Medics at el-Fasher's Saudi Hospital performed a Caesarean by phone light on the day it was bombed. A BBC investigation has found evidence that Sudanese paramilitary fighters systematically destroyed el-Fasher's healthcare system during their long siege and subsequent takeover of the city in Darfur a year ago.
Disturbing Findings
UN human rights chief Volker Türk called the findings "deeply disturbing", stating that multiple attacks by the Rapid Support Forces (RSF) on civilian infrastructure, including health facilities, were serious violations of international humanitarian law and may amount to war crimes. The RSF has rejected the BBC's findings, with the paramilitary group's health minister describing the allegations as propaganda and a deliberate attempt by the national army and its allies to smear the RSF's reputation.
Using sources who were on the ground in el-Fasher, the BBC has documented at least 43 separate attacks on hospitals and healthcare sites from May 2024 to October 2025, with some facilities hit multiple times. Under international law, it is illegal to attack health facilities or their staff during conflict.
Impact on Medical Workers
The investigation also reveals the toll on medical workers in the western city. From April 2023 to October 2025, the BBC's data shows 120 were injured, 55 killed, and 10 forcibly "disappeared" or abducted.
“"The RSF [were] trying to evacuate the hospitals, to put them out of service because the health system is the cornerstone of any city or any state," says Dr. Muhamed Suliman, a surgeon who was based in el-Fasher during the siege. "The RSF started hitting these areas so citizens have no longer any way to stay there. It was intense. It was deliberate. It was planned."
Context of the Conflict
The investigation comes a year after the fall of el-Fasher, marking one of the most brutal chapters of the civil war that erupted in April 2023 between the RSF and Sudan's military. Both sides have been accused of attacks on health facilities. In March 2026, the World Health Organization (WHO) condemned the bombing of al-Daein hospital in RSF-held eastern Darfur, which killed dozens and forced the site to close. Sudan's military is believed to have carried out the drone strikes, although it has denied responsibility.
However, events in el-Fasher represent "one of the clearest and most severe examples of the wider impact of the conflict on health care in Sudan," the WHO stated in response to a BBC query. UN investigators have reported that the fighting in el-Fasher bore the "hallmarks of genocide", where historical ethnic animosities have seen Arab militias—now the backbone of RSF forces—target non-Arab groups such as those that populate the city.
Detailed Chronology of Attacks
The BBC's investigation reveals a detailed chronology of attacks on healthcare during the long siege of the city. Some medical facilities in el-Fasher closed down within weeks of the civil war starting in April 2023, including the Teaching Hospital, which was located in a conflict zone in the middle of the city. Its operations were moved to el-Fasher's South Hospital, where medical services continued, albeit increasingly hindered by power cuts and dwindling supplies.
The situation changed dramatically a year later when the RSF mounted its siege of el-Fasher. In late May and early June of 2024, the South Hospital was shelled several times as paramilitary fighters pushed forward from their positions in the east of the city. The first bombing came as a shock, says Dr. Suliman, as the area around the hospital was "very crowded because it was the only working hospital in the city providing surgical services."
On 8 June, the attacks culminated in an RSF raid. Hospital staff were taken by surprise, with many escaping over the back wall as RSF fighters entered the building. Dr. Mustafa Ahmed, a pharmaceutical specialist, recounted how the director general of the hospital, Izzeldin Ahmed Dawaud Asow, encountered a group of paramilitaries outside his office. They did not know he was a doctor but denounced him with ethnic slurs.
