Fighting between the army and paramilitaries in Sudan has killed around 200 people and wounded 1,800, damaging hospitals and hampering aid after three days of urban warfare.

A weeks-long power struggle exploded into deadly violence Saturday between the forces of two generals who seized power in a 2021 coup: Sudan’s army chief Abdel Fattah al-Burhan and his deputy, Mohamed Hamdan Daglo, who commands the paramilitary Rapid Support Forces (RSF).

Analysts say the fighting in the capital of the chronically unstable country is unprecedented and could be prolonged, despite regional and global calls for a ceasefire as diplomats mobilise.

US Secretary of State Antony Blinken said Tuesday he had spoken with the two generals and “underscored the urgent need for a ceasefire”.

“Too many civilian lives have already been lost,” Blinken tweeted, adding he had “stressed the importance of ensuring the safety of diplomatic personnel and aid workers”.

The European Union’s ambassador to Sudan was attacked in his home in Khartoum on Monday, the bloc’s top diplomat Josep Borrell said. A spokesperson told AFP the veteran diplomat was “OK” following the assault.

Battles have taken place throughout the vast country and there are fears of regional spillover.

Terrified residents of the capital are spending the last and holiest days of Ramadan watching from their windows as tanks roll through the streets, buildings shake and smoke from fires triggered by the fighting hangs in the air.

The conflict has seen air strikes, artillery and heavy gunfire.

Those compelled to venture out face queues for bread and petrol at outlets that are not shuttered. Residents are also dealing with power outages.

Hospitals ‘out of service’

Volker Perthes, the head of the United Nations mission to Sudan, told the Security Council in a closed-door session that at least 185 people had been killed and another 1,800 wounded.

“It’s a very fluid situation so it’s very difficult to say where the balance is shifting to,” Perthes told reporters after the meeting.

Earlier Monday, UN Secretary-General Antonio Guterres again urged Sudan’s warring parties to “immediately cease hostilities”. He warned that further escalation “could be devastating for the country and the region”.

Medics in Sudan had earlier given a death toll of nearly 100 civilians and “dozens” of fighters from both sides, but the number of casualties was thought to be far higher, with many wounded unable to reach hospitals.

The official doctors’ union warned fighting had “heavily damaged” multiple hospitals in Khartoum and other cities, with some completely “out of service”.

The World Health Organization had already warned that several Khartoum hospitals tending to wounded civilians “have run out of blood, transfusion equipment, intravenous fluids and other vital supplies”.

In the western region of Darfur, international medical aid organisation Doctors Without Borders (MSF) reported receiving 136 wounded patients at the only hospital in El Fasher still operating in North Darfur state.

“The majority of the wounded are civilians who were caught in the crossfire – among them are many children,” MSF’s Cyrus Paye said.

Due to limited surgical capacity, “11 people died from their injuries in the first 48 hours of the conflict”.

Call for talks

Three UN World Food Programme staff were also among those killed on Saturday in Darfur, where humanitarian missions have had medical and other supplies looted, according to Save the Children and MSF.

A number of organisations have temporarily suspended operations in the country, where one-third of the population needs aid.

“This renewed fighting only aggravates what was already a fragile situation, forcing UN agencies and our humanitarian partners to temporarily shutter many of our more than 250 programmes across Sudan,” said UN emergency relief coordinator Martin Griffiths.

Diplomatic manoeuvres seemed to ramp up on Monday, as the fighting showed no signs of abating.

Influential northern neighbour Egypt announced it had discussed with Saudi Arabia, South Sudan and Djibouti – all close allies of Sudan – “the need to make every effort to preserve stability and safety”.

President Abdel Fattah al-Sisi called on the two warring parties to “return to the negotiating table” and said he was working on the return of Egyptian military “trainers” captured Saturday at an air base by RSF forces.

There are no more civilian flights arriving in Khartoum, where fighting has damaged aircraft.

‘Unprecedented’

On Twitter, Daglo called on the international community to intervene against Burhan, branding him a “radical Islamist who is bombing civilians from the air”.

“We will continue to pursue Al-Burhan and bring him to justice,” said Daglo, whose RSF and its predecessor the Janjaweed in Darfur have previously been accused of atrocities and war crimes.

Army statements call the RSF “a rebel militia” intent on “engaging near populated areas”.

The fighting broke out after bitter disagreements between Burhan and Daglo over the planned integration of the RSF into the regular army – a key condition for a final deal aimed at ending a crisis since the 2021 coup, which derailed a transition to democracy.

Both claim to be in control of key sites, including the airport and the presidential palace – none of which could be independently verified.

On Monday, the army resumed broadcasting on state TV.

While Sudan has endured decades of bitter civil wars, coups and rebellions since independence, Sudanese analyst Kholood Khair said the level of fighting inside the capital was “unprecedented”.