Hospitals in El-Fasher Were Deliberately Destroyed, Investigation Finds

An investigation has found evidence that Sudanese paramilitary fighters systematically destroyed the healthcare system of El-Fasher in Darfur during their long siege and subsequent takeover of the city a year ago. Drawing on people who were on the ground in the city, the investigation documented at least 43 separate attacks on hospitals and healthcare sites between May 2024 and October 2025, with some facilities hit multiple times.

The UN human rights chief Volker Türk called the findings deeply disturbing, saying the 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. Under international law it is illegal to attack health facilities or their staff during conflict.

The investigation also laid bare the toll on medical workers. Between April 2023 and October 2025, its data shows 120 health workers were injured, 55 killed and 10 forcibly disappeared or abducted. Dr Muhamed Suliman, a surgeon based in El-Fasher during the siege, said the RSF was trying to put the hospitals out of service because the health system is the cornerstone of any city — once it collapses, citizens have no way to stay. In his words, the attacks were intense, deliberate and planned.

The paramilitary group's health minister dismissed the allegations as propaganda and a deliberate attempt by the national army and its allies to smear the RSF's reputation. But the World Health Organization told the investigators that events in El-Fasher represent one of the clearest and most severe examples of the wider impact of the conflict on healthcare in Sudan.

Some medical facilities in El-Fasher closed within weeks of the civil war starting in April 2023. Crucially, this included the Teaching Hospital, one of the main hospitals, located in a conflict zone in the middle of the city. Its operations were moved to the South Hospital, where services continued despite 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 2024, the South Hospital was shelled several times as paramilitary fighters pushed forward from the east of the city. Dr Suliman said the area around it was very crowded because it was the only working hospital providing surgical services; on one day, staff operated on 16 injured patients.

The attacks culminated in an RSF raid on 8 June. Pharmaceutical specialist Dr Mustafa Ahmed said hospital staff were taken by surprise and many escaped over the back wall as the fighters entered the building. The hospital's director general, surgeon Izzeldin Ahmed Dawaud Asow, encountered a group of paramilitaries outside his office; not knowing he was a doctor, they denounced him with ethnic slurs.

Dr Asow said he was beaten with rifle butts and lost consciousness at one point, ultimately saving himself by pretending to be dead — holding his breath as a fighter checked his chest, after which they left him. The RSF was driven out the same day by the Sudanese military and its allies, and Dr Asow returned to find the bodies of several patients and the surgical equipment in his operating room thoroughly destroyed. The hospital closed and later fell into RSF hands when the army retreated.

Dr Alaa Eldin Nugud, a prominent surgeon who has joined the RSF-backed civilian government as health minister, insisted the South Hospital was being used as a military base. Under international law, hospitals can lose their protection if they are used to commit an act harmful to the enemy. He declared that missile launchers were set up on the grounds and shared a video of weapon remains filmed more than a year after the hospital closed. Doctors, however, said the hospital was not incorporated into the base, the investigation found no independent evidence for the allegations, and the government of the Darfur region categorically rejected the charges.

After the South Hospital shut, its staff and remaining equipment were moved to the Saudi Maternity Hospital in the west of the city, near the army's main bases. Within days, attacks on the facility picked up pace. The medical charity Médecins Sans Frontières warned at the time that, whether or not hospitals were being intentionally targeted, the belligerents were taking no precautions to spare them. Six doctors who spoke to the investigation described a pattern of systematic targeting instead.

Those doctors described how the Saudi Hospital was repeatedly struck — on some days up to 25 times, with a mix of shelling and precision-guided drones. Smaller facilities also came under fire, and private hospitals and neighbourhood clinics steadily closed. When some facilities relocated, their new venues were attacked too: the Specialised Children's Hospital moved twice and was shelled into closure both times, and the main dialysis centre was struck again after it relocated.

By the time the RSF seized the city in October 2025, the Saudi Hospital was the only functioning health facility left. Staff set up sandbags to protect the building, built underground bunkers out of steel containers and established alternative sites for surgery as the damage mounted. Dr Asow said the makeshift surgery was attacked five times in 2025; in one case he kept operating on a patient's neck while an explosion shook the building and other staff ran out in fear.

He also described drones tracking the movement of patients. On 15 March 2025, people carrying the injured to a temporary ward were followed by a hunting drone that struck as they reached the gate, killing nine people. On 17 August the same year, with all ambulances destroyed, a donkey cart transferring patients to the alternative operating theatre was hit by a drone, killing two patients, the driver and the donkey. UN investigators have reported that the fighting in El-Fasher bore the hallmarks of genocide.

The investigation comes a year after the fall of El-Fasher, 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 WHO condemned the bombing of al-Daein hospital in RSF-held eastern Darfur, which killed dozens and forced the site to close, in strikes the military is believed to have carried out but has denied. The El-Fasher evidence now adds to the pressure for the war-crimes allegations to be pursued.