Both sides to the Sudanese conflict could commit war crimes against medical facilities and personnel, according to evidence seen by BBC News Arabic.
Hospitals were hit by airstrikes and artillery fire while patients were still in the building and doctors were also targeted for attacks – all of which are potential war crimes.
Only a handful of 88 hospitals in the capital, Khartoum, remain open after weeks of fighting, according to the Sudanese Doctors Union.
The BBC team used satellite data and mapping tools, analyzed user-generated content at scale and spoke to dozens of doctors to paint a picture of how hospitals and clinics are being affected.
The World Health Organization (WHO) called the attacks a “flagrant violation of international humanitarian law”, adding that they “must stop now”.
Fighting in Sudan began on April 15 and was sparked by a power struggle between former allies – the heads of the regular army and the paramilitary Rapid Support Forces (RSF).
Ibn Sina Hospital in Khartoum is one of several the BBC has identified as having been targeted by an airstrike or artillery fire as medics treated civilian patients.
Dr Alaa is a surgeon at the hospital and was present when the attack happened on April 19.
“There was no warning. The Ibn Sina hospital where I worked was hit by three bombs, while a fourth bomb hit the nurses’ house which was completely burnt down,” he said. he declares.
Christian de Vos, an international criminal law expert with the NGO Physicians for Human Rights, says it could qualify as a war crime.
“The duty to warn of any impending airstrike to ensure (…) that all civilians are able to evacuate a hospital before an airstrike – this is very clear under the laws of war” , did he declare.
Looking at footage of the attack, forensic weapons expert Chris Cobb-Smith said it could have been caused by artillery fire.
Uncertainty over the type of weapon used means it is unclear which party was responsible or whether it was a targeted attack.
Another medical facility affected was the Eastern Nile Hospital – one of the last operating in this part of the capital.
The BBC saw evidence that RSF fighters surrounded him with their vehicles and anti-aircraft weapons.
Patients were forcibly evacuated from the building. But we also spoke to witnesses who say civilians continued to be treated alongside RSF soldiers.
On May 1, a public area next to the Eastern Nile Hospital was hit by an airstrike by the Sudanese army. There was no warning, according to sources the BBC spoke to.
Five civilians died in this attack.
There was another airstrike two weeks later, but there was no independent confirmation of the number of casualties.
The WHO reported that nine hospitals have been taken over by fighters on one side or the other.
“The preferential treatment of the military over civilians [is] not proper use of a medical facility and that may well be a violation of the laws of war,” De Vos said.
An RSF political adviser, Mostafa Mohamed Ibrahim, denied that they were preventing the treatment of civilians. He told the BBC: ‘Our forces are just spreading…they are not occupying or preventing civilians from being treated in these hospitals.’
The Sudanese army did not respond to the findings of this investigation.
There is also evidence of another potential war crime – the targeting of doctors.
The BBC has seen social media posts threatening doctors by name, even sharing their ID numbers. The messages accuse them of supporting the RSF and receiving money from abroad.
In a widely circulated video, Major General Tarek al-Hadi Kejab of the Sudanese army said, “The so-called central doctors’ committee should be named the rebels’ committee!
Sudanese doctors’ organizations are monitoring threats they say come from both sides and the BBC has spoken to doctors who have gone into hiding.
“We know that this is a tactic used in wars, to pressure, which is illegal in all international laws. Unfortunately, this has pushed medical personnel into a propaganda war – between the RSF and the Sudanese army” , said Dr. Mohamed Eisa. of the Sudanese Association of American Physicians.
Doctors around the world have called for an end to the targeting of their colleagues.
At a conference in London last week, Sudanese Doctors for Human Rights said medical staff had been killed, ambulances targeted and hospitals forced to close.
Dr Ahmed Abbas said, “We are gathering all the evidence of these transgressions, which are crimes against humanity and war crimes, and this could be presented to international judicial authorities or national authorities in Sudan.”
Reporting by Lara El Gibaly, Vanessa Bowles, Mamdouh Akbiek, Ahmed ElShamy and Nawal al-Maghafi