Millions across war-torn Sudan are facing worsening conditions as the Rapid Support Forces (RSF) tighten their grip on the city of el-Fasher, the capital of North Darfur.

The takeover follows an 18-month siege marked by starvation and violence, leaving civilians trapped and desperate for aid.

International relief agencies on Sunday urged both the RSF and the Sudanese Armed Forces (SAF) to allow safe access for humanitarian assistance. Despite mediation efforts and a proposed roadmap, a ceasefire has yet to materialize.

Thousands trapped and missing

Authorities and aid groups estimate that tens of thousands of civilians remain trapped inside el-Fasher, while thousands more are missing after attempting to flee. Only a small fraction of those who escaped have reached Tawila, a town about 50 kilometers away.

Caroline Bouvard, Sudan country director for Solidarités International, told Al Jazeera that “very few people have made it out,” citing major security risks on the roads. “We keep hearing feedback that people are stuck in villages that are inaccessible,” she said.

Bouvard added that there is now a “complete blackout” in el-Fasher, with aid agencies relying on reports from nearby areas where around 15,000 people are believed to be stranded.

Reports of violence and displacement

Civilians who managed to reach Tawila described harrowing scenes of mass executions, torture, and sexual violence. Some reported being abducted and forced to pay ransoms to armed men to secure their release.

Thousands more have been displaced to the al-Dabbah refugee camp in Sudan’s Northern State, where many have been living for weeks without adequate food, clean water, or shelter. Aid agencies warn that more families could arrive in the coming days as violence continues to spread.

The United States, Saudi Arabia, United Arab Emirates, and Egypt — key mediators in the conflict — have condemned the RSF’s actions and called for immediate humanitarian access.

“The RSF must stop engaging in retribution and ethnic violence; the tragedy in El Geneina must not be repeated,” the U.S. State Department said in a statement, referring to the massacre of Masalit people in West Darfur’s capital.

Washington also emphasized that “there isn’t a viable military solution” and urged both sides to return to negotiations. U.S. lawmakers have echoed calls for decisive action following the RSF’s seizure of el-Fasher.