At a clinic in Sudan's North Darfur where dozens of bony children lie on cots and men with bandaged wounds await surgery, patients described a desperate escape from the city of al-Fashir as it was captured last week by a paramilitary force. 

They are among up to 10 000 people who arrived in the town of Tawila after fleeing the capture of nearby al-Fashir by the Rapid Support Forces, and are now being treated at the clinic run by international aid agency Medecins Sans Frontieres. 

Famine-stricken al-Fashir was the final stronghold of the Sudanese army in the vast, western Darfur region before it fell to the RSF after an 18-month siege. Witnesses have reported mass killings following the RSF takeover and many of al-Fashir's residents are unaccounted for. 

The city's capture marked a turning point in a two-and-a-half-year-old war between the RSF and the army. The siege had cut off food supplies, forcing many locals to eat animal feed as they sought shelter from drones and shelling. 

FLEEING ON A DONKEY CART

In addition to those who reached Tawila, more than 60 000 others are believed to have escaped al-Fashir, according to the International Organisation for Migration, though their whereabouts are unclear. As many as 200 000 people may still be trapped inside the city, according to estimates of the city's population towards the end of the siege.

The head of the RSF has called on his fighters to protect civilians and said violations will be prosecuted. Rights groups and US officials have accused the RSF and allied militias of ethnic cleansing in Darfur earlier in the conflict.

The dire conditions inside al-Fashir were described by two patients at the MSF clinic, in accounts obtained by a local journalist who has previously provided verified material for Reuters. 

One, who gave her name as Fatuma, said she was entrusted with the care of three children orphaned when their parents and brother had been killed by a drone strike as they fetched a meal.

The youngest, a thin infant just 40 days old, lay crying in her arms. His sister, sitting nearby, had suffered a leg injury when shrapnel hit her as she ran into a dugout shelter.

Fatuma took the children out of the city on a donkey cart with other injured people just before al-Fashir fell, but came across RSF soldiers on the road.

"They made us lay the baby on the ground and made all of us get down on the ground, and took everything we had," she said. She was eventually able to bring the baby to the MSF clinic. 

FAMINE AND MALNUTRITION

Some 170 other children arrived in Tawila unaccompanied, said Sylvain Penicaud, MSF project coordinator, and all the children screened by the agency were malnourished.

"People are arriving extremely emaciated," he said. On Monday, a global hunger monitor found that al-Fashir had been experiencing famine prior to its fall, conditions expected to persist until January. 

Mouna Hanebali, another member of the MSF team, said the clinic received almost 1 000 trauma cases stemming from attacks on the road, but also from inside al-Fashir. The city's last-standing hospital was under constant attack and deprived of antibiotics and gauze, leading to unstable fractures and infected wounds that need new surgeries.

A second patient, Abdallah, said he had escaped al-Fashir amidst intense shelling and gunfire on the day of the takeover. 

"People left in chaos, carrying children, some in wheelbarrows, some on donkey carts, some on their feet," he said. "No one walking around was untouched, everyone was injured."

Abdallah, awaiting surgery in the MSF clinic after being shot multiple times, said he saw what he estimated to be more than 1 000 bodies on the road.

"Some were killed by thirst, some by exhaustion, some by their injuries, the bleeding," he said. Reuters could not independently verify his account.  

With only a fraction of those who remained in al-Fashir arriving in Tawila, medical supplies are still plentiful but water and latrines less so, the MSF staff said.     

Cholera had ravaged Tawila during the rainy season, and Penicaud said a new case had been recorded on Sunday, though it was unclear if it was isolated or the result of a new outbreak of the disease.