As the war in Sudan enters its fourth month, Omdurman – the city across the River Nile from the capital Khartoum – has become the scene of some of the fiercest fighting between the two forces vying for power: the army and its rival, the paramilitary Rapid Support Forces.
Patients have been admitted en masse to one of the few functioning health facilities in Omdurman in recent days, their bodies riddled with bullets or slashed by shrapnel from airstrikes. Some of the victims were dead by the time they were brought in, their passage hampered by street fighting in Omdurman, once a bustling business center and home to many universities, hospitals and political and cultural institutions.
“It’s been hell,” said Dr. Rashid Mukhtar Hassan, the human resource manager of the health facility, Al-Nau Teaching Hospital, in a phone call.
The Rapid Support Forces have expanded their grip on the capital, according to residents, military analysts and humanitarian officials in contact with those trapped in the war zone. The clashes have intensified as the army has attempted to block the paramilitary group’s supply routes from its stronghold in Darfur, western Sudan.
Fighting continued on Monday even as a major international rally to negotiate a ceasefire began in the Ethiopian capital Addis Ababa. The Sudanese military boycotted the talks, insisting that the chairman, President William Ruto of Kenya, was not neutral. Egypt also plans to hold a summit on July 13 to find ways to end the conflict.
Showing global concern over the war, the talks included leaders and officials from nearby African countries, the United Nations, Saudi Arabia and the United States, including Molly Phee, the US assistant secretary of state for African affairs.
The war in northeastern Africa, which broke out on April 15, has sparked a devastating humanitarian crisis and fears of destabilization in the already fragile Horn of Africa.
More than 3,000 people have been killed and 6,000 others injured, according to the Sudanese health minister, though aid workers say the toll is likely higher. Medical personnel, humanitarian personnel and refugees have been targeted by the violence. At least 22 people were killed in an airstrike last weekend.
Dr. Hassan said his hospital received 125 wounded civilians and 20 bodies in the course of one day last week. Three others died during the operation. Then, he said, he used his car to take some of the dead to their families.
“It was the worst day ever,” said Dr. Hassan, 42, who was reached in two calls in recent days.
The conflict has displaced more than 2.2 million people in the country, and about 700,000 others have crossed to neighboring countries, including Chad, Egypt and South Sudan, according to the International Organization for Migration.
Sexual violence is also pervasive, according to the United Nations, with girls as young as 12 being attacked, according to the aid organization Save the Children.
From the outset, the paramilitary forces had a stronger presence than the army on the ground in Khartoum and the neighboring towns of Omdurman and Bahri. They also captured the Yarmouk ammunition factory in June, seized areas east of the strategic Halfaya Bridge and recently seized police bases in southern Khartoum and the Omdurman central reserve, according to residents and analysts.
“The Rapid Support Forces initially dealt a strong blow to the military,” said Alan Boswell, Horn of Africa project director at the International Crisis Group.
But as the war continues, he said, the Rapid Support Forces have been trying to bring more troops and equipment to the capital from their stronghold in Darfur, especially as the rainy season approaches.
“We are entering a new phase of the conflict where this is now becoming a war over supply lines,” said Mr. Boswell. “And Omdurman is at the heart of it.”
The army has tried to undermine those operations by launching ground offensives and intense airstrikes against paramilitary strongholds, including near the state broadcaster in Omdurman.
The army has also strengthened its presence near strategic posts it already controls, including the Wadi Saeedna air base just outside Khartoum and the General Command headquarters.
Outside the capital, the army remains dominant in northern and eastern Sudan. However, the paramilitary forces have also tightened their command over Darfur, a region ravaged by decades of genocidal violence. The outbreak of war has led to renewed violent communal violence in parts of Darfur.
In recent weeks, the Rapid Support Forces have captured Zalingei, the capital of Central Darfur, and won victories against the army in Nyala, the capital of South Darfur, according to residents, analysts and UN officials. In West Darfur, army troops rarely left their bases as violence swept through towns like El Geneina, said residents and aid workers fleeing the town. The paramilitary forces have also besieged El Obeid, the capital of North Kordofan, which is home to two sites of strategic value: an airport and an oil refinery.
Humanitarian aid workers say they have faced bureaucratic hurdles to release shipments or obtain visas. Much of the international aid is being coordinated through the military-controlled coastal city of Port Sudan, which is more than 1,000 miles from some of the hardest-hit parts of the country, such as West Darfur.
William Carter, the country director of the Norwegian Refugee Council, which coordinates aid deliveries from Kosti, a town about four hours south of Khartoum, said there was an urgent need for more humanitarian corridors to deliver aid quickly.
“Each passing day adds to the excruciating catastrophe faced by citizens across the country virtually alone,” he said.
But with diplomatic talks deadlocked and both sides calling for new mobilization, concerns remain about a protracted conflict.
“We are exhausted and working in a difficult situation,” said Dr. Hassan, just after taking medicine to treat his malaria.
“I shiver, but we can’t just stop helping Sudanese people,” he said.
