Sudan's Healthcare System Destroyed in Systematic RSF Campaign

A Health System Under Siege

When the Rapid Support Forces (RSF) laid siege to el-Fasher in Darfur last year, they didn’t just target military positions. A BBC investigation has uncovered evidence of a systematic destruction of the city’s entire healthcare infrastructure, with at least 43 separate attacks on hospitals and medical facilities documented between May 2024 and October 2025.

The numbers tell a grim story. Between April 2023 and October 2025, 120 medical workers were injured, 55 were killed, and 10 were forcibly disappeared or abducted. Under international humanitarian law, attacking health facilities during conflict is illegal. Yet the assault in el-Fasher appears to have been deliberate and comprehensive.

“The RSF was trying to evacuate the hospitals, to put them out of service because the health system is the cornerstone of any city or any state,” explains Dr Muhamed Suliman, a surgeon who witnessed the siege firsthand. “It was intense. It was deliberate. It was planned.”

The Collapse of Care

The destruction didn’t happen overnight. When Sudan’s civil war erupted in April 2023, some medical facilities closed immediately, including the Teaching Hospital located in a conflict zone. Operations shifted to the South Hospital, which continued functioning despite power cuts and dwindling supplies.

Then came May 2024. The RSF intensified its offensive, and the shelling began. Medical staff at South Hospital were operating on 16 injured patients when the first bombing struck. The situation escalated dramatically on 8 June, when RSF fighters stormed the facility.

Dr Izzeldin Ahmed Dawaud Asow, the hospital’s director general, encountered paramilitaries outside his office. They called him “Falangi,” a derogatory term used for non-Arab Sudanese. He was beaten with rifle butts, lost consciousness, and survived only by pretending to be dead. When the military retook the hospital that same day, Dr Asow found patients’ bodies and destroyed surgical equipment throughout the operating room.

The hospital closed. Later, it fell into RSF hands when the army retreated.

Precision Targeting

The RSF’s health minister, Dr Alaa Eldin Nugud, claims the South Hospital was being used as a military base. He provided video evidence of weapons found on the grounds more than a year after closure. However, the BBC found no independent verification of these allegations, and the Darfur regional government categorically rejected the claims.

What followed was more troubling. After South Hospital shut down, remaining staff and equipment moved to the Saudi Maternity Hospital in the west. Within days, attacks intensified. Doctors described a pattern of systematic targeting, not random violence. On some days, the facility was hit up to 25 times with a mix of shelling and precision-guided drones.

When smaller medical facilities relocated to escape the bombardment, their new locations were attacked too. The Specialised Children’s Hospital moved twice, and both new sites were shelled. The main dialysis centre suffered the same fate.

By October 2025, the Saudi Hospital was the only functioning health facility remaining in el-Fasher. Medical staff had constructed underground bunkers from steel containers and established makeshift surgical sites, treating patients in increasingly desperate conditions. Dr Asow describes operating on a patient’s neck when an explosion shook the building. In another instance, he ordered deep cleaning of an operating theatre due to the overwhelming caseload. The room was destroyed by shells minutes later, but the patient survived.

A Deliberate Pattern

Drones weren’t just dropping ordnance randomly. On 15 March 2025, drones tracked people carrying injured patients to a temporary ward, striking as they reached the gate and killing nine. On 17 August, a donkey cart transferring patients to an alternative operating theatre was hit by a drone, killing two patients, the driver, and the animal.

The UN human rights chief called the findings “deeply disturbing,” stating they represent serious violations of international humanitarian law that may amount to war crimes. The news from this investigation adds yet another layer to what UN investigators have described as bearing “hallmarks of genocide.”

Today, the RSF-backed government runs el-Fasher’s healthcare. They claim hospitals have reopened and are functioning normally. Yet doctors captured during the siege tell a different story, describing forced labor under threat of execution.

One year after el-Fasher’s fall, the question remains: can a healthcare system destroyed so methodically ever truly recover?

Source: BBC Investigation