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Hind Al Soulia - Riyadh - NAIROBI — A BBC investigation has uncovered evidence suggesting Sudanese paramilitary fighters systematically destroyed el-Fasher's healthcare system during their long siege and subsequent takeover of the city in Darfur a year ago.
UN human rights chief Volker Türk called the findings "deeply disturbing", saying multiple attacks by the Rapid Support Forces (RSF) on civilian infrastructure, including health facilities, were serious violations of international humanitarian law and may amount to war crimes.
"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.
The RSF has rejected the probe's findings.
Dr Alaa Eldin Nugud, health minister in the paramilitary group's civilian-affiliated government, described the allegations as propaganda and a deliberate attempt by the national army and its allies to smear the RSF's reputation.
Using sources who were on the ground in el-Fasher, the BBC has found details of at least 43 separate attacks on hospitals and healthcare sites from May 2024 to October 2025 — some hit multiple times.
Under international law it is illegal to attack health facilities or their staff during conflict.
The investigation also reveals the toll on medical workers in the western city. In the period from April 2023 to October 2025, the BBC's data shows 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 investigation comes a year after the fall of el-Fasher, one of the most brutal chapters of the civil war which erupted in April 2023 between the RSF and Sudan's military.
Both sides have been accused of attacks on 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 site to close. Sudan's military is believed to have carried out the drone strikes, although it has denied responsibility.
But events in el-Fasher represent "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 reported that the fighting in el-Fasher bore the "hallmarks of genocide", where historical ethnic animosities have seen Arab militias - now the backbone of RSF forces - target non-Arab groups such as those that populate the city.
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