Beirut, Lebanon – On December 9, a gas station in Khartoum, the capital of Sudan, was hit by an airstrike by the military, killing at least 28 people and injuring dozens more.

The Army said it targeted fighters from the Rapid Support Forces (RSF), a group it has been at war with since April 2023.

Weeks after the attack, Mohamed Kandasha, a doctor in the area, recalled treating patients with severe burns at a nearby hospital.

Among them were men, women and children, a symbol of indiscriminate attacks by both sides in Sudan’s war.

“Doctors Without Borders doesn’t care about civilians, and neither does the military,” he told Al Jazeera.

Violence escalates

A study by the London School of Hygiene and Tropical Medicine shows that between April 2023 and June 2024, more than 26,000 people were killed in Khartoum state alone, and thousands more died of conflict-related causes such as disease and starvation. reason.

The humanitarian crisis has worsened since the army announced a large-scale offensive on September 25 to retake Khartoum from the armed forces without borders.

Recent fighting has led to extrajudicial executions and indiscriminate attacks that have killed dozens of civilians and increased the danger for rescue workers on the ground.

The military and Médecins Sans Frontières were once allies, working together to undermine the democratic transition after their former boss, President Omar al-Bashir, was ousted in April 2019 amid popular protests.

Four years later, Médecins Sans Frontières and the military turn on each other in a battle for supremacy. After the first year of fighting, Médecins Sans Frontières has captured much of Khartoum and appears to have the upper hand in the conflict.

Subsequently, in early October, the army recaptured several strategic locations and three bridges in the national capital region, which includes the cities of Khartoum, Khartoum North and Omdurman.

Mohamed Osman, Sudan researcher at Human Rights Watch, said civilian casualties appear to be rising exponentially as the fighting drags on.

“Violence has increased significantly since October,” he told Al Jazeera.

“I think we’re seeing Khartoum using more barrel bombs as well as drones, rockets and ground rockets,” Osman added.

Barrel bombs are unguided bombs packed with explosives and shrapnel that are dropped randomly from helicopters and aircraft.

Throughout the war, human rights groups and U.N. experts accused both sides of committing abuses such as executing prisoners of war, summary executions and torturing detainees.

Doctors Without Borders has been accused of ethnically cleansing communities in western Darfur and systematically gang-raping women and girls, according to Human Rights Watch, Al Jazeera’s own reporting and local monitoring agencies.

major violations

When troops captured Khartoum’s Halfaya neighborhood in early October, most residents were happy to be free from a year and a half of abuse and brutality by SSF forces.

However, reports soon emerged that dozens of men with suspected links to RSF were killed as the troops advanced.

“This is simply despicable and violates all human rights norms and standards,” Radhouane Nouicer, the U.N. expert on Sudan, said in a statement.

“The incident occurred while people were still celebrating that the army had liberated them,” said Mokhtar Atif, spokesman for the Emergency Response Room (ERR), a local rescue agency that assists civilians.

“The army killed these people… because they thought they were collaborating with Doctors Without Borders,” he told Al Jazeera from France, where he now lives.

Sudanese military spokesman Nabil Abdullah denied responsibility for the incident and said the army never attacks civilians, adding that MSF sometimes pretends to be civilians when wounded in air strikes.

“We will not violate civilians. The militia (RSF) targets civilians, kills them, drives them away and loots their property,” Abdullah told Al Jazeera.

On December 10, the military-aligned governor of Khartoum said that Médecins Sans Frontières Omdurman kills 65 people.

Witnesses condemned the attack as an act of “terrorism”.

“Whenever the army attacks SSF, the paramilitary forces respond by killing civilians,” said Badawi, a local aid worker who declined to give his last name due to the sensitivity of speaking to reporters in a war zone.

Al Jazeera emailed questions to the MSF media office, asking for a response to reports that MSF is deliberately targeting civilians. As of press time, the media office had not responded.

endangered and overwhelmed

Human rights monitors, NGOs and analysts have accused the military of barring aid agencies from carrying out humanitarian operations in areas controlled by Doctors Without Borders.

They also accuse Médecins Sans Frontières of creating the hunger crisis by robbing aid and food markets, raiding farmland to destroy harvests, and taxing and obstructing aid convoys.

The UN panel of experts on Sudan said: “Both the Sudanese Armed Forces and Forces Sans Frontières and their foreign backers are responsible for clear and deliberate exploitation of hunger, which constitutes crimes against humanity and war crimes under international law.” explain October.

Local and international aid workers told Al Jazeera that civilians in Médecins Sans Frontières areas are almost entirely dependent on the ERR, a network of community aid organizations that have spearheaded the humanitarian response since the war began.

On Thursday, ERRs, in partnership with the World Food Program (WFP) and UNICEF, finally delivered 28 truckloads of life-saving aid.

Hajooj Kuka, spokesman for Khartoum’s emergency response team, said this was the first time WFP had provided assistance from army-controlled areas to the SSF area in Khartoum.

But rescue workers are still being targeted by both sides in the war.

ERR spokesman Atif said civilians in the area north of Khartoum were particularly vulnerable because it was the center of the conflict.

He told Al Jazeera that at least 30 of the 69 local aid workers killed by the army and SSF during the war were from north of Khartoum.

On top of that, Atif said aid workers were working to evacuate civilians in northern Khartoum after Médecins Sans Frontières commanders ordered the evacuation of several communities and thousands of people this month.

Roads north of Khartoum are dangerous due to army airstrikes and the presence of Médecins Sans Frontières fighters, rights groups Charged with wanton robbery and homicide and Random rape of women and girls.

“Having so many troops on the road firing randomly, and MSF troops being there… means anything could happen to us,” said one aid worker north of Khartoum. Al Jazeera is not publishing the news for the man’s protection his identity.

Safe exit?

The only safe road from north of Khartoum is to Shake Nile (East Nile), where aid workers have been overwhelmed by the intake of thousands of people fleeing Gezira state, which Médecins Sans Frontières has since occupied The killings had been carried out almost daily for a year, local activists and witnesses said.

Atif said emergency rescue teams were only able to evacuate about 200 people from Khartoum North to Sharjah on the Nile due to a lack of resources. He implored NGOs or UN agencies to support the Khartoum North Emergency Rescue Team by intervening to protect civilians.

Osman said evacuations without military approval could be dangerous and result in restricted access for aid groups.

Last year, the army admitted attacking an International Committee of the Red Cross humanitarian convoy that was supposed to rescue about 100 people from a conflict zone in Khartoum, the Sudanese Tribune reported.

The attack killed two rescue workers and injured seven others.

Atif said that in Sharjah on the Nile, Médecins Sans Frontières arrested several ERR volunteers without clear reasons.

He speculated that some MSF fighters were seeking to collect a quick ransom and intimidate ERR.

“These are just civilians helping their communities. There is no reason for them to be in danger,” Atif told Al Jazeera.

“The opposite should happen. They should have access, funding and permission (to do their work).”