Both sides in the Sudanese conflict could be committing war crimes against medical facilities and personnel, according to evidence seen by BBC News Arabic.
Hospitals have been hit by airstrikes and artillery fire while patients were still in the building and doctors have also been singled out for attacks – all potential war crimes.
Only a handful of the 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, extensively analyzed user-generated content and spoke to dozens of doctors to get 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” and added that they “must stop now”.
Fighting in Sudan began on April 15 and was provoked by a power struggle between former allies – the leaders of the regular army and the paramilitary Rapid Support Forces (RSF).
Ibn Sina Hospital in Khartoum is one of several hospitals identified by the BBC as the target of an airstrike or artillery fire as medics treated civilian patients.
Dr. Alaa is a surgeon at the hospital and was present at the attack on April 19.
“There was no warning whatsoever. The Ibn Sina hospital where I worked was hit by three bombs, while a fourth bomb hit the nurse’s home, which was completely on fire,” he said.
Christian de Vos, an expert in international criminal law at the NGO Physicians for Human Rights, says that this can be classified as a war crime.
“The duty to warn of an impending airstrike to ensure… that all civilians can evacuate a hospital in advance of an airstrike – that is very clear under the laws of war,” he said.
Looking at footage of the attack, forensic weapons expert Chris Cobb-Smith said it could have been caused by artillery fire.
Uncertainty about the type of weapon used means it is difficult to know for sure which party was responsible, and whether this was a targeted attack.
Another affected medical facility was East Nile Hospital – one of the last in that part of the capital.
The BBC has seen evidence of RSF fighters surrounding it with their vehicles and anti-aircraft guns.
There have been reports of patients being forcibly evacuated from the building. But we have also spoken to witnesses who say civilians are still being treated alongside the RSF soldiers.
On May 1, a public area next to East Nile Hospital was hit by an airstrike by the Sudanese army. According to sources the BBC spoke to, there was no warning.
Five civilians were killed in that attack.
Two weeks later there was another airstrike, but there is no independent confirmation of the number of people injured.
The WHO has reported that nine hospitals have been taken over by fighters from one side or the other.
“The preferential treatment of soldiers over civilians [is] improper use of a medical facility and it could well be a violation of the laws of war,” De Vos said.
A political adviser to the RSF, Mostafa Mohamed Ibrahim, denied that they prevented the treatment of civilians. He told the BBC: “Our forces are just spreading out… they don’t occupy or stop civilians from being treated in these hospitals.”
The Sudanese military has not commented on the findings of this investigation.
There is also evidence of another possible war crime: attacking doctors.
The BBC has seen social media posts threatening doctors by name and even sharing their ID number. 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 committee of doctors should be called the committee of rebels!”
Sudanese doctors’ organizations are monitoring threats they say come from both sides and the BBC has spoken to doctors in hiding.
“We know that this is a tactic used in wars, to exert pressure, and that is illegal in all international laws. Unfortunately, this has pushed the medical staff into a propaganda war – between the RSF and the Sudanese army,” said Dr Mohamed Eisa. of the Sudanese American Physicians Association.
Doctors around the world have called for an end to assaulting their colleagues.
At a conference in London last week, Sudanese Doctors for Human Rights said medical staff had been killed, ambulances had been attacked and hospitals had been forced to close.
Dr. Ahmed Abbas said: “We are collecting all evidence of these violations, 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 al-Gibly, Vanessa Bowles, Mamdouh Akbiek, Ahmed ElShamy and Nawal al-Maghafi