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Sudan: New MSF report documents mass atrocities in North Darfur

02 Jul 25 | 03 Jul 25

Sudan: New MSF report documents mass atrocities in North Darfur

Hitham, MSF nurse, checks the constants of an elderly woman as she recovers in MSF health post in Tawila Umda Caption
Hitham, MSF nurse, checks the constants of an elderly woman as she recovers in MSF health post in Tawila Umda

Mass atrocities are underway in Sudan's North Darfur region, with thousands of people affected by indiscriminate and ethnically targeted violence including looting, mass killings, sexual violence, abductions, and attacks against markets, health facilities and other civilian infrastructures.

The report, Besieged, Attacked, Starved, outlines a desperate situation for civilians in and around El Fasher that requires immediate attention and response. 


Médecins Sans Frontières / Doctors Without Borders (MSF) urges the warring parties in Sudan to halt the 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, civilians have continued to be the main victims.

“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.

Besieged, Attacked, Starved

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What does the report say?

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. It is 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.

Mathilde Simon, MSF’s humanitarian affairs advisor, says:

“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.

In light of the ethnically motivated mass atrocities committed on the Masalit communities 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."

Besieged, Attacked, Starved also details how the Rapid Support Forces 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 the camp population fled to El Fasher, where they remained trapped, out of reach of humanitarian aid and exposed to attacks and further mass violence. Tens of thousands more escaped to Tawila, about 37 miles away, and to camps across the Chadian border, where hundreds of survivors of violence received care from MSF teams.

Several witnesses report that 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. 

The impact of the violence

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 50-year-old woman highlights: “the SAF bombed our neighborhood by mistake, then came to apologise. 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 that many people are trapped or take life-threatening risk when fleeing. Men and boys are at high risk of killing and abduction, 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 that RSF and its allies were “asking people if they belonged to the Zaghawa, and if they did, they would kill them.”

“They would only let mothers with small children under the age of five through,” recalls a woman about her journey fleeing to eastern Chad.

“Other children and adult men didn’t go through. 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.” 

It became too unsafe to keep staff and patients inside El Fasher and MSF reoriented its activities in Zamzam camp. Caption
It became too unsafe to keep staff and patients inside El Fasher and MSF reoriented its activities in Zamzam camp.

A malnutrition catastrophe

The catastrophic nutritional situation continued deteriorating as the siege tightened: “[Three months ago] in Zamzam, we sometimes had three days a week without eating,” one man tells 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 displaced woman.

“Zamzam was completely blocked,” another displaced person tells us. “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, 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 mobilise and exert pressure to prevent further mass violence and allow emergency aid delivery.

The recent unilateral announcements of a possible local ceasefire have not yet been translated into concrete change on the ground, and time is running out.

What is MSF UK calling for?

The United Kingdom must lead and support a large-scale humanitarian response, prioritising regions where famine has been confirmed and areas that remain inaccessible to aid. 

The Foreign Secretary, David Lammy, must keep Sudan as a top priority and sustain the momentum generated by his visit to Adré, Chad, and the UK-hosted International Humanitarian Conference on Sudan earlier this year. Continued leadership is essential to help bring an end to the violence, ensure the protection of civilians, and secure unhindered access to life-saving humanitarian assistance for all affected populations.

MSF and the crisis in Sudan

The violence between the Sudanese Armed Forces (SAF) and the Rapid Support Forces (RSF) has trapped millions of people in the middle of an unexpected conflict. Sudan now has the world's largest displacement crisis, with millions forced to flee their homes, while access to essential services such as healthcare has become increasingly difficult.

Médecins Sans Frontières / Doctors Without Borders (MSF) teams already working in Sudan have been responding to the crisis since its first moments.