In one of the deadliest single incidents of Sudan’s brutal civil war, hundreds of patients and medical staff were massacred inside a hospital in El Fasher after the Rapid Support Forces (RSF) took control of the city on Sunday. The World Health Organization (WHO) and the Sudan Doctors Network (SDN) confirmed the killings, describing them as “cold-blooded” and “unprecedented in scale.”
WHO Director-General Tedros Adhanom Ghebreyesus said he was “appalled and deeply shocked” by reports that more than 460 people had been killed at the Saudi maternity hospital in El Fasher. Although he refrained from attributing direct blame, the SDN accused the RSF of executing everyone inside the facility.
“The Rapid Support Forces yesterday … killed in cold blood everyone they found inside the Saudi hospital,” the SDN said in a Facebook statement on Wednesday.
RSF completes control over Darfur region
The capture of El Fasher marks a significant turning point in Sudan’s ongoing conflict, giving the RSF full control over all five capitals of the Darfur region. The city, once home to over a million residents, had been under siege since May 2024, with food, medicine, and water supplies cut off.
The Sudanese army, which controls much of the country’s north and east, had withdrawn from the city earlier this month. With its fall, the RSF — a paramilitary force that emerged from the infamous Janjaweed militias — now dominates the west and southwest of Sudan.
The RSF, led by Gen Mohamed Hamdan Dagalo, known as Hemedti, rose to power during the Darfur conflict in the early 2000s, when Janjaweed fighters carried out ethnic massacres under former dictator Omar al-Bashir. In January 2025, the United States formally declared the RSF guilty of genocide.
Reports of mass killings and atrocities
Eyewitness accounts describe a horrific scene at the hospital and across El Fasher. Survivors told Associated Press that RSF fighters went house to house, beating and shooting civilians, including women and children. “It was like a killing field. Bodies everywhere and people bleeding, and no one to help them,” said Tajal-Rahman, a survivor now sheltering at a displacement camp in Tawila, 60 km west of El Fasher.
The Joint Forces, a coalition allied with Sudan’s army, claimed the RSF executed more than 2,000 unarmed civilians since capturing the city. Women attempting to flee were reportedly sexually assaulted, while others were extorted or stripped of belongings. Many are believed to have died in the desert trying to reach overcrowded camps.
Satellite imagery suggests mass graves
The Yale Humanitarian Research Lab released satellite images from October 27–28, showing “reddish discoloration” and clusters of white objects near the Saudi hospital — consistent with mass graves. The lab also documented “evidence of systematic killing” at an RSF detention site inside a former children’s hospital and along El Fasher’s fortified earth walls.
“We’re not looking at small numbers. We’re looking at dozens, hundreds, and eventually, there will be thousands,” said Caitlin Howarth, the lab’s director of conflict analytics.
In a rare public statement, Hemedti admitted that there had been “abuses” by RSF fighters and promised an internal investigation. No timeline or details were provided.
Humanitarian catastrophe deepens
El Fasher’s fall has worsened what the United Nations calls one of the world’s worst humanitarian crises. The city’s Zamzam displacement camp, once home to half a million people, suffered a mass killing of around 2,000 residents in April when the RSF overran it.
With famine already declared in several parts of Darfur, humanitarian agencies say relief efforts are nearly impossible. Aid convoys are being looted, medical staff have fled, and communications with trapped civilians remain cut off.
WHO officials said hospitals in El Fasher and neighbouring regions were “completely non-functional,” and more than 90% of healthcare facilities in Darfur have been damaged or destroyed since fighting began in April 2023.
Echoes of Darfur’s past genocide
International observers have drawn parallels between the El Fasher massacre and the Darfur genocide of 2003, in which Janjaweed militias — now the RSF — killed hundreds of thousands of non-Arab civilians. The RSF’s tactics, including ethnic targeting and sexual violence, appear to follow a similar pattern, according to rights groups.
The United Nations, African Union, and European Union have all condemned the latest atrocities and called for immediate accountability. The International Criminal Court (ICC), which already has warrants against Darfur-era commanders, is expected to open a new investigation into the RSF’s actions in El Fasher.
A nation on the brink
As Sudan’s civil war enters its second year, the humanitarian toll continues to mount. Over 12 lakh people have been displaced within Darfur alone, while millions more face starvation. Analysts warn that the RSF’s unchecked dominance in western Sudan could embolden further violence and complicate international mediation efforts.
For the people of El Fasher, the massacre marks not just the fall of a city but the collapse of the last safe refuge in Darfur — a grim reminder of the atrocities that once shocked the world two decades ago.