In Besieged El Fasher… First Aid with Primitive Materials and Medicinal Plants

More than 30 people were killed in artillery shelling carried out by the Rapid Support Forces (RSF) on the besieged city of El Fasher in the Darfur region, activists announced on Tuesday.

According to Agence France-Presse (AFP), the “Resistance Committees in El Fasher” reported that civilians were killed on Sunday during “intense artillery shelling” by the RSF, which has been at war with the army since April 2023.

El Fasher is defended by armed groups allied with the army, known as the “Joint Forces,” which have repeatedly cut off RSF supply lines in recent months.

Experts describe the battle for El Fasher as “critical” for the Sudanese army and its allies, fearing a resurgence of ethnic cleansing and genocide at the hands of the RSF.

The RSF has been besieging El Fasher for months in an attempt to take control of the city, which remains the last major urban center in Darfur under army control. The RSF now controls most of the vast region in western Sudan.

The city is a strategic target for the RSF, which seeks to tighten its grip on Darfur after the army recaptured the capital, Khartoum, last month.

The war, which entered its third year on Tuesday, has killed tens of thousands and displaced 13 million people, in what the United Nations describes as the world’s largest hunger and displacement crisis.

The conflict has also effectively divided the country: the army controls central, northern, and eastern Sudan, while the RSF controls almost all of Darfur and parts of the south with its allies.

On April 13, the RSF announced its capture of the Zamzam IDP camp, prompting nearly 400,000 people to flee.

Primitive Treatment

Eight-year-old Mohammed is considered one of the lucky ones in El Fasher, located in western Sudan, even though his arm, which still contains shrapnel, was treated only with a cloth wrap. Many other war-wounded suffer more severe injuries that are difficult to treat due to the siege and a severe shortage of medical supplies in the city.

Last week, the RSF launched a deadly attack on North Darfur’s capital and surrounding areas, collapsing the health system. The repeated RSF assaults on the regional capital have made civilian movement extremely dangerous. All healthcare facilities in the city have also been shelled or attacked.

Isa Saeed, 27, Mohammed’s father, told AFP via a Starlink satellite call—since all communications in the area are cut off—“With the help of our neighbor, who used to be a nurse, we managed to stop the bleeding. But the arm is swollen, and Mohammed can’t sleep at night from the pain.”

Like many others in the city besieged by the RSF since May 2024, Isa cannot take his son to any emergency room. Mohammed, a humanitarian aid coordinator who arrived in El Fasher this week, said hundreds of wounded people are now trapped in the city.

Medicinal Plants for Healing

Mohammed himself was injured in the thigh during the deadly RSF attack on the Zamzam camp, located 15 kilometers south of El Fasher. He added—without revealing his full name for security reasons—“People are opening their homes, and everyone is receiving treatment privately in houses.”

According to humanitarian sources, hundreds of thousands fled the Zamzam camp—declared famine-stricken by the UN—to seek refuge in El Fasher.

In the city, residents try to offer first aid and treat burns or injuries from bullets and shrapnel using primitive materials and medicinal plants.

Mohammed Abkar, 29, said he was fetching water for his family when he was shot in the leg. “My neighbors carried me into the house and called another neighbor who knows how to treat fractures using splints—traditional treatment using wooden sticks and cloth,” he said. “The problem is that even if the fracture heals, the bullet is still in my leg.”

With medical equipment becoming extremely scarce, Mohammed pointed out that if there were money, “someone could be sent to buy gauze or painkillers—if they can be found at all. But generally, there are no supplies; we treat with whatever we have.”

Salt as a Disinfectant

The latest RSF attacks on El Fasher and nearby displacement camps have killed more than 400 people, according to the UN on Monday. Warnings continue to grow about the dangers of such an operation in the area, where at least 825,000 children are trapped in a “hell,” according to UNICEF.

A large-scale RSF attack on the besieged city could have devastating consequences.

After 11 months of siege and two years of war, many El Fasher residents have built improvised shelters, often digging holes and covering them with sandbags for protection from shelling. But not everyone can reach safety in time.