A key humanitarian hub in Sudan's war faces jeopardy as paramilitary forces clash with the army for territorial control on its edges.
The United Nations (UN) has suspended all humanitarian field missions within and from the breadbasket Al Jazirah state until further notice, as doctors on the ground report dozens of civilian injuries from fighting.
Sudan's harrowing humanitarian crisis threatens to take an even darker turn after the paramilitary Rapid Support Forces (RSF) launched its offensive towards Wad Madani, a critical sanctuary city and medical care centre in Sudan's Al Jazirah state.
Half a million people flocked to Al Jazirah to find a semblance of safety and relief when war broke out in the capital Khartoum on 15 April.
Exactly eight months to the day, the sound of gunfire, shelling and airstrikes gripped Wad Madani residents as the RSF confronted the army across the eastern bank of the Blue Nile on Friday.
'We can hear the bullets'
"People here are now feeling that what happened in Khartoum is going to happen here in Madani. They are very anxious. Some have started to flee their houses," Dr Faisal Nugud, the country director for the Sudanese American Physicians Association (SAPA) tells Sky News from his home in Wad Madani.
The army said it repelled the attack early in the day as the sounds of fighting raged.
"Uncertainty and incorrect data is a feature of this war. We don't know what is happening, although it is happening 5km from my house. Who is winning on the ground, we do not know. The fighting is intensifying, we can hear the bullets and clashes," Dr Nugud says.
The sounds of warfare have stopped and started, and any calm feels tentative.
A 6am to 6pm curfew has been enforced by the state governor.
RSF assaults are known to go on for days and the army has incurred major losses in Darfur where four out of five of its state headquarters have fallen to RSF control.
'After eight months of war, it needs to end now'
"This advance speaks to a dangerous security deficit in Al Jazirah state which is a sister state to Khartoum and is vulnerable to the spillover from the violence there," says Yasir Abdullah, veteran journalist and Managing Editor of Al Sudani Newspaper.
The threat of more violence looms after the UN announced it has suspended its field missions within and from Al Jazira state until further notice to assess the unfolding security situation.
"The potential impact on the humanitarian situation of a further spread of fighting into the state, Sudan's breadbasket, is very worrying," Sofie Karlsson, the United Nations Office for the Coordination of Humanitarian Affairs Sudan spokesperson, tells Sky News
"Today marks eight months of war, it needs to end now."
Read more:
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Wad Madani's already stretched healthcare services are also bracing for what might come.
"Right now, almost all the private hospitals are closed and the governmental hospitals are evacuated. In my own [SAPA] hospital, we have evacuated all patients who may not need urgent critical or surgical care," says Dr Nugud.
The SAPA hospital opened at the start of the war to provide free disease treatment for those displaced by the war is being converted into a 24-hour hospital for trauma injuries.
"If Madani becomes an arena of war like Khartoum this will be a major catastrophe," Dr Nugud adds solemnly.
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'We can hear the bullets': Sudan's 'sanctuary' city at risk of 'catastrophe' as fighting intensifies - Sky News
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