As fighting between warring factions has engulfed Sudan in recent days, hospitals treating people wounded in clashes have themselves become the targets for attacks, dealing the nation’s healthcare sector a devastating blow.
In one episode, five eyewitnesses told CNN that the paramilitary group battling Sudan’s military for control of the country besieged and shelled a hospital in the capital Khartoum on Sunday, leaving at least one child dead and sending panicked medical staff fleeing for their lives.
The leaders of the opposing sides, Sudan’s military leader Abdel Fattah al-Burhan and his former deputy and paramilitary chief Mohamed Hamdan Dagalo, have traded blame for instigating the fighting that has spread across the country since Saturday. Burhan has accused Dagalo of staging an “attempted coup”; Dagolo has in turn called Burhan a “criminal.”
But at al-Moallem hospital in central Khartoum, where intense shelling forced staffers to evacuate, leaving some patients behind, witnesses said they have little doubt about what happened.
“I have no doubt that they deliberately targeted the hospital,” said one medic who evacuated the hospital on Sunday after Dagalo’s paramilitary Rapid Support Forces (RSF) laid siege to it. CNN is not using any of the real names of the hospital medics in this article for safety reasons.
The hospital is meters away from Sudan’s army headquarters, which the RSF has made repeated attempts to take over. Medics said it was treating scores of wounded army soldiers and their families. The hospital’s maternity ward was struck in the shelling, causing a wall there to collapse, according to hospital employees.
A 6-year-old child died in the building, one medic said. Two other children were seriously wounded. As the shelling intensified, medics and patients huddled together in the corridor and prayed.
At first we were praying for salvation,” the medic said. “Then when the shelling got worse, we started to discuss what would be the most painless part of the body to be shot in and began to pray instead to die painlessly.”
It’s unclear whether the RSF has taken control of the hospital as it attempts to take over the nearby army headquarters, a flashpoint in Khartoum’s violence.
“The evacuation was chaos,” the medic said. “I thought I was going to vomit. I was stumbling and falling on the ground.”
“Can you believe that we left the hospital and left behind children in incubators and patients in intensive care without any medical personnel,” another medic said. “The smell of death was everywhere.”
“There was no electricity, no water there inside the hospital,” said a third medic. “None of our equipment was working, a woman sheltering with us had a two-day-old baby. I don’t even know what happened to her.”
At least half a dozen hospitals have been struck by both warring sides, according to Sudan’s Doctors Trade Union.
“Sudan’s hospitals under fire,” the Central Committee of Sudan doctors said in a statement on its Facebook page, warning of the potential collapse of the health sector if clashes continue.
“Most of the large and specialized hospitals are out of service as a result of being forcibly evacuated by the conflicting military forces or being targeted by bombing and others. Some other hospitals have been cut off from human and medical supplies, water and electricity,” the committee said.
Doctors Without Borders said its teams were “trapped by the ongoing heavy fighting and are unable to access warehouses to deliver vital medical supplies to hospitals,” and that its premises in Nyala, South Sarfur, had been looted.
Food, water and power shortages are rampant as Sudan has endured a third day of fighting, that has spread from Khartoum across the nation.
“Food in the fridge and freezers have gone bad,” Eman Abu Garjah, a Sudanese-British doctor based in Khartoum, told CNN. “We don’t have any supplies at the moment, that’s why we’re trying to go somewhere where the shops are open.”
“The planes were flying overhead earlier in the day. They didn’t just wake us up, they prevented us from going back to sleep,” she said.
“It’s Ramadan, we’re up for early morning prayers and after that usually you have a little bit of a siesta and wake up again for the afternoon prayers. But sleep was just not possible. The house was rattling and the windows were shaking.”
A broken alliance
Until recently, Dagalo and Burhan were allies. The pair worked together to topple ousted Sudanese President Omar al-Bashir in 2019 and played a pivotal role in the military coup in 2021.
However, tensions arose during recent negotiations to integrate the RSF into the country’s military as part of plans to restore civilian rule.
In an interview with CNN on Monday, Burhan accused Dagalo of attempting to “capture and kill” him during an attempt by the paramilitary leader to seize the presidential palace.
In response to the allegation, an RSF spokesperson called Burhan, “a wanted fugitive.”
“We are seeking to capture him and bringing him to justice. We are fighting for all Sudanese people,” the RSF spokesperson said.
Burhan also accused the RSF of breaking a proposed ceasefire on Sunday and Monday.
“Yesterday and today a humanitarian ceasefire proposal was put forward and agreed upon,” said Burhan from army headquarters, as gunshots rang out in the background.
“Sadly, he did not abide by (the ceasefire),” he added. “You can hear right now the attempts to storm the Army headquarters, and indiscriminate mortar attacks. He’s using the humanitarian pause to continue the fight.”
The RSF denies that it broke ceasefire.
It is unclear how much control the RSF has wrested from the country’s military. Dagalo claims he now controls the country’s main military sites, a claim repeatedly disputed by Burhan.
“We’re under attack from all directions,” Dagalo told CNN’s Larry Madowo in a telephone interview on Sunday. “We stopped fighting and the other side did not, which put us in a predicament and we had to keep fighting to defend ourselves,” he claimed.
Ascent to power
The RSF is the preeminent paramilitary group in Sudan, whose leader, Dagalo, has enjoyed a rapid rise to power.
During Sudan’s Darfur conflict, starting in the early 2000s, he was the leader of Sudan’s notorious Janjaweed forces, implicated in human rights violations and atrocities.
An international outcry saw ex-President Bashir formalize the group into paramilitary forces known as the Border Intelligence Units.
In 2007, its troops became part of the country’s intelligence services and, in 2013, Bashir created the RSF, a paramilitary group overseen by him and led by Dagalo. Dagalo turned against Bashir in 2019.
Months before the coup that unseated Bashir in April 2019, Dagalo’s forces opened fire on an anti-Bashir, pro-democracy sit-in in Khartoum, killing at least 118 people.
He was later appointed deputy of the transitional Sovereign Council that ruled Sudan in partnership with civilian leadership.
International powers have expressed alarm at the current violence in Sudan. Apart from concerns over civilians there are likely other motivations at play, the country is resource-rich and strategically located. CNN has previously reported on how Russia has colluded with its military leaders to smuggle gold out of Sudan.