The attack on Friday killed 67 people and injured dozens, local activists and a medical source told the AFP news agency on Saturday, updating an earlier toll.

“Thirty-seven of those injured in the drone strike yesterday died today, bringing the number of victims up to 67,” the was cited as saying by AFP, requesting anonymity for fear of retaliation.

Regional governor Mini Minawi posted graphic images of bloodied bodies on his X account on Saturday, saying that the attack “exterminated” more than 70 patients, including women and children.

It was not immediately clear which of Sudan’s warring sides carried out the attack.

The Sudanese army has been at war with the paramilitary RSF, who have seized nearly the entire vast western region of Darfur, since April 2023.

The RSF has besieged el-Fasher, the state capital of North Darfur, since May, but army-aligned armed groups have repeatedly pushed its fighters back, preventing them from claiming the city.

Attacks on healthcare facilities have been rampant in el-Fasher, where medical charity Doctors Without Borders said this month the Saudi Hospital was “the only public hospital with surgical capacity still standing”.

Across the country, up to 80 percent of healthcare facilities have been forced out of service, according to official figures.

The war, which broke out after disputes on the integration of the two forces, has killed tens of thousands of people, driven millions from their homes and plunged half of the population into hunger.

In the area around el-Fasher, famine has already taken hold in three displacement camps – Zamzam, Abu Shouk and Al-Salam – and is expected to expand to five more areas including the city itself by May, according to a UN-backed assessment.

The attack on the hospital in el-Fasher occurred as the Sudanese army claimed to have broken an RSF siege of its headquarters in Khartoum, in place since the war broke out.

In a statement, the army said troops in Khartoum North and Omdurman had “merged with our forces stationed at the General Command of the Armed Forces”.

Sudan’s capital, Khartoum, comprises three main cities – Khartoum, Omdurman, and Khartoum North – separated by the Nile River and collectively referred to as the triangular capital.

The army added that it had “expelled” the RSF from the strategically important al-Jili oil refinery north of the capital, the country’s largest.

The RSF said in a statement that it rejected the Sudanese army’s claims as “propaganda” designed to boost morale, and accused it of spreading falsehoods through doctored videos.

The Federal Ministry of Health blamed the paramilitary Rapid Support Forces (RSF) for the attack, which took place on Friday.

Officials say the group fired four rocket-propelled grenades towards the city’s main healthcare facility.

A resistance committee in el-Fasher, involved in relief efforts, said the attack targeted the Saudi hospital, forcing it to suspend medical services. It was the last remaining open hospital in the city.

The Sudanese army and RSF have been fighting in el-Fasher since May 10. The city has been a hub for humanitarian efforts in Darfur by the United Nations and other international aid agencies.

Friday’s strike was the latest in a wave of devastating attacks in the region this week.

On Monday, more than 100 people – including women and children – were killed in an air strike on an open-air market in Kabkabiya, a town in northern Darfur, about 180km (111 miles) from el-Fasher, according to the rights group Emergency Lawyers.

Human rights groups condemned the Sudanese army for the attack.

“Bombing a market full of civilians is one of the clearest examples of a war crime that exists,” said Tigere Chagutah, Amnesty International regional director for East and Southern Africa.

On Tuesday, the RSF also shelled the Zamzam displacement camp in North Darfur. The attack killed five people, according to the civil society group Darfur General Coordination of Camps for the Displaced and Refugees.

The mounting civilian casualties come amid continuing clashes across the country between the Sudanese army and RSF.

On Tuesday, the RSF targeted an army-controlled area within the city of Omdurman in Khartoum – Sudan’s second-most populous city – with heavy artillery fire.State-aligned Khartoum Governor Ahmed Othman Hamza said the attack killed at least 65 people.

More than 16,000 people have been killed since the conflict began, with another 10 million displaced and 25 million in need of humanitarian assistance, according to the UN.