing it quite that fast [as the British show]. I have faith in them that we’ll land it in a good way.

Ellen Soraya Nikbakht as a peculiar patient and Josh Charles as Martin Best in the Season 2 premiere of “Best Medicine.”

(Danielle Mathias / Fox)

You’ve played in comedy and drama in your career. It’s fun to watch you straddle both sides with this character. How has it been finding the rhythm or tone with him?

A lot of the comedy I’ve done, I’ve done some stuff that’s more silly and kind of over the top. I love playing the fool. What’s really fun [here], to me, are the circumstances they put Martin in where things are blowing up in front of him and he’s just trying to deal. I’ve enjoyed doing a lot of the physical comedy on the show.

I [also] found it really interesting to have a character who doesn’t want to be around people, but he actually does. He just doesn’t really know how to do it, and he’s never really had any kind of practice at it in his life. And he’s gone through a lot of trauma in his life. He’s a really specific kind of workaholic. For him to grow up with what he did, and losing his sister really young in his life — I did research on that and what that does to people and how that can sort of frame your life. I imagine he went to private school, maybe a boarding school, then he goes on the track of going to college and medical school — we know how hard that is, the kind of hours they put in; then to be really successful at it, you put everything you have into your work. There’s this other side of his life that is completely empty. This town kind of just softens off the edges of him a little bit and helps him become a little more authentic version of who he was maybe meant to be. That gives me some place to build off of and to go with the character, other than it feeling kind of just very one-note.

Matthew Goode, left, as Finn Polmar and Josh Charles as Will Gardner in a scene from Season 5 of “The Good Wife.”

(CBS)

This series marks your return to broadcast television after leaving “The Good Wife” in its fifth season. You’ve done TV since then, of course. But a big reason you left broadcast was because of the grind of a 20-plus episode season. With “Best Medicine,” you’re the lead and the second season will have 14 episodes. Does that feel like the sweet spot?

If “The Good Wife” was “The Good Fight,” I would have done that until the wheels come off. I would have never wanted to leave that because I would have had a life. I could have been able to go do a play, travel with my family, see my kids. At the time of “The Good Wife,” I didn’t have kids, but we were about to get married and wanted to have children. I was only going to do 18 [episodes] at most with this show, if they wanted it. And then I asked them this year, “Well, we’re just at 14. What was the decision [there]?” And I’m happy about it. They also agree. This just feels like where the show wants to live creatively. You work really hard for four or five months, and then you get to go explore other projects and travel and live your life.

Your departure from “The Good Wife,” with your character Will Gardner dying, felt like an out–of–body viewing experience as it happened. The fact that it was kept under wraps —

I can’t believe we did it, honestly. There was one journalist who obviously had a source somewhere and did find out. Part of being able to keep that silent until the moment was an agreement that they would come to set and be there as long as it was [kept secret]. I remember like when the episode aired, I was in the editing bay with the editors in L.A. [for an episode I directed]. I’m seeing things come in and I was like, “Oh my God!” I thought it was going to get ruined for people on the West Coast. These days, you know how they make something, how much this cost, how they did this scene … we used to be surprised by things. To be able to truly shock people you know like in an Orson Welles-style “War of the Worlds” way. I felt like in our own sort of network TV way, this was the equivalent of that. We really got to narratively pack a punch. That season was one of the great treats of my career. I just felt the writing on that show that season was at another level.