In the dusty village of Qoz Nafisa in rural Sudan, the pharmacy shelves of the lone public clinic are turning bare. Boxes of antibiotics, painkillers and epilepsy drugs that once lined the walls have dwindled to a few scattered packets. Staff say they have no clear idea when the next shipment will arrive.

The clinic, supported by the International Rescue Committee, serves around 5,000 people in a region already battered by years of civil war, displacement and hunger. Now, the conflict involving Iran and its regional adversaries has added a new layer of hardship, choking off maritime routes that carry much of the world’s medical supplies.

Key shipping lanes such as the Strait of Hormuz have been heavily disrupted, while traffic from major Gulf hubs including Dubai, Doha and Abu Dhabi has slowed or been rerouted. The United Nations estimates shipping costs have risen by up to 20 percent as vessels take longer, more expensive paths and insurers hike premiums. For aid agencies operating on tight budgets, that means fewer medicines can be purchased and delivered.

In Sudan, where international aid shipments have stalled for months, the impact is immediate and personal. Glaucoma patient Abbas Awad describes going weeks without the eyedrops that prevent his vision from deteriorating.

“Now you could be cut off from this eyedrops for up to a month,” he said. “You call for help from Saudi Arabia, Egypt, or sometimes you have to survive without it. This affected my eye more.”

The IRC reports that about $130,000 worth of pharmaceuticals bound for Sudan was stranded in Dubai for weeks. Instead of a direct flight to Port Sudan, the consignment had to be trucked overland to Oman and then flown out, adding both time and cost. The shipment includes basic but vital items: Amoxicillin, Benzylpenicillin, Prednisolone, Ibuprofen and even stethoscopes.

At the clinic window, health worker Ahmed Ibrahim faces the anger and despair of patients who leave empty-handed.

“When people come to the window, they say, why are you here and there is no medicine?” he said.

Just outside, grandmother Rashiqa Alqadi searches desperately for anti-seizure drugs for her disabled granddaughter, who has severe epilepsy. She travels to other towns, scours social media groups and leans on distant relatives, but supplies are increasingly erratic.

“Last week especially, we couldn’t get some,” she said. “Even tomorrow we could wake up and look for it, we might find some, we might not.”