Displaced people in Tawila. Sudan, 2025. © Jérôme Tubiana
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Sudan: Ongoing mass atrocities against civilians in and around El Fasher, North Darfur documented in latest MSF report

Mass atrocities are underway in Sudan’s North Darfur region, Doctors Without Borders/Médecins Sans Frontières (MSF) warns in the new report “Besieged, Attacked, Starved.” We are urging warring parties to halt indiscriminate and ethnically targeted violence and facilitate an immediate large-scale humanitarian response. MSF is extremely concerned about the threats of a full-blown assault on the hundreds of thousands of people in the state capital of El Fasher, which would lead to further bloodshed.

As the conflict has intensified in the area since May 2024, the majority of people suffering in the conflict are civilians. The report outlines a desperate situation for civilians in and around El Fasher that requires immediate attention and response. “People are not only caught in indiscriminate heavy fighting between the Rapid Support Forces (RSF) and the Sudanese Armed Forces (SAF) and their respective allies – but also actively targeted by the RSF and its allies, notably on the basis of their ethnicity,” says Michel Olivier Lacharité, MSF head of emergencies.

Hitham, an MSF nurse, checks the condition of a woman as she recovers in the MSF health post in Tawila Umda. Over the past few days, hundreds of people – women, children, older adults – were brought by their relatives in an advanced state of exhaustion and dehydration. Sudan, 2025. © Thibault Fendler/MSF

Besieged, Attacked, Starved

Based on MSF data, direct observations and over 80 interviews conducted between May 2024 and May 2025 with patients and people who were displaced from El Fasher and nearby Zamzam camp, the report exposes systematic patterns of violence that includes looting, mass killings, sexual violence, abductions, starvation and attacks against markets, health facilities and other civilian infrastructures.

“As patients and communities tell their stories to our teams and asked us to speak out, while their suffering is hardly on the international agenda, we felt compelled to document these patterns of relentless violence that have been crushing countless lives in general indifference and inaction over the past year,” says Mathilde Simon, MSF humanitarian affairs advisor.

“In light of the ethnically motivated mass atrocities committed on the Masalit in West Darfur back in June 2023, and of the massacres perpetrated in Zamzam camp in North Darfur, we fear such a scenario will be repeated in El Fasher. This onslaught of violence must stop.”

Mathilde Simon, MSF humanitarian affairs advisor

Besieged, Attacked, Starved also details how the RSF and their allies conducted a large-scale ground offensive in April on Zamzam displacement camp, outside of El Fasher, causing an estimated 400,000 people to flee in less than three weeks in appalling conditions. A large portion of people fled to El Fasher, where they remained trapped, out of reach of humanitarian assistance and exposed to attacks and further mass violence. Tens of thousands more escaped to Tawila, about 60 kilometres away, and to camps across the Chadian border, where hundreds of survivors of violence received care from MSF teams.

Dispaced people in and around Tawila. Sudan, 2025. © Jérôme Tubiana 

“In light of the ethnically motivated mass atrocities committed on the Masalit in West Darfur back in June 2023, and of the massacres perpetrated in Zamzam camp in North Darfur, we fear such a scenario will be repeated in El Fasher. This onslaught of violence must stop,” says Simon.

Several witnesses report RSF soldiers spoke of plans to ‘clean El Fasher’ of its non-Arab community. Since May 2024, the RSF and their allies have besieged El Fasher, Zamzam camp and other surrounding localities, cutting communities from food, water and medical care. This has contributed to the spread of famine and debilitated the humanitarian response.

“Men over fifteen can hardly cross the border [into Chad]. They take them, they push them aside and then we only hear a noise, gunshots, indicating that they are dead, that they have been killed […] Fifty families came along with me. Not even one boy of 15 years old or above was among us.”

A woman who fled to eastern Chad.

Repeated attacks on healthcare facilities forced MSF to end our medical activities in El Fasher in August 2024 and in Zamzam camp in February 2025. In May 2024 alone, health facilities supported by MSF in El Fasher endured at least seven incidents of shelling, bombing or shooting by all warring parties. Indiscriminate airstrikes conducted by the SAF had devastating consequences, as a woman highlights: “The SAF bombed our neighbourhood by mistake, then came to apologize. SAF planes sometimes bombed civilian areas without any RSF [presence], I saw it in different places.”

The harrowing level of violence on the roads out of El Fasher and Zamzam means many people are trapped or take life-threatening risks when fleeing. Men and boys have a high risk of being killed or abducted, while women and girls are subjected to widespread sexual violence. Most witnesses also report increased risks for Zaghawa communities. “Nobody could get out [of El Fasher] if they said they were Zaghawa,” says a displaced woman. Another man tells us RSF and its allies were “asking people if they belonged to the Zaghawa, and if they did, they would kill them.” 

Patients wait for medical care, at the entrance of the emergency unit of Tawila hospital. Sudan, 2025. © Thibault Fendler/MSF

“They would only let mothers with small children under the age of five through,” says a woman about her journey fleeing to eastern Chad. “Other children and adult men didn’t go through. Men over 15 can hardly cross the border [into Chad]. They take them, they push them aside and then we only hear a noise, gunshots, indicating that they are dead, that they have been killed […] Fifty families came along with me. Not even one boy of 15 years old or above was among us.” 

The catastrophic nutritional situation continued deteriorating as the siege tightened: “[Three months ago] in Zamzam, we sometimes went three days a week without eating,” says one man to our teams. “Children died from malnutrition. We were eating ambaz [residue of peanuts ground for oil], like everyone, although usually it’s used for animals,” says a displaced woman. “Zamzam was completely blocked,” says another displaced person. “Water wells depend on fuel and there was no access to fuel, so all of them stopped working. Water was very limited and very expensive.” 

MSF urges the warring parties to spare civilians and respect their obligations under International Humanitarian Law. The RSF and their allies must immediately stop ethnic violence perpetrated against non-Arab communities, lift the siege of El Fasher and guarantee safe routes for civilians fleeing violence. Safe unrestricted access to El Fasher and its surroundings must be granted for humanitarian agencies to provide critically needed assistance. International actors, including UN institutions and members states, and states who provide support to the warring parties must urgently mobilize and exert pressure to prevent further mass violence and allow emergency assistance delivery. The recent unilateral announcements of a possible local ceasefire have not yet been translated into concrete change and time is running out.