In a conflict that has already killed tens of thousands in Sudan, fighting has once again intensified between the Sudanese Armed Forces (SAF) and the paramilitary Rapid Support Forces (RSF).

The site of the latest escalation is Khartoum, the nation's capital, where the SAF has launched a major offensive to retake areas under RSF control. According to local emergency response rooms, civilian-led initiatives that were nominated for this year's Nobel Peace Prize for supporting civilians, recent clashes have killed scores of people in Khartoum markets.

Sudan's army and the RSF have been engaged in a civil war since April 2023 that has plunged Sudan into a humanitarian crisis. The conflict stemmed from a power struggle between Army chief Abdel Fattah al-Burhan and RSF leader Mohamed Hamdan Dagalo, who had previously shared power after a military coup in 2021.

At least 20,000 people have been killed, but the death toll is likely to be much higher as the ongoing fighting and the collapse of the health system has made updating or verifying casualty figures impossible.

According to the United Nations, the war has also prompted the world's largest displacement crisis, with more than 11 million people displaced to refugee camps and neighboring countries. The UN also said in early October that famine and the outbreak of diseases like cholera have further exacerbated an already desperate situation.

'Catastrophic situation' in El Fasher

Shelling at markets has also occurred near El Fasher, a city in Sudan's western Darfur region and another key battleground since the start of the civil war.

"For the past 10 days, shelling has gotten more intense," Salah Adam, a resident of the Abu Shouk camp for displaced people and active member of the local emergency response room, told DW.

Adam said RSF airstrikes hit a market he visited on Monday to buy some groceries. Three people were killed and 10 others injured in the strike as grocery shoppers ran for their lives.

"You cannot imagine our catastrophic situation," Adam said. "There are no organizations who provide support or aid. We are the only people working on the ground, and we simply don't have enough of anything."

People suffer from hunger, injuries and diseases, he said. "Every day, I see children die. These are the toughest moments."

According to the Reuters news agency, RSF looters have increasingly targeted international humanitarian organizations. Michelle D'Arcy, the Sudan country director of the Norwegian People's Aid organization, points out that access to humanitarian aid is only one of many challenges.

"Locally led humanitarian responses such as the emergency response rooms and communal kitchens need protection as they continue to face threats and insecurity while operating within the conflict zones," she told DW.

Forgotten crisis

Most recently, also UN Human Rights Chief Volker Türk sounded the alarm about the "growing horrific toll on civilians" in El Fasher's Abu Shouk refugee camp and the nearby Zamzam camp.

"People in those camps are at grave risk of retaliatory attacks [by the RSF] based on their tribal identity, real or perceived," Türk stated. He added that armed movements aligned with the SAF within the camps have become a key target for the RSF forces.

In the near future, the humanitarian situation is likely to worsen at the Zamzam camp, which houses at least 80,000 people.

This week, Doctors Without Borders (MSF) suspended their work after the RSF obstructed aid and the SAF had systematically blocked aid to areas outside of its control, MSF's Sudan coordinator Claire San Filippo explained in a briefing.

"Now, 5,000 children who are malnourished, including 2,900 children who are severely malnourished, are left without support," Filippo said.

"The Sudanese Armed Forces are still not allowing access of crucial aid to areas controlled by the Rapid Support Forces, and the Rapid Support Forces continue to loot supplies and aid that managed to reach some of the civilians in their areas of control," Mohamed Osman, Sudan researcher at Human Rights Watch, confirmed.

In his view, there is also not enough international attention. "This is definitely a forgotten crisis," he told DW.

Unclear battlelines

Hager Ali, who researches Sudan at the German Institute for Global and Area Studies (GIGA), told DW that the situation is becoming increasingly complicated. Ali said that when the war started 18 months ago, it was a clear-cut power struggle between the Sudanese Armed Forces and the Rapid Support Forces.

"Since then, factionalism became a particularly concerning trend," Ali said. "The once clear SAF-RSF front line has now shattered over many questions and goals. The SAF and RSF had to recruit and outsource to many other factions in a short time and with a limited capacity to train recruits. The paramilitary RSF recruited especially quickly, so fighters likely never underwent real training. This substantially weakens the chain of command, especially if factions question the RSF's local authority."   

In a war fought on so many fronts over such a vast country, Ali said it is increasingly difficult to oversee who is actually doing what, who is adhering to orders and who isn't. There are signs for both the RSF and SAF that neither is fully in control of their own troops in the country anymore.

All of this is happening against the challenge to actually also govern the territory that is brought under the respective control, Ali added.

The lack of aid, decreasing support and ongoing fighting have taken its toll on Adam, the emergency response room member. "I am calling on the humanitarian organizations and human rights activists to take immediate action and save the people of El Fasher," he told DW.

He added that if nothing changes, he is exhausted enough to give up hope for good.