May 28, 2024—Hospitals have been hit and the death toll is soaring as violent fighting engulfs El Fasher, Sudan, leaving nowhere safe in the city. Doctors Without Borders/Médecins Sans Frontières (MSF) renews its urgent call for the protection of civilians, health workers, and health structures.

The intense, non-stop fighting in El Fasher, Sudan, leaves no safe place for civilians in the city as patients and medical staff are increasingly becoming part of the staggering toll, warns Doctors Without Borders.

South Hospital, supported by Doctors Without Borders, was hit twice over the past few days and all three major medical facilities in El Fasher have been damaged as the Sudanese Armed Forces (SAF) and the Rapid Support Forces (RSF) face off in North Darfur’s capital. Only two of these facilities, South Hospital and Saudi Maternity Hospital, are currently able to function, while fighting endangers patients and staff.

“We see a bloodbath unfolding before our own eyes in El Fasher,” says Claire Nicolet, MSF program manager for Sudan. “The intensity of the fighting is leaving civilians with no respite and now hospitals are being increasingly engulfed in the fighting, making it harder and harder to treat the wounded. Medical facilities should be protected, and the warring parties should respect their neutral role as sanctuaries for the sick and wounded, where people can safely receive medical assistance.”

Hospitals are hit by artillery

El Fasher’s South Hospital was first hit on May 25, when a mortar landed on the prenatal care unit, killing one person and injuring eight among patients and their families. The next day a shell landed inside the hospital and injured three more people, while its fragments broke the windows of the delivery room and the ambulance. Three other shells landed outside the hospital.

“South Hospital is very congested—it is the only hospital capable of treating the mass arrivals of wounded people and has received over 1,000 patients since fighting began in the city on May 10,” says Abdifatah Yusuf Ibrahim, MSF project coordinator. “Sadly, 145 of them were in critical condition and died from their injuries. Now the hospital finds itself on the front lines, with a significant risk of going out of service.”

Children in El Fasher already lost access to specialized treatment when a bomb landed close to the city’s only pediatric hospital on May 11, killing two children who were in the intensive care unit and damaging the facility. The Saudi Maternity Hospital was hit on May 19.

“Health facilities must remain safe for patients and staff, who are working under intense pressure to treat those who are in critical need of health care. We urge the warring parties in Sudan to spare medical facilities and respect their neutrality, and to uphold their obligation to protect civilians, health care workers, and health structures,” says Nicolet.

A Doctors Without Borders employee was killed on May 25 when his house, which was located close to the city's main market, was hit by shelling—another example of how no place in El Fasher is spared by the violence of this conflict.

Displacement, supply shortages, and other challenges

Since conflict erupted in Sudan in April 2023, the movement of aid, supplies, and humanitarian staff has faced significant challenges, with delays, denied permits, and a ban on surgical supplies by the warring parties. These factors have pushed Sudan’s health care system to the brink of collapse as humanitarian needs soar.

More than 8.6 million people have been displaced by the conflict, including over 2 million people who have fled to neighboring countries such as Chad, South Sudan, and Central African Republic.

Malnutrition is a persistent threat for those sheltering in displacement camps. In Zamzam camp, approximately 9 miles from El Fasher, an estimated 30 percent of children are acutely malnourished.