Sudanese paramilitaries killed the entire staff of the last medical clinic in a famine-stricken camp in the western region of Darfur, Sudan, as part of a broader assault that killed at least 100 people, aid groups and the United Nations said on Saturday.
The assault on the Zamzam camp, which holds 500,000 people in the besieged city of El Fasher, was notable even by the standards of a civil war that has seen countless atrocities as well as accusations of genocide.
Paramilitaries with the Rapid Support Forces, or R.S.F., broke through the camp perimeter on Friday evening after hours of shelling. They then destroyed hundreds of homes and the camp’s main market before turning their attack on the camp’s last remaining medical clinic, according to Relief International, the aid group that runs the facility.
Nine hospital employees were killed, including the head doctor, the aid group said in a statement on Saturday. “We have learned the unthinkable,” the statement said. “This is a profound tragedy for our organization.”
Kashif Shafique, the group’s Sudan director, said in a phone interview that the aid workers — five medics and four drivers, his entire staff at the clinic — had been shot dead.
Paramilitaries had warned the medics to leave the day before the attack, Mr. Shafique said. But they had to treat civilians wounded by shelling and, in any event, the main routes out of the camp were closed.
“There was no way out,” he said.
The R.S.F. has been battling Sudan’s military since April 2023, in a sprawling conflict that has caused the world’s largest humanitarian crisis. As many as 150,000 Sudanese have been killed, according to U.S. estimates, and 13 million have been forced from their homes.
The head of the United Nations in Sudan, Clementine Nkweta-Salami, said she was “appalled and gravely alarmed” by the violence in El Fasher, which continued into Saturday. At least 20 children were among 100 people killed, she said.
Satellite images posted on Friday by the Humanitarian Research Lab at the Yale School of Public Health showed military vehicles near the camp and fires burning inside it. The group called it “the most significant ground-based attack” on Zamzam camp in a year.
The escalating violence comes days before a major international conference on Sudan that is scheduled to take place in London on Tuesday, the second anniversary of the war. The purpose of the conference is to attract funds for Sudan’s severe humanitarian crisis. So far, donors have committed to just 10 percent of a $4.2 billion appeal by the United Nations.
The conference has stoked criticism from some Sudanese because it will be attended by delegates from the United Arab Emirates, which has been accused of providing military and financial support to the R.S.F.
Human Rights Watch urged the U.N. Security Council to impose sanctions on R.S.F. commanders responsible for abuses, and to condemn “countries providing support to parties in violation of the ongoing U.N. arms embargo.”
“Global leaders need to act,” the organization said in a statement.
Both sides in Sudan’s war have been accused of war crimes by right groups, the United Nations and the United States, although only the R.S.F. has been accused of genocide. Sudan’s military has regularly been accused of indiscriminately bombing crowded markets, often in the Darfur region, in multiple incidents that have sometimes killed more than 100 people at a time.
Earlier this month, the top United Nations human rights official, Volker Türk, said he was “utterly appalled” by reports of widespread summary executions of civilians in the capital, Khartoum, following the city’s recapture by the Sudanese military.
On March 24, the military killed at least 54 people in an attack on a busy market in Toura, a small town in North Darfur.
Most of Darfur, however, is held by the R.S.F., which has been laying siege for more than a year to El Fasher, the last major city in the region that it does not control. It had been expected to step up the assault in recent weeks, since R.S.F. forces were expelled from Khartoum by the military in late March.
There were signs for days before Friday’s violence that a major attack was imminent.
Video of the R.S.F. deputy leader Abdul Rahim Dagalo mobilizing his forces in the area circulated on social media. On Thursday, the R.S.F. began to shell Abu Shouk, another camp in the north of the city, killing at least 12 people, according to local rescue workers.
The fighters also began to attack Zamzam camp with artillery, gunfire and drones, according to aid groups and local activists. A famine was officially declared at the camp last August.
A Sudanese research group, Fikra for Studies and Development, urged the U.N. to begin airdrops of food to Zamzam.
American officials have repeatedly warned of a possible ethnic massacre if the R.S.F. overruns El Fasher. Similar violence against the ethnic Masalit group in late 2023 led to thousands of deaths and was central to the U.S. decision in January to accuse the R.S.F. of genocide.
Abdalrahman Altayeb contributed reporting from Port Sudan, Sudan.
