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Mass casualties in Sudan as warring parties strike populated areas

A series of recent attacks on residential areas and medical facilities has sent scores of wounded people to MSF-supported facilities in Sudan’s Khartoum, North Darfur, and South Darfur states.

Displaced people reaching Tawila locality, Sudan.

Displaced people arrive in Tawila. | Sudan 2024 © MSF

Doctors Without Borders/Médecins Sans Frontières (MSF) teams in three different parts of Sudan—Khartoum, North Darfur, and South Darfur states—have treated mass influxes of war-wounded patients in recent days as the war between the Sudanese Armed Forces (SAF) and the Rapid Support Forces (RSF) continues, with little respect shown for civilian life.  

On February 4 in Nyala, South Darfur, 21 injured patients were brought to Nyala Teaching Hospital, which MSF supports, after airstrikes by the Sudanese Armed Forces hit a peanut oil factory, reportedly killing 25 people. 

On February 3, airstrikes hit residential areas of Nyala, hitting and destroying homes. The airstrikes took place in the afternoon, when many people were circulating, and reportedly killed 32 in addition to injuring dozens. Many patients were brought to Nyala Teaching Hospital.

A patient is treated for a leg injury in Sudan.
A patient at Nyala Teaching Hospital receives treatment for injuries caused by airstrikes on February 3. | Sudan 2025 © MSF

An MSF doctor who was working in the hospital when the airstrikes took place, and requested to remain anonymous, describes the scene: 

“The bombing was near the hospital. We felt the building shaking. Once I went to the ER, the situation was horrible. Blood was everywhere; some patients were suffering from fractures, some had limbs amputated. While I was going around the ER, I saw two children. One was 4 years old, the other was 2 years old. Their aunt told us that this child had lost three of her siblings and that her mother had died, and only her older brother and father survived because they were at work.”

MSF doctor at Nyala Teaching Hospital

"We saw the dust and smoke at the northern part of the hospital"

"Suddenly, while we were doing our routine work, we heard a bomb. The first bomb was when everything became chaotic. People, caretakers, and caregivers were running everywhere, trying to find shelter and a safe place. We heard the bomb near the hospital. We saw it! Some of us were able to see it from inside the hospital. We saw the dust and smoke at the northern part of the hospital.

We tried to take cover everywhere. First, I took cover in the mosque near the ER. After that, when the plane left, we knew it would return. We spoke to the team and advised them to take cover, prioritizing their safety. We also identified the pediatric department as a safe place. We stayed there for a while, but another bombing occurred near the hospital. We felt the building moving; the doors and windows were shaking. There was some shrapnel inside the hospital...

At that moment, one of the nurses came and told us that casualties were starting to arrive at the hospital, and we were torn between staying safe or going to help. We had to choose … When I went to ER I found blood everywhere, patients with multiple injuries and trauma.

The situation was very terrifying. Some of the team was holding on, but some of them were very afraid. Nevertheless, we kept working. Some were wondering whether they’d come to work at the hospital tomorrow, worried it’ll be bombed. The situation was very terrifying.

We do what we can, and we don't know what will happen later."

 Displaced people reaching Tawila locality in Sudan.

Fierce clashes in North Darfur

North Darfur has been the scene of fierce clashes in recent months. Over the last few days MSF teams have been treating wounded civilians in Zamzam camp after an escalation in heavy fighting between RSF and SAF and their Joint Forces allies that has resulted in scores of casualties. On February 2, the MSF field hospital in Zamzam camp received 21 wounded patients who had been injured while fleeing the village of Shagra, more than half of them children.

Among the wounded were four patients who passed away and five who were successfully referred to El Fasher on February 3, where the Saudi Hospital remains somewhat functional despite relentless attacks. A recent bombing of the facility on January 24 reportedly killed 70 people.

The violence continues to ruin lives, making it harder for people to access health care and putting health care workers at risk. We urge the warring parties to protect civilian life and spare them from this war on people.

Ozan Agbas, MSF emergency manager

MSF’s field hospital in Zamzam is for pediatric and maternal health care and is not equipped to handle trauma injuries requiring surgery. The only remaining surgical services available are located a few miles away, but people are unable to use the road between Zamzam and El Fasher due to the ongoing fighting and shifting front lines. As a result, patients in critical condition have been trapped in Zamzam camp with no access to lifesaving care.

Thousands of people fleeing Shagra have arrived in Zamzam in recent days, leaving everything behind in desperate search of safety. They have told our teams of horrific violence in the area. About 60 families from Shagra also reached Tawila, where MSF runs a program providing emergency, nutritional, pediatric, and maternal health care. They told MSF teams that people were robbed and attacked as they fled along the road.

MSF receives medical supplies during its emergency intervention in Tawila, Sudan.
MSF receives medical supplies during its emergency intervention in Tawila. | Sudan 2024 © MSF

Horrific attacks in Khartoum state

Violence has also intensified in Khartoum state since the beginning of February. On February 4, as RSF shelled Omdurman, there were explosions within about 300 feet of the MSF-supported Al Nao Hospital. The Ministry of Health reported that 38 people were injured and six people were killed, including a volunteer from a local group assisting in running the hospital.

This is the second time medics working at the hospital have responded to a mass influx of wounded patients in recent days. On February 1, an RSF attack on a market killed 54 people, according to the Ministry of Health. Since the war in Sudan started, Al Nao Hospital has been hit by explosions three times: in August and October 2023 as well as in June 2024.

“The violence that the Rapid Support Forces and Sudanese Armed Forces are inflicting on civilians right across Sudan is tragic and appalling,” said Ozan Agbas, MSF emergency manager. “The violence continues to ruin lives, making it harder for people to access health care and putting health care workers at risk. We urge the warring parties to protect civilian life and spare them from this war on people.”

Sudan crisis response