(LONDON) — At least 134 people have been killed and another 979 have been wounded since May 10 as fighting intensifies between Sudan’s military and a powerful Sudanese paramilitary force in a major city of the country’s northwestern Darfur region, according to an international aid group.

Doctors Without Borders, also known by its French acronym MSF, said Sunday that the casualties were all recorded at a single hospital in el-Fasher, the provincial capital of Sudan’s North Darfur state. South Hospital is currently the last functioning medical center in North Darfur and only has around 10 days of supplies left, according to the aid group.

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MSF said one of its staff members was among those killed when shelling hit his home near el-Fasher’s main marketplace.

Civilians with a range of injuries are arriving in droves at South Hospital in el-Fasher, according to MSF.

“Some have gunshot wounds, some have been wounded by bomb fragments, and others have been wounded by shelling,” Claire Nicolet, MSF’s head of emergency programs, said in a statement last Tuesday.

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An estimated 505,000 people have been displaced from their homes in North Darfur since clashes escalated earlier this month between the official Sudanese Armed Forces (SAF) and the paramilitary Rapid Support Forces (RSF), according to the United Nations.

“Reports from el-Fasher in Sudan are terrible: deadly attacks on civilians, horrifying accounts of ethnic targeting, people too fearful of checkpoints to even flee,” U.N. High Commissioner of Refugees Filippo Grandi said in a statement last Thursday. “Deliberate violence on civilians must stop.”

A report released last week by the Yale School of Public Health’s Humanitarian Research Lab found “significant new conflict–related damage to the northeastern, eastern, and southeastern neighborhoods” from May 14 to May 20, as RSF forces gained control in “several directions.”

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The SAF and the RSF, as well as their allied militias, have been locked in a bitter battle for control of the resource-rich North African nation since April 2023. The fighting first erupted on the streets of Sudan’s densely populated capital, Khartoum, before spreading elsewhere across the country.

El-Fasher is the last major city in Darfur still in the hands of the SAF. The besieged city is a key humanitarian hub and “safe haven” to an estimated 800,000 people, according to the U.N.

U.N. Secretary-General Antonio Guterres said last Thursday that hostilities have entered an “alarming new chapter” with the humanitarian situation “rapidly deteriorating.”

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During last Friday’s U.N. Security Council meeting on the situation in Sudan, U.S. Ambassador to the U.N. Linda Thomas-Greenfield warned that “history is repeating itself” and “there is no time to waste,” citing the RSF’s tightened siege on el-Fasher and the SAF’s continued obstruction of aid.

“The people of Sudan have endured immense suffering at the hands of the warring parties who continue to plunge the country into a spiral of death and despair,” Thomas-Greenfield said. “Five million Sudanese are on the brink of famine, and tens of millions more are in desperate need of food.”

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