One year after the fall of El-Fasher, the capital of North Darfur in Sudan, reports have emerged alleging that the paramilitary Rapid Support Forces (RSF) systematically targeted hospitals and healthcare workers during an 18-month siege of the city. The RSF seized control of El-Fasher on October 26, 2025, after a prolonged and intense campaign.
An investigation conducted over several months documented at least 43 attacks on medical facilities between May 2024 and October 2025. During this period, 55 healthcare workers were reportedly killed, 120 injured, and 10 forcibly disappeared or abducted. Interviews with medical personnel who escaped the city highlighted deliberate efforts by the RSF to disable healthcare services, with the objective of depriving residents of essential medical care, thereby undermining civilian resilience.
South Hospital suffered repeated shelling in mid-2024 before being briefly occupied by RSF forces in June 2024, during which government troops later found patients killed and medical equipment destroyed. The health minister of the RSF-backed Government of Peace and Unity, Dr. Alaa Eldin Nugud, dismissed claims that the hospital was solely civilian, asserting it had been used as a military base, a claim rejected by doctors. Following South Hospital’s closure, staff and resources relocated to Saudi Maternity Hospital, which faced persistent attacks, reportedly up to 25 times a day. Other facilities, including the Specialized Children’s Hospital, were forced to close, leaving Saudi Maternity Hospital the only operational medical center at the time of El-Fasher's capture.
Officials aligned with the RSF have denied allegations of deliberate targeting, labeling them as falsehoods aimed at discrediting the paramilitary group. They maintain that healthcare services have been largely restored and released videos showing operational hospitals. However, medical personnel speaking under duress indicated forced compliance. One doctor told investigators he remained only out of fear for his life.
A United Nations fact-finding report issued in February 2026 characterized the actions of the RSF in El-Fasher as indicative of a genocidal trajectory. It cited mass killings and atrocities targeting non-Arab communities, particularly the Zaghawa and Fur ethnic groups. The report linked these crimes to an extended siege during which the RSF allegedly imposed conditions intended to physically destroy these populations.
Humanitarian organizations that accessed El-Fasher in early 2026 described a city dramatically depopulated and largely destroyed. Médecins Sans Frontières (MSF), granted limited supervised access in January, reported that while acute medical emergencies appeared limited among the remaining population estimated at 70,000—down from one million—public services and infrastructure had been devastated. MSF noted that many civilians had yet to return, and the city now resembled a "ghost town."
Amnesty International, based on testimony from 25 civilians and humanitarian workers interviewed after fleeing El-Fasher, depicted a pervasive climate of fear and ongoing repression under RSF control. Survivors described arbitrary detention, torture, and extrajudicial killings. Former prisoners recounted routine beatings and deaths resulting from medical neglect, while women and children were reportedly held in converted schools under harsh conditions, with widespread malnutrition and shortages of medicine.
Residents reported that humanitarian workers faced heavy surveillance, restricting independent assessments and limiting civilians’ ability to speak freely. One El-Fasher resident described the city as unrecognizable, with "completely destroyed" public infrastructure and an atmosphere of terror under RSF oversight.
Amnesty International’s secretary-general Agnes Callamard condemned the international community’s failure to adequately respond to the plight of civilians amid the ongoing conflict in North Darfur.