In the heart of North Darfur, Sudan, the capital city of El Fasher is once again a battleground, its streets echoing with the sounds of conflict and despair. As fighting escalates between the Rapid Support Forces (RSF) and the Sudanese Armed Forces (SAF), hundreds of thousands of civilians find themselves trapped in a cycle of violence that shows no signs of abating.
In mid-September 2024, as a new wave of intense shelling and air strikes decimated much of what is left of the city’s infrastructure, global leaders renewed their calls for an immediate ceasefire, fearing a possible massacre if El Fasher, the SAF’s last foothold in the region, were to fall.
Half a world away, Nathaniel Raymond, executive director of the Yale School of Public Health’s Humanitarian Research Lab and a team of more than two dozen researchers and specialists monitor the situation in El Fasher closely. Each day, they pour over satellite images, news reports, social media channels, and other open-source data in an attempt to gather and corroborate as much information as they can on what has become the globe’s largest displacement crisis and one of the most perilous humanitarian catastrophes in the world today.
The lab’s detailed real-time reports on Sudan as well as the ongoing war in Ukraine have been an essential resource for world leaders, policymakers, humanitarian organizations, and global justice advocates. A report warning of a potentially devastating RSF attack on El Fasher in June 2024 contributed to the United Nations Security Council passing Resolution 2736 calling for an immediate halt to the fighting to allow badly needed food, medicine, and other humanitarian aid to reach the 1.8 million people sheltering there. In March 2023, the lab’s arrest warrant for Russian President Vladimir Putin for war crimes.
Documenting these conflict-driven atrocities—the desperate humanitarian crises, the potential war crimes, the crimes against humanity—is exhausting and emotionally draining work. Raymond, a respected international expert on the prevention and documentation of mass atrocities, said that at one point during the Darfur fighting his team documented more than 50 mass casualty events and arson attacks in 91 days, which amounts to one attack about every 36 hours. The RSF, Raymond explained, has taken a literal scorched earth approach as it pushes toward El Fasher, capturing smaller cities surrounding the provincial capital and burning entire urban neighborhoods and villages to the ground so their inhabitants cannot return.
As difficult as it can be bearing witness to such human pain and suffering, Raymond and the lab’s faculty director, Associate Professor Kaveh Khoshnood, MPH ’89, PhD ’95—an epidemiologist who investigates humanitarian crises and the impact of conflict and displacement on the health of vulnerable populations—share an unwavering commitment to the lab’s work.
“I feel as though it is an honor and privilege to have the ability to help at a time when people often feel powerless,” Raymond said. “One of the things we can do is provide warning. We can warn governments and the public and the international community before an attack occurs. We also can provide situational awareness that can move policymakers. The information and documentation we shared catalyzed U.N. Security Council Resolution 2736, which demanded the RSF halt the siege of El Fasher. That’s a real thing. And lastly, we are gathering information that will be shared with the International Criminal Court, which has called for evidence of possible war crimes and crimes against humanity in El Fasher. We have that evidence. So, one of the things we can do is support accountability and international law enforcement.”
Fear of Genocide
The siege of El Fasher is the latest chapter in a long history of political instability, violence, and racial and ethnic tensions in Sudan, one of the largest countries in Africa. In the current conflict, two rival military groups are vying for control—the SAF, whose soldiers are loyal to current government leader Abdel Fattah al-Burhan, and the RSF, whose fighters support paramilitary General Mohamed Hamden Dagalo, known popularly as Hemedti. Each is trying to fill the power vacuum created when former dictatorial Sudanese President Omar Hassan al-Bashir was ousted in 2019.
One of the things we can do is provide warning. We can warn governments and the public and the international community before an attack occurs.
Nathaniel Raymond, executive director of the Yale School of Public Health’s Humanitarian Research Lab
In Darfur, a western region the size of Spain, the fighting has been particularly brutal, with distinct racial and ethnic undertones. The RSF includes many former members of the Janjaweed, an Arab nomad militia group. The Janjaweed have been accused by the ICC of crimes against humanity for perpetrating one of the worst mass killings in the region’s history—the Darfur genocide—where an estimated 200,000 members of the non-Arab Masalit, Fur, and Zaghawa ethnic groups were systematically killed between 2003 and 2005. Allegations of rape, torture, extrajudicial killings of boys and men, killing of women and children, mass graves, and torture have been levied against the RSF, which has denied the accusations. The SAF, in return, has been criticized for its indiscriminate shelling of war zones, putting civilians at great risk.
It is estimated that more than 13 million people have been displaced since the current fighting began on Ramadan in April 2023. It is the largest human displacement in the world. More than 2 million people are believed to have escaped across the border to Chad, Libya, or Egypt. Hundreds of thousands of others have settled in massive refugee camps, where conditions are dire. In the war ravaged east, near the capital of Khartoum where the fighting initially began, cholera has set in following months of heavy rainfall and severe flooding. Health officials reported over 350 deaths and thousands of people sickened by the disease as of late September. In the west and just north of El Fasher, widespread famine has been reported and confirmed in the Zamzam refugee camp, temporary home to more than 500,000 internally displaced people. The humanitarian organization Médecins Sans Frontières has reported that a child dies there of starvation or disease "every two hours.” Across Darfur, the U.N. estimates as many as 1.7 million people are starving.
According to the World Health Organization, at least 20,000 people have been killed in the 17 months since the latest fighting began, but U.S. special envoy for Sudan, Tom Perriello, has said the number of deaths could be closer to 150,000. Many fear a repeat of the ethnic-driven killings of the Darfur genocide should the RSF capture El Fasher, which has a long been a hub for refugees and relief efforts. The RSF has already seized other key population centers around El Fasher including Nyala, Zalingei, Kas, and El Daein. In a portent of what may be to come, as many as 15,000 people, most of them members of the Masalit tribe, are believed to have been killed in a torrent of violence in El Geneina from April to November of 2023.
Early Warnings
The Humanitarian Research Lab warned U.S. and international authorities that El Fasher was in trouble as early as October 2023, when, Raymond said, the team noticed foxholes and large earthen berms suddenly appearing south of the city in satellite images. When images started showing SAF tanks lining up behind the berms and artillery units turning to the south, Raymond and his team felt they had enough evidence to report an imminent invasion and briefed U.S. officials and members of the U.N. Security Council member states. The lab recommended that international peacekeeping organizations set up a protective zone around El Fasher while officials continued to negotiate a ceasefire.
Now, a year later, diplomatic efforts have stalled and the fighting around El Fasher has only gotten worse. In a major report issued in mid-September, the Humanitarian Research Lab said it had confirmed “unprecedented large scale combat operations” in El Fasher with the SAF intensifying its bombardment of the region and the RSF launching a new multidirectional offensive from the north, east, and south of the city. “This high-tempo, intense combat activity represents a new stage of the conflict in El Fasher,” the report warned. If the current “free-fire” zone continues, the report said, the result will likely turn “what is left of El Fasher to rubble.”
The report sparked an immediate reaction from the international community. The U.N.'s special adviser on the prevention of genocide, Alice Wairimu Nderitu, said the RSF's multi-pronged assault had "unleashed a maelstrom of violence that threatens to consume everything in its path.” In an address to the U.N. Security Council, Martha Ama Akyaa Pobee, the U.N.’s assistant secretary-general for Africa, said, “hundreds of thousands of people are now at risk of the consequences of mass violence” and that the months-long siege of El Fasher by the Rapid Support Forces has caused “appalling” levels of suffering for the civilian population. She urged the RSF and SAF “to respect and uphold their obligations under international human rights and humanitarian law.”
As world leaders decry the death and suffering in Sudan, the Humanitarian Research Lab carries on, generating dozens of rigorously analyzed reports that are archived with the U.S. Department of State’s Conflict Observatory. Launched in May 2022. the observatory’s initial charge was “to capture, analyze, and make widely available evidence of Russia-perpetrated war crimes and other atrocities in Ukraine.” One of the inaugural members of the observatory, the lab pivoted to monitoring conditions in Sudan when the civil car there reignited in April 2023 and the observatory expanded its mission.
Khoshnood, who has more than a decade of experience in humanitarian health, said public health has a critical role in bringing attention to humanitarian crises around the world, supporting international responses to complex global emergencies, and contributing solutions to protect and improve the health of people in distress.
“As a school of public health, we are not in a position to end the conflict; we don't have the power or the politics,” said Khoshnood, “But that doesn't mean that there's nothing we can do. There's plenty we can do. We're seeing the absolute start of a genocide, and we don't want this to happen over and over again. This violence needs to stop.”