Hospitals deliberately targeted by Sudan's RSF fighters, BBC investigation finds

Hospitals deliberately targeted by Sudan's RSF fighters, BBC investigation finds

Medics at el-Fasher's Saudi Hospital performed a Caesarean by phone light on the day it was bombed

A BBC investigation has uncovered evidence that Sudanese paramilitary fighters systematically wrecked el-Fasher's healthcare system during the city’s long siege and its eventual capture in Darfur a year ago.

UN human rights chief Volker Türk described the findings as "deeply disturbing", saying repeated RSF attacks on civilian infrastructure, including health facilities, were grave breaches of international humanitarian law and could amount to war crimes.

The RSF has denied the BBC's findings.

The paramilitary group's health minister called the claims propaganda and said they were a deliberate effort by the national army and its allies to damage the RSF's reputation.

Drawing on sources who were in el-Fasher, the BBC identified at least 43 separate attacks on hospitals and healthcare sites between May 2024 and October 2025, with some locations hit more than once.

International law forbids attacks on health facilities or medical staff during conflict.

The investigation also shows the impact on medical workers in the western city. From April 2023 to October 2025, BBC data indicates 120 were injured, 55 killed and 10 forcibly "disappeared" or abducted.

"The RSF [were] trying to evacuate the hospitals, to put them out of service because the health system is the cornerstone of any city or any state," says Dr Muhamed Suliman, a surgeon who was based in el-Fasher during the siege and spoke to the BBC.

"The RSF started hitting these areas so citizens have no longer any way to stay there. It was intense. It was deliberate. It was planned."

The investigation comes one year after el-Fasher fell, marking one of the most brutal phases of the civil war that began in April 2023 between the RSF and Sudan's military.

Both sides have faced accusations of attacking health facilities.

In March 2026, the World Health Organization (WHO) condemned the bombing of al-Daein hospital in RSF-held eastern Darfur, which killed dozens and forced the hospital to close. Sudan's military is believed to have carried out the drone strikes, though it has denied responsibility.

Still, the events in el-Fasher amount to "one of the clearest and most severe examples of the wider impact of the conflict on health care in Sudan," the WHO said in response to a BBC query.

UN investigators have said the fighting in el-Fasher carried the "hallmarks of genocide", with long-standing ethnic tensions seeing Arab militias - now the core of RSF forces - target non-Arab groups such as those living in the city.

For the first time, the BBC's investigation lays out a detailed timeline of attacks on healthcare during the city’s prolonged siege.

Some medical facilities in el-Fasher shut within weeks of the civil war beginning in April 2023.

This included one of the main hospitals, the Teaching Hospital, which was in a conflict zone in the city centre.

Its services were transferred to el-Fasher's South Hospital, where medical care continued, though increasingly under strain from power cuts and shrinking supplies.

The situation changed sharply a year later, when the RSF began its siege of el-Fasher.

In late May and early June 2024, South Hospital was shelled several times as paramilitary fighters advanced from positions in the east of the city.

Dr Suliman says the first strike came as a shock.

The area around the hospital that was hit was "very crowded because it was the only working hospital in the city providing surgical services", he says.

He added that medical staff treated 16 injured patients that day.

The attacks ended with an RSF raid on 8 June. Hospital staff were caught off guard - many escaped over the back wall as RSF fighters entered the building, says Dr Mustafa Ahmed, a pharmaceutical specialist.

But the hospital's director general, surgeon Izzeldin Ahmed Dawaud Asow, came across a group of paramilitaries outside his office.

He said they did not know he was a doctor, but they insulted him with ethnic slurs.

"There are no citizens here. You are Falangi," they said, using a derogatory term suggesting non-Arab Sudanese are foreigners.

Dr Asow says he was struck with rifle butts and lost consciousness at one point. In the end, he survived by pretending to be dead.

"They put their hand on my chest, and I stopped breathing. And they said: 'Leave him, leave him. The rubbish has died. Leave him.' They left me."

That same day, the Sudanese military and its allies drove the RSF out, and Dr Asow returned to find several patients dead and the surgical equipment in his operating room badly destroyed, he said.

The hospital shut down and later came under RSF control after the army withdrew.

Dr Alaa Eldin Nugud, a prominent Sudanese surgeon who has joined the RSF-backed civilian government as health minister, insisted South Hospital was being used as a military base.

Under international law, hospitals can lose protection if a party to the conflict uses them to commit an "act harmful to the enemy".

In an interview with the BBC, Dr Nugud said missile launchers were placed on the grounds and showed a video of weapon remains filmed more than a year after the hospital closed, which he said backed his claim.

He also showed what he said were maps of landmines laid around the Teaching Hospital, which sits beside Sudanese military headquarters.

Doctors told us the hospital was not part of the base and said they went there to collect medical equipment during the war.

The BBC found no independent evidence for Dr Nugud's claims. The government of the Darfur region also flatly rejected them.

After South Hospital closed, staff and remaining equipment were moved to the Saudi Maternity Hospital in the west of the city, where the army had its main bases.

Within days, attacks on the facility intensified. At that point, the medical charity Médecins Sans Frontières (MSF) raised the alarm.

"We do not know if hospitals are being intentionally targeted, but… the belligerents are not taking any precautions to spare them," it said in a statement.

But during the investigation, six doctors described what they said was a pattern of deliberate targeting.

They said Saudi Hospital was hit repeatedly - on some days as many as 25 times - by shelling and drones, including what they called "intelligent rockets" with precision-guided strikes.

Smaller medical sites were also attacked. The BBC's timeline shows a steady shutdown of private hospitals and neighbourhood clinics.

In addition, when some healthcare buildings were moved, the new locations were also struck.

The Specialised Children's Hospital, which closed at the start of the war along with the Teaching Hospital, relocated to two other sites, both of which were shelled and forced to shut.

Likewise, the main dialysis centre was hit and then attacked again after it moved.

By the time the RSF captured the city in October 2025, Saudi Hospital was the last functioning health facility.

The staff there had tried to keep working as conditions deteriorated.

Doctors said sandbags were used to shield the building.

They built underground bunkers from steel containers and set up several alternative sites to receive patients and carry out surgery as the threat of attacks and damage to the main building steadily grew.

Dr Asow said this improvised surgery was attacked five times in 2025.

In one incident, he says he was operating on a patient's neck when an explosion shook the building - the medical staff fled in fear, but he stayed.

In another, health workers had prepared the theatre for surgery, but he told them to move the patient elsewhere because it needed a deep clean after the relentless caseload. Soon after, the room was destroyed by shells - and the patient survived.

"From that day, some of my staff called me 'Mr Deep Cleaning' because they think that the issue of deep cleaning saved that patient," he said.

Dr Asow also says drones tracked patients as they moved.

On 15 March 2025, people carrying the wounded from an attack site to one of the temporary wards were followed by a hunting drone, he says.

It struck as they reached the building gate, killing nine people.

On 17 August that year, a donkey cart was moving patients to the alternative operating theatre because all the ambulances had been destroyed, Dr Asow told the BBC.

It was hit by a drone, killing two patients, the driver and the donkey, he says.

The RSF health minister dismissed these accounts as "a continuation of lies" by the military (SAF) and their local allies, the Joint Forces.

"Even the medics, and many of the people who were there, because of this conflict, these tribal issues, these racial issues, they are allied with the Joint Forces and with the SAF. That's why you don't depend on that narrative," he said.

Doctors told the BBC they believed RSF fighters intentionally targeted medical facilities because army or allied fighters were among the patients.

The shelling and bombing campaign ended on 25 October 2025 when the RSF stormed the hospital amid allegations of a massacre that killed more than 460 patients and their companions.

The RSF has denied that a massacre took place, although the WHO condemned the reported killings and satellite images appeared to show clusters of bodies on the blood-soaked hospital grounds.

The BBC shared the findings with the UN human rights chief, who said they were "deeply disturbing" and matched the assessment of his office.

"Our monitoring and documentation shows the RSF repeatedly struck el-Fasher's main hospitals and makeshift health facilities, destroying or seriously damaging them and severely impacting access to health services for thousands of civilians trapped in the city," Türk said.

Healthcare in el-Fasher is now being run by the RSF-backed government. It has released several videos showing the Saudi Hospital and the Teaching Hospital reopened, cleaned up and treating some patients.

Dr Nugud says South Hospital is also due to reopen. He denied that doctors were forcibly abducted, telling the BBC they had chosen to remain and work.

"I have a video in front of the children's hospital when we freed a consultant, a doctor and six of the medical staff who were working with the SAF, and then when el-Fasher got liberated, there was a forgiveness for all of them.

"We liberated them," he said.

The BBC spoke to one of the doctors in the video, Dr Al-Haj Mohamed Ahmed. He said he had no choice: "I was forced to be there.

"If I spoke out of line, they'd put a bullet through my head."

He was among several medical workers captured while trying to flee the city and sent back, along with Dr Mustafa Ahmed.

They were credited with bringing a cholera outbreak under control in a temporary prison at the paediatric hospital and were later taken to Saudi Hospital.

"They started to say that you are the people of the city, and we take the city, so we need to work together for the sake of the city," says Dr Mustafa Ahmed, who says he woke up several mornings in a row at the prison to find 50 inmates dead of cholera.

A year after el-Fasher fell, the trauma of this dark chapter in Sudan's civil war remains painfully raw.

The front lines have moved elsewhere, with no sign of the conflict ending. Attacks on healthcare continue as part of a broader and devastating humanitarian crisis.