Sudanese soldiers from the Rapid Support Forces unit, led by Gen. Mohammed Hamdan Dagalo, the deputy head of the military council, secure the area where Dagalo attends a military-backed tribe's rally, in the East Nile province, Sudan, on June 22, 2019. The RSF, attacked the South Hospital in al-Fasher, the capital city of North Darfur province on Sunday, June 9, 2024 opening fire on medical staff and patients, Doctors Without Borders said in a statement. 

The notorious Rapid Support Forces paramilitary group, fighting Sudan’s military for over a year, fired shots and looted a main hospital in the western region of Darfur, forcing its closure, an international aid group said.

The RSF attacked the South Hospital in al-Fasher, the capital city of North Darfur province on Sunday, opening fire on medical staff and patients, Doctors Without Borders said in a statement.

Images published by local media showed abandoned wards and corridors at the hospital, with patient beds and other medical equipment damaged and blood stains on the floor. Local news outlets also reported that the military managed to kick RSF fighters out of the hospital.

“It is outrageous that the RSF opened fire inside the hospital. This is not an isolated incident, as staff and patients have endured attacks on the facility for weeks from all sides, but opening fire inside a hospital crosses a line,” said Michel Lacharite, head of emergency operations at Doctors Without Borders.

At the time of the attack, there were 10 patients and a reduced medical crew as the aid group and the Sudanese health ministry had begun evacuating patients and transferring medical services last week to other facilities, the aid group said.

Most patients and the medical team, including Doctors Without Borders staff, managed to flee the shooting. It was not immediately clear whether there were casualties from the attack, according to the aid group.

However, Lacharite told The Associated Press the group's staff found two bodies inside the facility and they identified them as an RSF fighter and a military soldier. The circumstances of their deaths were not immediately clear.

The World Health Organization decried the RSF attack on the South Hospital, which is the only facility with surgical capacity in al-Fasher.

It said the hospital’s closure has stretched the city’s two other hospitals beyond capacity, further limiting access to life-saving services.

In a post on X, formerly known as Twitter, United Nations Under-Secretary-General for Humanitarian Affairs Martin Griffiths said he was “horrified” by the attack.

“The escalating violence in Sudan’s al-Fasher is dealing a crushing blow to civilians at their most vulnerable,” he said.

The attack came as the RSF intensified its offensive to try and wrest control of the city, the military’s last stronghold in the sprawling Darfur region. Two weeks of fighting last month in and around al-Fasher has killed more than 120 people.

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Meanwhile, the military has allied itself with rebel groups and formed a joint force to retain control of the city, where hundreds of thousands of displaced people have taken shelter since the conflict began.

A spokesman for the RSF didn't return phone calls seeking comment.

The facility had been hit by mortar shells and bullets three times between May 25 and June 3, killing two people and wounding 14 patients, Doctors Without Borders said.

The paramilitary group also rampaged through a village in the east-central province of Gezira province, killing more than 100 people a few days earlier.

Sudan’s conflict began in April last year when soaring tensions between the leaders of the military and the RSF exploded into open fighting in the capital, Khartoum and elsewhere in the country.

The war has wrecked Sudan, killing more than 14,000 people and wounding thousands others, while pushing its population to the brink of famine. The U.N. food agency warned the warring parties last month that there is a serious risk of widespread starvation and death in Darfur and elsewhere in Sudan if they don’t allow humanitarian aid into the region.

The war also created the world’s largest displacement crisis with more than 10 million people were forced to flee their homes, including over 2 million people who crossed into neighboring countries, the U.N. migration agency told the AP Monday.

Widespread sexual violence and other atrocities from both sides have also been reported, amounting to war crimes and crimes against humanity especially in Darfur, according to the United Nations.

Two decades ago, the RSF was born out of Arab militias, commonly known as Janjaweed, mobilized by ex-Sudanese President Omar al-Bashir against populations that identify as Central or East African in Darfur. At the time, they were accused of mass killings, rapes and other atrocities, and Darfur became synonymous with genocide.

Janjaweed groups still aid the RSF.

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Sudan's al-Fashir main hospital shut after RSF attack, aid group says

The main hospital in Sudan's al-Fashir city has been attacked by the paramilitary Rapid Support Forces and put out of service, Doctors Without Borders (MSF), which supports the facility, told Reuters on Sunday.

The city, in the Darfur region of northwestern Sudan, is home to more than 1.8 million residents and displaced people, and is the latest front in a war between the Sudanese army and the RSF which began in April 2023.

The RSF, which has taken over the capital Khartoum and most of western Sudan, is also seeking to advance further within the centre, as United Nations agencies say the people of Sudan are at "imminent risk of famine".

Some 130,000 people have fled their homes in al-Fashir as a result of the fighting in April and May, the United Nations has said.

The RSF did not respond to a request for comment.

South Hospital was the only hospital in al-Fashir capable of handling daily mass casualty events, according to MSF.

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From May 10 to June 6, some 1,315 wounded arrived at the facility and 208 people have died there, but many people are not able to reach the hospital due to the fighting, MSF told Reuters.

"It is outrageous that the RSF opened fire inside the hospital. This is not an isolated incident - staff and patients have endured attacks on the facility for weeks from all sides, but opening fire inside a hospital crosses a line," said Michel Lacharite, head of MSF emergencies in a statement.

The hospital had previously started evacuating patients after being impacted by fighting three times since May 25, and the remaining patients and staff were able to flee.

The al-Fashir Emergency Response Room, a volunteer group, said on Sunday that several people were killed and injured in the attack and that medicine and an ambulance were looted.

An eyewitness told Reuters he saw people evacuating the hospital, and other eyewitnesses said the RSF had launched missiles at the hospital and its vicinity.

A separate attack on Saturday on the Abu Shouk camp to the north of the city impacted another medical centre, injured more than 30, and killed at least two, the camp committee and a volunteer said.

A report last week from The Yale Humanitarian Research Lab said some 40 settlements outside the city have been struck with arson attacks since March.

Local residents have blamed the RSF for the attacks.

Leaving the city has proven dangerous, as residents say those fleeing have been attacked and even killed on the main RSF-controlled road out of the city.

Most of those leaving have taken routes either south to Zamzam camp, or west to the Tawila and Jebel Mara areas, which are controlled by armed groups, including the faction of the Sudan Liberation Army headed by Abdelwahid Mohamed Nour, an aid worker and residents said.

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