Introduction

A BBC investigation has uncovered systematic attacks on el-Fasher's healthcare infrastructure during a year-long siege by Rapid Support Forces. The findings reveal a pattern of deliberate strikes on hospitals, leaving the western Darfur city without functional medical services and highlighting the broader humanitarian toll of Sudan's civil war.

What Happened

The civil war that began in April 2023 saw several hospitals shut down within weeks, including the Teaching Hospital, which relocated to el-Fasher's South Hospital. In May and June 2024, South Hospital was shelled multiple times as RSF fighters advanced from the city's east. On June 8, the facility was raided; its director, surgeon Izzeldin Ahmed Dawaud Asow, was beaten and subjected to ethnic slurs, then forced to feign death to survive. The hospital closed and later fell under RSF control.

Medical staff moved to the Saudi Maternity Hospital in the west. From that point, attacks intensified. The BBC documented at least 43 strikes on health sites between May 2024 and October 2025, including repeated hits on facilities that had already relocated. The Saudi Hospital was struck up to 25 times in a single day, using shells and drone attacks. The Specialised Children's Hospital and a main dialysis centre were each attacked twice after moving to new locations. Médecins Sans Frontières warned that belligerents were not taking precautions to spare medical facilities.

Specific incidents underscore the severity. On 15 March 2025, a drone struck a group carrying injured patients to a temporary ward, killing nine people. On 17 August 2025, a donkey cart transporting patients after all ambulances were destroyed was hit, killing two patients, the driver, and the animal. On 25 October 2025, RSF forces stormed the Saudi Hospital; allegations of a massacre killing over 460 patients and companions emerged, though the RSF denied the claims. Satellite imagery appeared to show bodies on the hospital grounds.

Throughout the siege, medical workers endured injury, death, and forced displacement. The BBC's data shows 120 injured, 55 killed, and 10 forcibly disappeared or abducted between April 2023 and October 2025. Dr Muhamed Suliman, a surgeon who remained in el-Fasher, described the campaign as intense, deliberate, and planned, aimed at removing any functioning health infrastructure.

Why This Matters

Under international law, attacking health facilities and their staff during conflict is prohibited. The BBC's findings, corroborated by UN human rights chief Volker Türk, suggest these may amount to war crimes. Türk called the evidence deeply disturbing and consistent with his office's documentation of repeated RSF strikes on civilian infrastructure.

El-Fasher represents one of the clearest examples of how Sudan's civil war has targeted the health system, with consequences that extend beyond the battlefield. Civilians trapped in the city lost access to emergency care, childbirth services, and life-saving dialysis. The case illustrates a broader pattern where medical infrastructure is used as a weapon of war, with lasting impacts on public health and collective trauma.

Key Takeaways

  • The BBC documented at least 43 attacks on hospitals and health sites in el-Fasher from May 2024 to October 2025.
  • At least 120 medical workers were injured, 55 killed, and 10 forcibly disappeared or abducted between April 2023 and October 2025.
  • By October 2025, the Saudi Hospital was the only functioning health facility left; staff operated using sandbags, underground bunkers made from steel containers, and alternative sites.
  • RSF denied targeting hospitals, calling the BBC's investigation propaganda; the group's health minister dismissed allegations as lies.
  • UN and WHO officials condemned the attacks, with the WHO describing el-Fasher's experience as one of the most severe examples of conflict damage to health care in Sudan.
  • Specific attacks included drone strikes killing patients, ethnic slurs during raids, and the systematic closure of every facility that relocated.

Conclusion

The el-Fasher siege demonstrates how quickly a city's health system can be dismantled when combatants target medical infrastructure. Even as front lines have shifted, the trauma persists for patients, families, and health workers who survived the onslaught. Sustained international attention and accountability remain essential to preventing further loss of life in Sudan's ongoing crisis.