Sudan's RSF Systematically Targeted Hospitals in El-Fasher, BBC Investigation Finds
Paramilitary forces allegedly destroyed the city's healthcare system during a year-long siege, leading to widespread violations of international humanitarian law.
A BBC investigation has uncovered evidence that Sudanese paramilitary fighters deliberately targeted and destroyed healthcare facilities in El-Fasher, the capital of North Darfur, during their siege and eventual takeover of the city. The attacks, spanning from May 2024 to October 2025, saw at least 43 separate assaults on hospitals and medical sites, some of which were hit multiple times.
UN human rights chief Volker Türk described the findings as "deeply disturbing," stating that the alleged attacks by the Rapid Support Forces (RSF) on civilian infrastructure, including health facilities, constitute serious violations of international humanitarian law and may amount to war crimes. The RSF has denied the BBC's findings, labeling the allegations as propaganda aimed at damaging their reputation.
The investigation detailed the severe toll on medical workers, with 120 injured, 55 killed, and 10 forcibly disappeared or abducted between April 2023 and October 2025. A surgeon in El-Fasher told the BBC that the RSF's actions were intended to cripple the city by dismantling its healthcare system, describing the attacks as "intense. It was deliberate. It was planned."
The conflict between the RSF and Sudan's military erupted in April 2023. While both sides have faced accusations of attacking health facilities, the events in El-Fasher are considered by the World Health Organization (WHO) to be "one of the clearest and most severe examples of the wider impact of the conflict on health care in Sudan."
Targeting of Medical Facilities
Some medical facilities in El-Fasher began closing within weeks of the conflict's start. The Teaching Hospital, located in a conflict zone, moved its operations to El-Fasher's South Hospital. However, by late May and early June 2024, the South Hospital itself came under shelling as RSF fighters advanced. The area around the hospital was reportedly crowded with civilians seeking medical services.
On June 8, 2024, the RSF raided the South Hospital. Medical staff fled as fighters entered the building. The hospital's director general, a surgeon, reported being beaten and denounced with ethnic slurs before being left for dead. Upon returning, he found bodies of patients and destroyed surgical equipment. The hospital subsequently closed and fell into RSF hands when the army retreated. The RSF-backed health minister claimed the South Hospital was used as a military base, a claim for which the BBC found no independent evidence.
Following the closure of the South Hospital, its staff and equipment were relocated to the Saudi Maternity Hospital, which was near army bases. This facility also came under repeated attack, with doctors reporting strikes from shelling and precision-guided drones occurring up to 25 times on some days. Smaller medical facilities and clinics also faced fire, and even relocated facilities were subsequently attacked.
Deliberate Destruction and Civilian Harm
By October 2025, the Saudi Hospital was the last functioning health facility. Medical staff worked to keep it operational amidst worsening conditions, creating makeshift surgeries and underground bunkers. Despite these efforts, the facility was attacked multiple times. One surgeon recounted operating on a patient when an explosion rocked the building, forcing staff to evacuate, but the patient survived as the operating room was later destroyed by shells.
There are also accounts of drones tracking patients. On March 15, 2025, a drone struck a group carrying injured individuals to a temporary ward, killing nine. On August 17, 2025, a donkey cart transferring patients to an alternative operating theater was hit by a drone, killing two patients, the driver, and the animal.
The RSF health minister dismissed these accounts, attributing them to biased narratives from medical personnel allied with the military. Doctors, however, told the BBC they believed medical facilities were deliberately targeted, partly because army or allied fighters were treated there.
The attacks culminated on October 25, 2025, when the RSF stormed the Saudi Hospital, amid allegations of a massacre involving over 460 patients and their companions. The WHO condemned the reported killings, and satellite imagery appeared to support the reports.
Healthcare in El-Fasher is now managed by the RSF-backed government. While videos show some hospitals reopening, a doctor previously quoted by the BBC stated he was forced to work there under threat of violence, contradicting the RSF's claim that medical staff had chosen to stay.
A year after the fall of El-Fasher, the conflict continues with no signs of resolution, and attacks on healthcare persist as part of a broader humanitarian crisis.