El Geneina, a city in Sudan's West Darfur region, has become the site of some of the worst documented violence in Sudan's civil war. It is also one of the hardest places for humanitarian organizations to deliver aid.

The Attacks and Who Is Being Targeted

Militia groups called the Rapid Support Forces (RSF) and their allies have killed thousands of people in El Geneina, according to Human Rights Watch in May 2024. In May 2023 alone, hundreds died when these militias attacked hospitals, markets, and residential neighborhoods, Reuters reported. Residents said the attackers wanted them gone from the city.

The main target has been the Masalit people, a non-Arab ethnic group who have lived in West Darfur for generations. In November 2023, Reuters documented witnesses accusing the RSF and allied militias of deliberately killing thousands of Masalit civilians. These accounts could be important evidence if cases are brought before the International Criminal Court, which oversees crimes in this region.

By June 2023, UNICEF identified El Geneina as the center of the fiercest fighting in Darfur. People trying to escape on foot were being shot at, according to Reuters reporters on the ground. The roads out of the city had become deadly.

The Hospital Is Gone

El Geneina Teaching Hospital was the only place in the region providing specialized medical care for both residents and displaced families—mostly women and children. International medical organizations like Médecins Sans Frontières had supported it since 2021. During the violence, the hospital was looted, according to ReliefWeb. It remains the main referral point for serious medical cases, per a July 2024 report, which means its destruction directly costs lives.

When the main hospital in a region is looted and damaged, people lose their last safety net for serious illness or injury.

Sudan's Broader Emergency

El Geneina's crisis is part of a much larger catastrophe. As of 2024, all of Sudan faced either a food crisis or a food emergency, according to Social Science in Action. In July 2024, famine conditions were formally declared in a displacement camp, the first time this has happened in Sudan's current conflict.

Malnutrition among children is severe. The World Food Programme projects that 825,000 children under five will suffer severe malnutrition by 2026. Without treatment, this condition kills more than one in five children. Approximately 12 million people have been forced to flee their homes—more than neighboring countries can absorb.

Neighboring countries like Chad and South Sudan are now receiving Sudanese refugees. The Norwegian Refugee Council helped more than 650,000 people in South Sudan and 26,672 refugees in Chad during 2024 alone. Chad already hosts one of the world's largest refugee populations and now faces a new wave of arrivals.

A Pattern of Ethnic Cleansing

What happened in El Geneina follows a clear pattern: one ethnic group was systematically targeted, civilian buildings like hospitals were destroyed, and people were forced to flee along dangerous routes. This is what the international community calls ethnic cleansing. It matters because it means the response cannot be just about providing food and medicine. It requires holding people accountable and ensuring safety before anyone can go home.

Sudan's civil war entered its third year in April 2025 with no agreement in sight to stop the fighting. Humanitarian groups cannot reach many areas because of the ongoing violence. As of October 2024, the crisis was classified as "severe" and is likely just as bad, if not worse, today.

For anyone trying to understand Sudan, El Geneina shows what happens when violence continues without restraint.