One month after RSF takeover of El Fasher, displaced people survive in precarious conditions while others remain blocked or unaccounted for
MSF patients in Tawila describe mass killings, torture, and kidnappings for ransom in El Fasher and along escape routes. Their stories confirm fears for those still missing. MSF continues to expand its capacities in Tawila to provide medical care, including war surgery, at the hospital which currently has a capacity of 220 beds, and distributes water in displacement camps.
After witnessing the deaths of his wife and daughter in the middle of bombings in El Fasher, A.M.* set out on a grueling four-day journey toward Tawila, 60 kilometers away, on Monday 27th. Four agonizing days walking on foot, in which he and his remaining family endure torture, beatings, and robbery. Along the way, in the village of Garni, he had to bury his niece, a young girl who had died of exhaustion and hunger. “She couldn’t bear walking such long distances. The journey has been very tough, and we are in great distress”, he says. Yet he kept moving forward to Tawila —taking his surviving children, his brother, and even orphans he met along the way.
But when they finally reached the town, they found nothing but despair: not enough water, not enough food, shelter, latrines.
Almost one month after the RSF took control of El Fasher on October 26th, the last Darfur city held by the Sudanese Armed Forces (SAF) and the Joint Forces, the situation in North Darfur remains critical. Based on NRC registration, around 10,000 people such as A.M. who survived mass atrocities have fled to Tawila, where they are facing dire conditions in overcrowded camps. This figure remains relatively low compared to the estimated 260,000 people who, according to the UN, were still in El Fasher as of late August.
While neither MSF nor any other international humanitarian organization has been able to reach El Fasher, our teams continue to try to identify survivors in need of medical assistance in various locations.
In North Darfur, we visited Um Jalbak, Shangil Tobay, Dar el Salam and Korma: we did not observe any mass arrivals, with only a few hundred people having left El Fasher in the last three weeks, and we referred several people in critical condition to the hospital in Tawila. We are also conducting medical activities in Umbaru, Mazbet, Karnoy, and Tina, localities on the route of exodus to Chad: no major influx there either. The situation is similar in Belliseraf, in South Darfur and Golo and Fanga, in Central Darfur, where our teams are assessing the needs and getting ready to distribute kits to the recent arrivals. Although the IOM estimated that more than 100,000 individuals had been displaced from El Fasher by 17 November, its reports also indicated that the vast majority remained within the El Fasher locality, primarily
in rural villages to the west and north of the city. Our observations, survivor testimonies and external information such as satellite analysis conducted by the Yale School of Public Health’s Humanitarian Research Lab (HRL) point to a catastrophic scenario in which a large part of the civilians who were still alive in El Fasher before October 26 were killed, died, are detained, trapped, and unable to receive vital assistance and move to a safer place.
Inadequate conditions in the camps across Tawila
Survivors who reach Tawila arrive at camps where existing services were already overwhelmed by over 650,000 internally displaced people from El Fasher in the last two years, including almost 380,000 new arrivals since April 2025 when the RSF attacked Zamzam camp.
During an MSF assessment in Daba Naira and Tawila Umda camps, we found that there is an average of only 1.5 litres of water per person per day, which is far below the humanitarian standard threshold of 15 litres minimum.
IO*, around 30 years old, sits with her two children under one of the makeshift tarpaulin tents. They walked for three days until they reached Daba Naira, currently the biggest displaced camp in Tawila, with around 210,000 people. Her husband was struck by shelling in El Fasher when he went out to search for food. When she finally decided to flee with her two children on October 25, they found his lifeless body on the street. “Everything we owned was stolen. The only thing I have left is this garment, which my children and I spread out on the ground to sleep on,” she says. “I need clothes for my children, as they only have one pair of shoes, which is passed around for whoever needs to go to the bathroom. We are still missing many basic items”.
According to the Sudanese American Physicians Association (SAPA), around 74% of Tawila’s displaced people live in informal gathering sites without adequate infrastructure, and less than 10% of households have reliable access to water or latrines. Throughout the Daba Naira camp, it is common to see open air defecation, which can increase the risk of diseases such as cholera spreading. With the cold season approaching, displaced families are also worried about not having warm clothes and blankets.
“The people who are missing are still behind us, and they won’t let them go”
IA* used to work as a watchman in a university in El Fasher. A day before the fall of the city, he was shot in the leg in the middle of a shooting and his tibia shattered in several places. “The wound was bleeding, and my brother made a tourniquet. Then he lifted me onto a donkey cart and brought me here. Can you imagine the pain? It was very hard”, he says. He spent three days on the trails. Despite their efforts, part of his leg had to be amputated when they finally reached Tawila hospital.
As IA’s, the testimonies of our patients who managed to flee are devastating. All the survivors report fleeing during shelling and shootings, walking on foot for between three and five days, often hiding during the day and moving at night to avoid detentions and attacks. They describe extreme violence, including mass killings and ethnically motivated atrocities. On their journey, they saw many dead bodies, and experienced torture, kidnappings for ransom, sexual violence, humiliation, and had everything they owned stolen. Patients also mention mass arrests where men, mainly the young, were detained and separated from women and children in places like Garni, northwest of El Fasher.
FI*, a 50-year-old man visibly exhausted, was detained for ten days, beaten, and forced to endure unspeakable violence, including a rope tied around his neck. His captors demanded 10 million Sudanese pounds [4,000 USD] for his release “They got drunk and took us to the desert. They made us lie down in bushes, beat us and humiliated us terribly. They said they would kill us and they shot at us with a lot of live ammunition”, he says. In the end, his captors let him go after he paid 500,000 Sudanese pounds [200 USD] because his wounds were badly infected.
According to patients we treat, many civilians are still detained in Garni and other towns around El Fasher for ransoms or prevented by the RSF and its allies from reaching safer areas like Tawila. “The people who are missing are still behind us, and they won’t let them go”, warns FI.
MSF response
MSF has increased its capacity in Tawila to respond to the growing needs of the population. Our teams have built a health post at the entrance to Tawila Umda, one of the main arrival points for displaced people from El Fasher. There, they provide injury dressings and outpatient services, stabilize critical cases, and arrange referrals with ambulances to the hospital for patients with the most severe condition. MSF has also identified an urgent need for mental healthcare, which will be a priority for our teams in the coming weeks.
At Tawila hospital, where we have set up an emergency area for arrivals from El Fasher since mid-August, we have expanded bed capacity for wounded and trauma patients from 24 to over 100 beds.
Our teams also continue to treat people arriving with alarming malnutrition, evidence of the siege they endured in El Fasher. Recently, our teams began distributing water and installing latrines in Daba Naira camp.
MSF teams are also beginning an intervention to restore and increase healthcare access in Tine and Kornoi, North Darfur, near the border with Chad, as well as in Chad.
MSF calls on the RSF and its allies to urgently provide a safe and free passage to the sick, injured and all civilians seeking to reach safer places and to facilitate humanitarian access to Garni, El Fasher, and other places where there are survivors. We also call donors and humanitarian actors to increase their response to the growing health, protection, food, water and sanitation needs in Tawila.
*Names have been changed to protect the identities of those involved.
