CAIRO — Sudan’s army and its rival paramilitary said Sunday they will extend a humanitarian cease-fire a further 72 hours. The decision follows international pressure to allow the safe passage of civilians and aid but the shaky truce has not so far stopped the clashes.
In statements, both sides accused the other of violations. The agreement deescalated the fighting in some areas but violence continues to push civilians to flee. Aid groups have also struggled to get badly needed supplies into the country.
The conflict erupted on April 15 between the nation’s army and its paramilitary force, and threatens to thrust Sudan into a raging civil war. The U.N. warned on Sunday that the humanitarian crisis in Sudan was at “a breaking point.”
“The scale and speed of what is unfolding in Sudan is unprecedented,” the UN’s humanitarian chief Martin Griffiths said in as statement.
He said water and food are becoming increasingly hard to find in the country’s cities, especially the capital, Khartoum, and the lack of basic medical care means many could die of preventable causes. Griffiths said that “massive looting” of aid supplies has hindered efforts to help civilians.
Earlier Sunday, an aircraft carrying eight tons of emergency medical aid landed in Sudan to resupply hospitals devastated by the fighting, according to the International Committee of the Red Cross, which organized the shipment. It arrived as the civilian death toll from the countrywide violence topped 400 and aid groups warned that the humanitarian situation was becoming increasingly dire.
More than two-thirds of hospitals in areas with active fighting are out of service, a national doctors’ association said, citing a shortage of medical supplies, health workers, water and electricity.
The air-lifted supplies, including anesthetics, dressings, sutures and other surgical material, are enough to treat more than 1,000 people wounded in the conflict, the ICRC said. The aircraft took off earlier in the day from Jordan and safely landed in the city of Port Sudan, it said.
“The hope is to get this material to some of the most critically busy hospitals in the capital” of Khartoum and other hot spots, said Patrick Youssef, ICRC’s regional director for Africa.

Khidir Dalouk via AP
Dr. Bushra Ibnauf Sulieman, an American citizen, right, poses for a photo with a school friend. Sulieman was the second American killed in Sudan after battles erupted in Khartoum and turned the capital city into a war zone.
The Sudan Doctors’ Syndicate, which monitors casualties, said Sunday that over the past two weeks, 425 civilians were killed and 2,091 wounded. The Sudanese Health Ministry on Saturday put the overall death toll, including fighters, at 528, with 4,500 wounded.
The fighting pits the army chief, Gen. Abdel Fattah Burhan, against Gen. Mohammed Hamdan Dagalo, the head of a paramilitary group known as the Rapid Support Forces. The generals, both with powerful foreign backers, were allies in an October 2021 military coup that halted Sudan’s fitful transition to democracy, but since turned on each other.
Ordinary Sudanese have been caught in the crossfire. Tens of thousands fled to neighboring countries, including Chad and Egypt, while others remain pinned down with dwindling supplies. Thousands of foreigners have been evacuated in airlifts and land convoys.
Some of the deadliest battles have raged across Khartoum.
Bound to the country by ailing parents and his devotion to treating Sudan’s poor, U.S.-born doctor Bushra Ibnauf Sulieman kept working as long as he could after fighting engulfed Sudan’s capital.
For days after the battles erupted, the 49-year-old gastroenterologist who divided his time and work between Iowa City, Iowa, and Khartoum, treated the city’s wounded. He and other doctors ventured out as explosions and gunfire resounded in the streets.
“Say, ‘Nothing will happen to us except what God has decreed for us,’” Sulieman said in one of his last messages to worried friends on Facebook last week, as fighting persisted. ”And in God let the believers put their trust.”

Mohamed Eisa via AP
Dr. Bushra Ibnauf Sulieman, an American citizen, left, poses for a photo with Dr. Mohamed Eisa.
The morning that Sulieman decided he had to risk the dangerous escape from Sudan’s capital with his parents, American wife and his two American children was the morning that the war found Sulieman, friends say.
In the wholesale looting that has accompanied fighting in the capital, Khartoum, a city of 5 million, a roving band of strangers surrounded him in his yard Tuesday, stabbing him to death in front of his family. Friends suspect robbery was the motive. He became one of two Americans confirmed killed in Sudan in the fighting, both dual nationals.
Authorities say the other, with ties to Denver, was caught in a crossfire. They have not released that American’s name.
“You killed thousands of patients,” a Sudanese colleague, Hisham Omar, posted among Facebook tributes from the country’s medical workers, in a message aimed at the attackers who killed Sulieman. “You killed thousands of needy people. You killed thousands of his students.”
On Sunday, a second U.S.-government organized convoy arrived in Port Sudan, State Department spokesperson Matthew Miller said. He said the U.S. is assisting American citizens and “others who are eligible” to leave for Saudi Arabia where U.S. personnel are located. There were no details on how many people were in the convoy or specific assistance the U.S. provided.
-
Sudan’s generals battle for 3rd day; death toll soars to 185
Marwan Ali
A destroyed military vehicle is seen in southern in Khartoum, Sudan, Thursday, April 20, 2023. The latest attempt at a cease-fire between the rival Sudanese forces faltered as gunfire rattled the capital of Khartoum. Through the night and into Thursday morning, gunfire could be heard almost constantly across Khartoum. (AP Photo/Marwan Ali)
Marwan Ali
A destroyed military vehicle is seen in southern in Khartoum, Sudan, Thursday, April 20, 2023. The latest attempt at a cease-fire between the rival Sudanese forces faltered as gunfire rattled the capital of Khartoum. Through the night and into Thursday morning, gunfire could be heard almost constantly across Khartoum. (AP Photo/Marwan Ali)
-
Sudan’s generals battle for 3rd day; death toll soars to 185
Marwan Ali
Residential buildings damaged in fighting are seen in Khartoum, Sudan, Thursday, April 20, 2023. The latest attempt at a cease-fire between the rival Sudanese forces faltered as gunfire rattled the capital of Khartoum. Through the night and into Thursday morning, gunfire could be heard almost constantly across Khartoum. (AP Photo/Marwan Ali)
Marwan Ali
Residential buildings damaged in fighting are seen in Khartoum, Sudan, Thursday, April 20, 2023. The latest attempt at a cease-fire between the rival Sudanese forces faltered as gunfire rattled the capital of Khartoum. Through the night and into Thursday morning, gunfire could be heard almost constantly across Khartoum. (AP Photo/Marwan Ali)
-
-
Sudan’s generals battle for 3rd day; death toll soars to 185
Marwan Ali
Destroyed military vehicles are seen in southern in Khartoum, Sudan, Thursday, April 20, 2023. The latest attempt at a cease-fire between the rival Sudanese forces faltered as gunfire rattled the capital of Khartoum. Through the night and into Thursday morning, gunfire could be heard almost constantly across Khartoum. (AP Photo/Marwan Ali)
Marwan Ali
Destroyed military vehicles are seen in southern in Khartoum, Sudan, Thursday, April 20, 2023. The latest attempt at a cease-fire between the rival Sudanese forces faltered as gunfire rattled the capital of Khartoum. Through the night and into Thursday morning, gunfire could be heard almost constantly across Khartoum. (AP Photo/Marwan Ali)
-
Sudan’s generals battle for 3rd day; death toll soars to 185
Marwan Ali
Smoke is seen in Khartoum, Sudan, Wednesday, April 19, 2023. Terrified Sudanese are fleeing their homes in the capital Khartoum, witnesses say, after an internationally brokered cease-fire failed and rival forces battled in the capital for a fifth day. (AP Photo/Marwan Ali)
Marwan Ali
Smoke is seen in Khartoum, Sudan, Wednesday, April 19, 2023. Terrified Sudanese are fleeing their homes in the capital Khartoum, witnesses say, after an internationally brokered cease-fire failed and rival forces battled in the capital for a fifth day. (AP Photo/Marwan Ali)
-
-
What sparked the violent struggle to control Sudan’s future?
Marwan Ali
Smoke rises from a central neighborhood of Khartoum, Sudan, Sunday, April 16, 2023, after dozens have been killed in two days of intense fighting. The Sudanese military and a powerful paramilitary group are battling for control of the chaos-stricken nation for a second day.(AP Photo/Marwan Ali)
Marwan Ali
Smoke rises from a central neighborhood of Khartoum, Sudan, Sunday, April 16, 2023, after dozens have been killed in two days of intense fighting. The Sudanese military and a powerful paramilitary group are battling for control of the chaos-stricken nation for a second day.(AP Photo/Marwan Ali)
-
What sparked the violent struggle to control Sudan’s future?
HONS
This satellite image provided by Maxar Technologies shows fires burning near a hospital in Khartoum, Sudan, Sunday April 16, 2023. The Sudanese military and a powerful paramilitary group are battling for control of the chaos-stricken nation for a second day. (Satellite image ©2023 Maxar Technologies via AP)
HONS
This satellite image provided by Maxar Technologies shows fires burning near a hospital in Khartoum, Sudan, Sunday April 16, 2023. The Sudanese military and a powerful paramilitary group are battling for control of the chaos-stricken nation for a second day. (Satellite image ©2023 Maxar Technologies via AP)
-
-
What sparked the violent struggle to control Sudan’s future?
Planet Labs PBC
This satellite photo by Planet Labs PBC shows fires burning near a hospital in Khartoum, Sudan, Sunday April 16, 2023. The Sudanese military and a powerful paramilitary group are battling for control of the chaos-stricken nation for a second day. (Planet Labs PBC via AP)
Planet Labs PBC
This satellite photo by Planet Labs PBC shows fires burning near a hospital in Khartoum, Sudan, Sunday April 16, 2023. The Sudanese military and a powerful paramilitary group are battling for control of the chaos-stricken nation for a second day. (Planet Labs PBC via AP)
-
What sparked the violent struggle to control Sudan’s future?
Marwan Ali
People walk past shuttered shops in Khartoum, Sudan, Monday, April 17, 2023. Sudan's embattled capital has awoken to a third day of heavy fighting between the army and a powerful rival force for control of the country. Airstrikes and shelling intensified on Monday in parts of Khartoum and the adjoining city of Omdurman. (AP Photo/Marwan Ali)
Marwan Ali
People walk past shuttered shops in Khartoum, Sudan, Monday, April 17, 2023. Sudan's embattled capital has awoken to a third day of heavy fighting between the army and a powerful rival force for control of the country. Airstrikes and shelling intensified on Monday in parts of Khartoum and the adjoining city of Omdurman. (AP Photo/Marwan Ali)
-
-
What sparked the violent struggle to control Sudan’s future?
Marwan Ali
A man sits by shuttered shops in Khartoum, Sudan, Monday, April 17, 2023. Sudan's embattled capital has awoken to a third day of heavy fighting between the army and a powerful rival force for control of the country. Airstrikes and shelling intensified on Monday in parts of Khartoum and the adjoining city of Omdurman. (AP Photo/Marwan Ali)
Marwan Ali
A man sits by shuttered shops in Khartoum, Sudan, Monday, April 17, 2023. Sudan's embattled capital has awoken to a third day of heavy fighting between the army and a powerful rival force for control of the country. Airstrikes and shelling intensified on Monday in parts of Khartoum and the adjoining city of Omdurman. (AP Photo/Marwan Ali)
-
What sparked the violent struggle to control Sudan’s future?
Marwan Ali
People walk past shuttered shops in Khartoum, Sudan, Monday, April 17, 2023. Sudan's embattled capital has awoken to a third day of heavy fighting between the army and a powerful rival force for control of the country. Airstrikes and shelling intensified on Monday in parts of Khartoum and the adjoining city of Omdurman. (AP Photo/Marwan Ali)
Marwan Ali
People walk past shuttered shops in Khartoum, Sudan, Monday, April 17, 2023. Sudan's embattled capital has awoken to a third day of heavy fighting between the army and a powerful rival force for control of the country. Airstrikes and shelling intensified on Monday in parts of Khartoum and the adjoining city of Omdurman. (AP Photo/Marwan Ali)
-
-
What sparked the violent struggle to control Sudan’s future?
Marwan Ali
CORRECTS THE DATE People walk past shuttered shops in Khartoum, Sudan, Monday, April 17, 2023. Sudan's embattled capital has awoken to a third day of heavy fighting between the army and a powerful rival force for control of the country. Airstrikes and shelling intensified on Monday in parts of Khartoum and the adjoining city of Omdurman. (AP Photo/Marwan Ali)
Marwan Ali
CORRECTS THE DATE People walk past shuttered shops in Khartoum, Sudan, Monday, April 17, 2023. Sudan's embattled capital has awoken to a third day of heavy fighting between the army and a powerful rival force for control of the country. Airstrikes and shelling intensified on Monday in parts of Khartoum and the adjoining city of Omdurman. (AP Photo/Marwan Ali)
-
What sparked the violent struggle to control Sudan’s future?
Marwan Ali
Smoke is seen rising from a neighborhood in Khartoum, Sudan, Saturday, April 15, 2023. Fierce clashes between Sudan’s military and the country’s powerful paramilitary erupted in the capital and elsewhere in the African nation after weeks of escalating tensions between the two forces. The fighting raised fears of a wider conflict in the chaos-stricken nation. (AP Photo/Marwan Ali)
Marwan Ali
Smoke is seen rising from a neighborhood in Khartoum, Sudan, Saturday, April 15, 2023. Fierce clashes between Sudan’s military and the country’s powerful paramilitary erupted in the capital and elsewhere in the African nation after weeks of escalating tensions between the two forces. The fighting raised fears of a wider conflict in the chaos-stricken nation. (AP Photo/Marwan Ali)
-
-
What sparked the violent struggle to control Sudan’s future?
Marwan Ali
Smoke is seen rising from a neighborhood in Khartoum, Sudan, Saturday, April 15, 2023. Fierce clashes between Sudan’s military and the country’s powerful paramilitary erupted in the capital and elsewhere in the African nation after weeks of escalating tensions between the two forces. The fighting raised fears of a wider conflict in the chaos-stricken nation. (AP Photo/Marwan Ali)
Marwan Ali
Smoke is seen rising from a neighborhood in Khartoum, Sudan, Saturday, April 15, 2023. Fierce clashes between Sudan’s military and the country’s powerful paramilitary erupted in the capital and elsewhere in the African nation after weeks of escalating tensions between the two forces. The fighting raised fears of a wider conflict in the chaos-stricken nation. (AP Photo/Marwan Ali)
-
What sparked the violent struggle to control Sudan’s future?
Marwan Ali
Smoke is seen rising from a neighborhood in Khartoum, Sudan, Saturday, April 15, 2023. Fierce clashes between Sudan's military and the country's powerful paramilitary erupted in the capital and elsewhere in the African nation after weeks of escalating tensions between the two forces. The fighting raised fears of a wider conflict in the chaos-stricken nation. (AP Photo/Marwan Ali)
Marwan Ali
Smoke is seen rising from a neighborhood in Khartoum, Sudan, Saturday, April 15, 2023. Fierce clashes between Sudan's military and the country's powerful paramilitary erupted in the capital and elsewhere in the African nation after weeks of escalating tensions between the two forces. The fighting raised fears of a wider conflict in the chaos-stricken nation. (AP Photo/Marwan Ali)
-
-
What sparked the violent struggle to control Sudan’s future?
Marwan Ali
Smoke is seen rising from a neighborhood in Khartoum, Sudan, Saturday, April 15, 2023. Fierce clashes between Sudan's military and the country's powerful paramilitary erupted in the capital and elsewhere in the African nation after weeks of escalating tensions between the two forces. The fighting raised fears of a wider conflict in the chaos-stricken nation. (AP Photo/Marwan Ali)
Marwan Ali
Smoke is seen rising from a neighborhood in Khartoum, Sudan, Saturday, April 15, 2023. Fierce clashes between Sudan's military and the country's powerful paramilitary erupted in the capital and elsewhere in the African nation after weeks of escalating tensions between the two forces. The fighting raised fears of a wider conflict in the chaos-stricken nation. (AP Photo/Marwan Ali)
-
What sparked the violent struggle to control Sudan’s future?
Marwan Ali
Smoke rises from a central neighborhood of Khartoum, Sudan, Sunday, April 16, 2023, after dozens have been killed in two days of intense fighting. The Sudanese military and a powerful paramilitary group are battling for control of the chaos-stricken nation for a second day.(AP Photo/Marwan Ali)
Marwan Ali
Smoke rises from a central neighborhood of Khartoum, Sudan, Sunday, April 16, 2023, after dozens have been killed in two days of intense fighting. The Sudanese military and a powerful paramilitary group are battling for control of the chaos-stricken nation for a second day.(AP Photo/Marwan Ali)
-
-
What sparked the violent struggle to control Sudan’s future?
HONS
This satellite image provided by Maxar Technologies shows the burned and heavily damaged general command of the Sudanese armed forces headquarter building in Khartoum, Sudan, Sunday April 16, 2023. The Sudanese military and a powerful paramilitary group are battling for control of the chaos-stricken nation for a second day. (Satellite image ©2023 Maxar Technologies via AP)
HONS
This satellite image provided by Maxar Technologies shows the burned and heavily damaged general command of the Sudanese armed forces headquarter building in Khartoum, Sudan, Sunday April 16, 2023. The Sudanese military and a powerful paramilitary group are battling for control of the chaos-stricken nation for a second day. (Satellite image ©2023 Maxar Technologies via AP)
-
What sparked the violent struggle to control Sudan’s future?
HONS
This satellite image provided by Maxar Technologies shows two burning planes at Khartoum International Airport, Sudan, Sunday April 16, 2023. The Sudanese military and a powerful paramilitary group are battling for control of the chaos-stricken nation for a second day. (Satellite image ©2023 Maxar Technologies via AP)
HONS
This satellite image provided by Maxar Technologies shows two burning planes at Khartoum International Airport, Sudan, Sunday April 16, 2023. The Sudanese military and a powerful paramilitary group are battling for control of the chaos-stricken nation for a second day. (Satellite image ©2023 Maxar Technologies via AP)