A hospital turned graveyard: El-Fasher and the reverberations of a broken peace
When the sun slides over El-Fasher these days, it lights a city where silence no longer holds the ordinary shape of everyday life. Markets that once smelled of roasted coffee and za’atar are shuttered. Donkey carts sit idle in dust-strewn lanes. The minaret of a mosque rings not with prayer but with the metallic clink of fear. And in the shell of what was the Saudi Maternity Hospital, cries have been replaced by a ledger of loss: more than 460 people, according to witness reports and aid agencies, were shot dead inside its wards and corridors.
“We came here to give life, not to count the dead,” Aisha, a midwife who managed to slip out with a bandage on her arm, told me by phone from Tawila, west of El-Fasher. “They took our colleagues. They burned records. Children who were born a week ago now have no papers, no names on a birth certificate—only a story of horror.”
What happened — and what the numbers say
The assault on the Saudi Maternity Hospital is the most chilling in a string of attacks on medical facilities in the region. The World Health Organization reports the hospital was attacked for the fourth time in a month; one nurse was killed and three other health workers were injured in one strike, and later six health staff — including four doctors, a nurse and a pharmacist — were abducted. The WHO, voices from the field and satellite analysts say more than 460 patients and their companions were reportedly shot and killed.
Yale University’s Humanitarian Research Lab has supported those accounts with satellite imagery: they describe “mass killing events” with corroborated executions around the Saudi Hospital and at a former children’s hospital now suspected of being a detention site. The lab warned earlier of an “intentional process of ethnic cleansing” in Darfur. Whether counted in tens, hundreds, or thousands, the human toll in Sudan is unmistakable: tens of thousands killed, millions displaced, and the globe’s largest hunger and displacement crisis in living memory.
Maps of power: who controls what — and why it matters
Sudan’s war, which flared into full-blown fighting in April 2023, has cleaved the country into zones of control. The Rapid Support Forces — the RSF, rooted in the Janjaweed militias of two decades ago — now hold much of western Sudan, including El-Fasher, as well as vast swathes of the south and southwest. Mohammad Hamdan Daglo, the RSF commander often known as Hemedti, has publicly vowed to unify the country “by peace or through war.”
Opposing him is the regular army under Abdel Fattah al-Burhan, dominant in the north, east and centre, and, as of March, the owner of a retaken Khartoum. Analysts warn, and local residents fear, that the country is effectively partitioned — a brittle map that could prove almost impossible to stitch back together.
Control, disruption and the new rules of war
In El-Fasher, everyday communications were severed for most people — roads closed, satellite services cut off. But the RSF, interestingly, maintained access to Starlink networks in the city, a grim reminder of how modern tools can be swept into the hands of armed groups long before governance returns. The result is a fractured information landscape: footage of atrocities circulates, but independent verification becomes harder. That vacuum breeds rumor and terror.
Faces in the flood: displacement and desperation
Since the fall of El-Fasher, more than 33,000 people fled west to Tawila in a few days, joining a landscape already groaning under more than 650,000 displaced people. Photos from humanitarian convoys show families moving with what they could carry — mattresses, a few tins of food, the small bundle that is a lifetime. Some bear bandages or the awkward, faraway look of trauma.
“We walked for two days,” said Hassan, a 42-year-old shopkeeper, his voice low with grief. “My wife is pregnant. My son keeps asking when we will go home. How do you tell a child that home is not a place anymore?”
Inside El-Fasher itself, estimates suggest roughly 177,000 remain — people trapped in a city that once held over a million. Humanitarian corridors have been sporadic and perilous, and aid workers say the siege tactics resemble a slow-lock strategy: starve, isolate, and then claim control.
The echoes of Darfur’s past and the specter of ethnic targeting
Darfur is a place where memory presses heavily. Two decades ago, Janjaweed militias were accused of ethnic massacres that reshaped communities. Now, the RSF’s lineage from those groups has raised alarms that history could be repeating itself. Non-Arab communities in Darfur — the Fur, Masalit, and Zaghawa among them — have long borne the brunt of intercommunal and state-aligned violence.
“We are not just fighting for territory; we are fighting for existence,” said Amal, a Fur elder who crossed into Tawila last week. “When the killers come, they do not ask names. They ask what tribe you belong to.”
Sudanese government sources accuse the RSF of killing more than 2,000 civilians in recent operations, targeting mosques and even Red Crescent volunteers. The International Federation of Red Cross and Red Crescent Societies said five Sudanese volunteers were killed and three went missing in Bara, Kordofan — a stark example of how those trying to help the wounded have themselves become targets.
Diplomacy falters — and the world watches
Outside Sudan, a group known as the Quad — the United States, Egypt, the United Arab Emirates and Saudi Arabia — spent months trying to broker a truce. Those talks have stalled, with diplomats pointing fingers at “continued obstructionism” from army-aligned officials. For all the summitry and shuttle diplomacy, the fighting has continued, and with each failed negotiation the misery multiplies.
“We are running out of diplomatic adjectives to describe the disaster,” said a veteran UN official in Khartoum. “Each ceasefire paper signed and unsigned is another pile of unfulfilled promises to the people of Sudan.”
Why this should matter to you
It’s tempting, in a world of scrolling headlines, to treat this as a distant conflict — a tragic but remote item on a morning briefing. But the collapse of Sudan has ripple effects that reach beyond its borders: a foretaste of how state breakdowns fuel migration, famine and regional instability; a lesson in how modern technology can empower violent actors; an urgent reminder that when medical facilities become battlegrounds, the most basic rules of humanity are at risk.
How do we respond to images that demand action but only ever elicit words? What does it mean for the international system when healthcare workers are abducted and hospitals become killing fields? These are not just questions for diplomats; they are an invitation to every reader to reckon with the human costs of geopolitics.
What people on the ground want
- Immediate and verifiable humanitarian access to El-Fasher and other besieged towns.
- Protection for civilians and medical personnel under international law.
- An end to the siege tactics and targeted ethnic violence.
- Robust international monitoring to document crimes and prevent impunity.
Closing: a plea and a warning
“We are tired of being the story that no one remembers until it gets worse,” said Dr. Leila Mansour, a WHO coordinator who has coordinated evacuations and supplies under fire. “You cannot unsee the faces of a burned-out ward. You can, however, change the arc of what happens next.”
There is still time to act — to keep aid corridors open, to press for accountability, to stop the dissolution of a nation into carved-out fiefdoms. But time is not on the side of those trapped inside El-Fasher or the camps filling with people whose only crime was to live where power decided to make a spectacle of war.
As you read this, ask: what would we want the world to do if it were our family, our hospital, our market? The answers may be hard, but indecision will cost more lives than any headline ever could.
