Doctors Without Borders / Médecins Sans Frontières (MSF) has condemned what it described as “horrendous mass atrocities and killings” in and around El Fasher, North Darfur, warning that thousands of civilians remain in grave danger after the Rapid Support Forces (RSF) seized the city on 26 October following a 17-month siege.

MSF said many of those attempting to flee the violence are being hunted down, tortured, or killed. The humanitarian organization called for urgent action to protect civilians and allow safe passage to towns such as Tawila, where its teams are treating survivors.

“The arrival numbers don’t add up, while accounts of large-scale atrocities are mounting. Where are all the missing people who have already survived months of famine and violence in El Fasher?” said Michel Olivier Lacharité, MSF head of emergencies.

“Based on what patients tell us, the most likely, albeit frightening, answer is that they are being killed, blocked, and hunted down when trying to flee. We urgently call on the RSF and its allied armed groups to spare civilians and allow them to reach safety. We also urge all diplomatic stakeholders, including the ‘Quad’ comprising the US, Saudi Arabia, the UAE and Egypt, to use their leverage to stop the bloodbath,” he added.

According to MSF, more than 5,000 people managed to reach Tawila in recent days, describing massacres, kidnappings, and sexual violence in El Fasher and neighboring towns. Many survivors arrived malnourished and injured.

Among those who arrived on 27 October, all 70 children under five years old were acutely malnourished—57 percent severely so. The next day, MSF screened 120 men, 20 percent of whom also suffered from severe acute malnutrition. “These shocking indicators point to the sheer agony endured by people in El Fasher,” MSF said, noting that the area has been in famine conditions for over a year.

Survivors recounted harrowing scenes, including a failed mass escape attempt involving 500 civilians and soldiers, most of whom were killed or captured by RSF fighters. Some were reportedly crushed by vehicles, while others were held for ransom ranging from ₤S5 million to ₤S30 million (US$7,000–43,000).

Between 26 and 29 October, MSF treated nearly 400 injured and more than 700 new arrivals in Tawila, most suffering from gunshot wounds, fractures, and injuries linked to torture.

“Given the state of people who escaped and made it barely alive to Tawila, it’s clear that they are in urgent need of medical and nutritional care, psychosocial assistance, shelter, water, and humanitarian aid in general,” said Dr. Livia Tampellini, MSF deputy head of emergencies.

MSF has expanded emergency operations in Tawila, providing surgical care and life-saving medical services. Many of its Sudanese staff have lost relatives in the violence.

The organization reiterated its appeal for the protection of civilians, humanitarian access, and immediate international intervention to halt the escalating atrocities in Darfur.