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The number of Sudanese risking their lives to leave the besieged city of El Fasher in northern Darfur is increasing as paramilitary Rapid Support Forces (RSF) intensify their attacks on the regional capital, according to aid agencies including Medecins Sans Frontiers (MSF).
“The numbers continue to increase (from) until now,” said Romain Madjissembaye, MSF project manager in Tawila. Located about 60 kilometers west of El Fasher, it has become an important center for displaced people.
He said that last week, they saw about 90 people who arrived in critical condition. “Many of them are malnourished and facing executions along the way, some shot,” Madjissembaye told CBC News via a Zoom interview.
An estimated 260,000 civilians, including 130,000 children, remain trapped in El Fasher according to UN agencies. Surrounded by RSF militias on three sides, the city has now endured more than 500 days of siege, cut off from food, medicine or safe escape.
Some media reports suggest that people have to eat animal food to survive.
MSF withdrew from El Fasher, one of the few remaining places not under RSF control in Darfur, in August 2024, just months after the siege began in May.
“The situation became very, very complicated,” Madjissembaye said. “(We face) a lot of security problems, bombings. Our team, our patients, they don’t feel safe.”
Watch | Human rights officials speak about conditions in El Fasher, Sudan:
Human rights organizations are sounding the alarm after a drone attack on a mosque killed at least 70 people in the besieged town of El Fasher in Sudan’s North Darfur region, according to aid workers and the Sudanese military.
Doctors use mosquito nets to dress wounds
He says they are now resellers of those who manage to reach Tawila from El Fasher to obtain information about conditions inside.
One man, who arrived last month with gunshot wounds to his shoulder and leg, told MSF that doctors at the last hospital in El Fasher were using mosquito nets for clothing.
Madjissembaye says another man had also described terrible conditions at the hospital.
“He found many patients (with) bullets in their bodies. Some of them required amputation. But there are few (left) doctors. And they also ran out of medicine.”
He says there were also many reports of women who had been raped or abused on the El Fasher path.
Tawila has become a massive refugee camp with hundreds of thousands of people displaced from El Fasher and the Zamzam displacement camp on the outskirts of the city.
Last week, while visiting Tawila, UN humanitarian coordinator Denise Brown called it “one of the epicenters of a humanitarian catastrophe.”
“It took us five days, through three countries, three different planes and three days of driving. We had it all because there are many frontlines inside Sudan,” he said, highlighting the challenges in moving aid.
“Stop the violence, stop the war, let us through.”
Agencies challenged to bring help to
Sudan has been caught in the grip of a devastating war since April 2023, when two generals who had joined forces to stop a transition to civilian rule fell and turned on each other.
The RSF has clashed with the Sudanese Armed Forces (SAF) ever since, now controlling most of Darfur and neighboring Khordofan, while the SAF controls the north and east of the country.
When the SAF recaptured Khartoum earlier this year, the RSF turned its attention more fully to El Fasher, the SAF’s last stronghold in Darfur.
Reports from the ground suggest that civilian collection points such as communal kitchens are increasingly being targeted by RSF shelling as fighters move closer to the city centre.
Last month, a drone attack on a mosque killed more than 70 people.
On Saturday, an umbrella group of several “resistance committees” in El Fasher made up of local residents said on Facebook that the city had become an “open morgue.”
The group said residents faced deliberate and indiscriminate shelling with attacks on markets and hospitals.
Despite its absence from the world’s headlines, Sudan is the world’s largest humanitarian crisis, according to international monitors.
The United Nations says More than 12 million people They have been displaced since spring 2023.
Watch | South Sudan’s hunger crisis pushes aid agencies to the limit: 
South Sudan faces one of the most severe hunger crises in the world, second only to Gaza. As 7.7 million people face malnutrition, according to the World Food Programme, aid workers say US funding cuts have removed the backbone of the country’s health system.
Aid agencies say they fear an even bigger humanitarian crisis if the RSF invades the city.
Madjissembaye says MSF’s capacity has already been pushed to the limit.
The town and surrounding area are controlled by a group called the Sudan Liberation Movement (SLM), which has adopted positions of neutrality in the past. But aid must come from the border with Chad, and those convoys face enormous challenges.
“It can take weeks before you receive a supply,” Madjissembaye said. “And sometimes they (militants) stop the convoy on the way. Sometimes they go to the convoy.”
‘Horror technology has evolved’
International monitors have accused both sides in the conflict of atrocities.
The RSF today, led by General Mohamed Hamdan Dagalo, emerged from the notorious Janjaweed militias accused of genocide against non-Arab tribes in Darfur in the early 2000s.
On Monday, the International Criminal Court in The Hague issued its First Crime War verdict for Darfur during those years.
Ali Muhammad Ali Abd-Al-Rahman, a leader of the Janjaweed militia known as Ali-Khoshayb, was found guilty of crimes against humanity, including murder, rape and torture.
Dr. Mukesh Kapila was the UN representative in Sudan in 2003-2004, witness to the horrors taking place. More than 20 years later, he says what’s happening on the ground now is even more brutal.
“And the reason for that is that horror technology has evolved. Twenty years ago, when Ali-Khoshayb was running the roost he was using camels and horses and Land Rovers and Toyotas and things like that,” said Kapila, now an emeritus professor of global health and humanitarian affairs at the University of Manchester.
“Today we have drones. We have missiles. We have deadlier weaponry, better targeting weaponry, but still with massive area effects.”
