Montaha Omer Mustafa, 18, was among many people who managed to get out of el-Fasher before the city’s seizure by the Rapid Support Forces (RSF) paramilitary group, but only after paying for passage and going days on foot with little water, moving through villages and scrubland.

As fighting closed in on the last big city held by the government-aligned Sudanese Armed Forces (SAF) in North Darfur state, tens of thousands of residents fled westwards, abandoning homes, possessions, and even family members.

El-Fasher almost emptied in a matter of days in October.

“Armed men stopped us and stole everything of value, gold, cash and food,” Mustafa told Al Jazeera from the Tawila refugee camp, some 50km (30 miles) west of el-Fasher.

Somewhere along the road – amid thirst, fear and the rush of thousands moving at once – her brother disappeared. They searched, then had to keep going.

There was no choice, she said, and she remains unsure of his fate.

Three Sudanese refugees narrated to Al Jazeera about their escape from el-Fasher, making a journey from a city which was under bombardment and siege to the Tawila refugee camp, where the sudden arrival of thousands has pushed already scarce resources to the brink.

‘Ghost town’

What the fleeing people left behind has become a “ghost town”, according to medical charity Doctors Without Borders (also known by its French acronym MSF), whose teams visited the city in January.

MSF said it fears that “a majority of the civilians who were still alive when the RSF seized the city were killed or displaced”.

More than 120,000 people fled the RSF’s capture of el-Fasher – approximately 75 percent of whom were already internally displaced people (IDPs) seeking refuge there – the International Organization for Migration said in January, while the World Food Programme says between 70,000 and 100,000 remain trapped in the city.

Nathaniel Raymond, executive director of the Humanitarian Research Lab at Yale’s School of Public Health, which has been monitoring the war, recounted a rare call last year with someone trapped in el-Fasher, telling Al Jazeera: “They had run out of food and water. And they … saw bodies everywhere … they came out during the night.

“We only got them on the phone once. We haven’t talked to them again.”

RSF accused of more war crimes

The RSF mounted a large offensive to capture el-Fasher late last year, after besieging the city for nearly 18 months.

Its long-anticipated fall, despite the fighters marooned in the city putting up a determined resistance, precipitated mass atrocities in el-Fasher, including the systematic targeting of non-Arab populations, particularly from the Zaghawa and Fur tribes, according to the United Nations and rights groups.

On January 19, the International Criminal Court’s (ICC) deputy prosecutor told the UN Security Council that the RSF had committed war crimes and crimes against humanity during its capture of el-Fasher.

Nazhat Shameem Khan said the fall of the city was followed by a “calculated campaign of the most profound suffering”, particularly targeting members of the Zaghawa and Fur ethnic groups. “This criminality is being repeated in town after town in Darfur,” she said.

Marwan Mohammed, an activist at the Tawila refugee camp, where the majority of the refugees have fled, told Al Jazeera recent escapees described scenes in the city as “the worst they’ve seen”, with neighbourhood streets strewn with corpses.

Satellite imagery analysed by Yale’s Humanitarian Research Lab showed systematic RSF efforts to destroy evidence of mass killings as piles of objects consistent with human remains were formed, large enough to be seen from space.

By late November, 72 percent of the clusters had shrunk and 38 percent were no longer visible.

A Sudan Tribune investigation published in January identified suspected mass graves across el-Fasher, along with secret detention centres where the RSF reportedly murders, rapes, tortures, starves and financially extorts civilians.

RSF leader Mohamed Hamdan “Hemedti” Dagalo acknowledged that his fighters had committed abuses in October and said some perpetrators had been arrested, a move met with scepticism by activists and rights groups.

Mohamed Badawi, a Sudanese human rights activist with the Uganda-based African Centre for Justice and Peace Studies who monitors Darfur, told Al Jazeera that a war economy had emerged to sustain the city, with RSF fighters charging exorbitant prices for goods to enter. The first aid convoy to enter el-Fasher since mid-2024 only came in mid-January.

“The stuff which gets through includes animal feed, salt, really basics for people,” Badawi said.

“The people inside are depending on their friends around the world … who send them money. There are no services inside the city. No water, no internet, no food. It has become a city in the dark centuries,” Badawi added.

Badawi said escaping el-Fasher has now become a system of extortion, with RSF fighters frequently kidnapping fleeing people for ransom.

“People are paying from $500 at the lower end and as much as $1,600,” he told Al Jazeera. “Many people in el-Fasher simply cannot afford this.”

‘My children and I are suffering’

Many of the displaced people leaving el-Fasher make a days-long journey to the Tawila refugee camp, some 50km (31 miles) west, through multiple checkpoints manned by RSF fighters who often charge fees for passage.

There, they join an estimated 1.4 million displaced people in what is now a sprawling network of camps in Tawila.

Long a refuge for those fleeing violence in North Darfur, the town offers distance from the front lines but little else for those on its margins.

“The weather is very cold. We do not have mattresses to sleep on or blankets to cover ourselves. We lack food, and getting water is extremely difficult,” Mustafa, the 18-year-old who lost her brother as she fled, said.

Zahra Mohamed Ali Abakar, 29, who fled el-Fasher months earlier, in June, said: “We sleep on the ground and under the sky.

“There are no tents; people are using sacks to cover themselves from the sun and in cold weather.”

The Sudan Doctors Network warned in October that Tawila’s health facilities are suffering from a severe shortage of medicines and medical supplies, a lack of suitable food for children, and even safe drinking water.

Very little has changed since then, said Mohammed, the activist in the Tawila camp.

Abdalla Ahmed Fadul Abu-Zaid escaped el-Fasher four-and-a-half months ago, after RSF shelling shattered his left leg, forcing doctors to amputate in the city, where medical supplies had all but run out months earlier, he said.

Since arriving in Tawila with his family of eight, they have received aid only twice, small rations of corn that ran out quickly.

His wound still requires regular dressing, but the journey to the hospital is costly, money he does not have.

“My children and I are suffering a lot,” he said.