Groups of gunmen who reportedly killed at least 460 people at a hospital in Sudan attacked in several waves, abducting doctors and nurses, then gunning down staff, patients and people sheltering there, the World Health Organisation said Friday.
The attack Tuesday in the country’s Darfur region was part of a reported rampage by the Rapid Support Forces, a powerful paramilitary group, as it captured the key city of el-Fasher after besieging it for 18 months.
Witnesses have reported fighters going house-to-house, killing civilians and committing sexual assaults.
Many details of the hospital attack and other violence in the city have been slow to emerge, and the total death toll remains unknown.
The fall of el-Fasher heralds a new phase of the brutal, two-year war between the RSF and the military in Africa’s third-largest country.
The war has killed more than 40,000 people, according to UN figures, but aid groups say that is an undercount and the true number could be many times higher. The war has displaced more than 14 million people and fuelled outbreaks of diseases believed to have killed thousands.
Famine has been declared in parts of Darfur, a region the size of Spain, and other parts of the country.
Escaping el-Fasher
Communications are down in el-Fasher, located deep in a semi-desert region some 800 kilometres southwest of Khartoum, the capital.
Aid groups that had been operating there have largely been forced out.
Some survivors have staggered into a refugee camp about 64 kilometres away in the town of Tawila.
More than 62,000 people are believed to have fled el-Fasher between Sunday and Wednesday, the UN migration agency said. But far fewer have made it to Tawila.
The Norwegian Refugee Council, which manages the camp, put the number at around 5000 people, raising fears over the fate of tens of thousands.
Fatima Abdulrahim, 70, fled el-Fasher with her grandchildren a few days before it was captured to escape the siege.
She described to The Associated Press a harrowing five-day journey to reach Tawila, hiding in trenches, dodging bullets and gunmen behind walls and empty buildings.
“We ran on the streets, hiding for ten minutes behind the berm, then charging out, running until we made it out,” she said, adding that she kept falling and getting up amid gunfire and shelling.
Her companions carried her at times, she said.
“Thirst almost killed us,” she said, describing picking grass to eat from the side of the road.
Along the way, she said she also witnessed militiamen shoot and kill young men trying to bring food into the city.
“The people dead on the streets were countless,” she said.
“I kept covering the eyes of the little ones so they don’t see. Some were injured and beaten and could not move. We pulled some to the paved road, hoping a car would come and take them.”
She said some fighters stopped her and the group she was travelling with, took all their belongings and beat the children.
At least 450 people have been admitted to the hospital in Tawila, some suffering from severe malnutrition and sexual violence, said Adam Rojal, spokesperson for a local group that works with displaced people in Darfur.
The Norwegian Refugee Council said people were arriving at the camp with broken limbs and other wounds, and some with injuries sustained months ago.
Many children arrived at the camp who had lost their parents in the fighting.
Of the 70 children younger than 5 that arrived in Tawila on Monday, 40 were severely malnourished, according to Doctors Without Borders.
Hospital attack
Christian Lindmeier, a WHO spokesman, provided new details about the killings at el-Fasher’s Saudi Hospital, which had been the only hospital in the city still providing limited services during the siege.
Gunmen returned to the facility at least three times, Lindmeier told a UN press briefing in Geneva.
At first, the fighters came and abducted several doctors and nurses, and at least six are still being held, he said.
They later returned and “started killing,” he said.
They came a third time and “finished off what was still standing, including other people sheltering in the hospital,” Lindmeier said, without specifying who the attackers were.
A number of grisly videos from the hospital have circulated online showing bodies and at least one fighter shooting a man.
The Associated Press has not been able to independently verify the details of the assault.
The RSF denied committing killings at the hospital.
On Thursday, it posted on social media a video filmed at the hospital, showing what it said were some patients at the facility.
A person speaking in the video said RSF fighters were caring for the patients, offering them change of wounds and food.
At least one wounded man spoke to the reporter.
It was not immediately clear when the video was filmed, although a timestamp stated it was Thursday.
Dr Teresa Zakaria, WHO’s unit head for humanitarian operations, told the briefing that the hospital was offering “limited service” now.
But he said that since el-Fasher’s seizure on Sunday, “there is no longer any humanitarian health presence in the city, and access has remained blocked.”
Militia accused of repeated mass killings
El-Fasher was the Sudanese military’s last stronghold in Darfur, and its fall secures the RSF’s hold over most of the large western region.
That raises fears of a new split in Sudan, with the military holding Khartoum and the country’s north and east.
The RSF and its allied militias have been accused of repeated mass killings and rapes when it controlled the capital Khartoum, and as it has seized towns across Darfur and further south over the past two years – mostly targeting civilians of Central and East African ethnicities.
The RSF is largely made up of fighters from the Arab Janjaweed militia, which is accused of carrying out a government-backed genocidal campaign in Darfur in the 2000s in which some 300,000 people were killed.
The Janjaweed were initially recruited by the military to fight Darfur insurgents, who were rebelling against power concentrated in the north. The militia was later reorganised into the RSF as an official force.
The military and the RSF were briefly allied in ruling Sudan following popular protests that ousted longtime leader Omar al-Bashir. They had a falling out in 2023 in a power struggle.
