Sudanese paramilitaries have attacked the city of el-Fasher killing at least 38 people, according to local activists, while international rights groups accuse the fighters of widespread sexual violence.

The local resistance committee, a volunteer group coordinating aid in el-Fasher, said on Sunday that the paramilitary Rapid Support Forces (RSF) targeted the centre of the capital of North Darfur state “with four high-explosive missiles”.

The massacre followed an earlier drone attack on the city’s Saudi Hospital on Friday, which killed nine people and wounded 20, forcing doctors to halt operations.

World Health Organization (WHO) chief Tedros Adhanom Ghebreyesus described attacks on healthcare facilities across Sudan as “deplorable” in a post on X on Saturday.

The RSF and Sudan’s army have been locked in a power struggle since mid-April 2023, creating one of the worst humanitarian crises, with tens of thousands killed and more than 11 million displaced.

Nearly all of Darfur is now controlled by the RSF, which has also taken over swaths of the South Kordofan region and central Sudan, while the army holds the north and east.

Rights groups accuse both sides of targeting civilians.