Dr Mustafa Ali Abdulrahman Ibo and his colleagues bravely operate due to the bombings in the last remaining hospital in El-Fasher, a city that has been besieged for the past nine months in the western Sudan region of Darfur.

Last month the hospital recorded 28 deaths and over 50 injuries among staff and patients due to shelling. This is the highest number of casualties recorded in a month since the city began.

“The recent continuous attack on the Saudi hospital has become so widespread, it has become part of our daily life,” Dr Ibo, a Darfuri who has lived in El-Fasher since 2011, told the BBC.

He said the scariest day was when a team of medics were doing emergency surgery when the bullets started – which almost killed them all.

”The first one hit the wall of the hospital… (then) another bullet hit the operating room, the debris destroyed the electricity generator, cut the power and plunged us into complete darkness,” he said.

The surgical team had no choice but to use the flashlight on their phones to complete the two-hour operation.

Part of the building had collapsed and the room was full of dust and statues scattered everywhere.

Dr Khatab Mohammed, who is leading the operation, explained the risks.

“It was difficult, the environment wasn’t that bad,” the 29-year-old doctor told the BBC.

After making sure that we were safe and that the patient was protected from the mud, we washed him and changed our surgical gowns as our clothes were full of dust and we continued the operation,” he said, adding that the patient could have died from the complications.

After the baby was safely delivered, the doctors moved the mother and newborn to another room to recover and then gathered for a group photo.

It was proof of their survival, but Dr Mohammed added: “I thought it might be our last photo, I believe another bullet will hit the same spot and we will all die.”

They went on to perform two more life-saving surgeries that day.

These doctors – most of whom are graduates of the University of el-Fasher – have not been active since the civil war in Sudan began in April 2023.

The conflict has torn apart the army and the Rapid Support Forces (RSF) and has led to the world’s worst humanitarian crisis, forcing more than 12 million people from their homes.

The two dissidents were allied – beginning to rule together in chaos – but clashed over the internationally-backed plan to move to civilian rule.

One year into the conflict, the siege of El-Fasher began. It is the only city still under military control in Darfur, where the RSF is accused of cleansing non-Arabs.

The RSF began to attack el-Fasher from three sides and cut off the supply lines. In a report issued last month, the UN Human Rights Office said the war has left more than 780 people dead and more than 1,140 injured – most of them from fire.

The fighting has forced all other hospitals in El-Fasher to close.

The South Hospital, which was supported by the medical organization Médecins Sans Frontières (MSF), was the main hospital in the city that dealt with people wounded in the war.

It was close to the front line and was bombed in June by RSF fighters, who also stole medicine and weapons and beat workers.

The Saudi hospital, which is managed by the Ministry of Health and supported by non-governmental organizations, the UN and MSF, which specializes in medical and gynecological services but now provides full medical care – is the only facility in North Darfur with surgical capabilities.

Between the lack of medicine, equipment and staff, the Saudi Hospital is facing “a serious problem that violates all human rights laws and international practices,” the head of the hospital, Mudathir Ibrahim Suleiman, 28, told the BBC.

He recalled how terrifying it was when the recent bombs were detonated: “Pregnant women, children and workers were shocked and paralyzed, some people were injured and had to pick up debris.

“Everything that is happening now forces us to think about quitting our job, but women and children have no other place to save their lives except this hospital,” he said.

“The staff at this hospital are doing what they can to save lives.”

All normal living things have completely disappeared from El-Fasher, especially in the north and east. The university, for example, works in online learning, with test centers set up in safe cities like Kassala in eastern Sudan.

Due to widespread hunger and insecurity, the city is empty again. About half of the people have fled to the nearby Zamzam camp, where about 500,000 people are now living in conditions of starvation.

A Saudi hospital also operates in the camp, while MSF runs ambulances to bring emergency cases.

But it has also come under attack, including an incident earlier this month in which a gunman opened fire on “a well-known ambulance with the MSF logo and flag”.

“We are saddened by this horrific killing of a humanitarian group that is working to save lives where it is most needed,” MSF’s Michel Olivier Lacharité said in a statement.

Dr Ibo admitted that it was his colleagues – there are 35 doctors and 60 nurses at the Saudi hospital – who helped him.

”We lose people every day, and offices and rooms are destroyed, but because of the determination of the young workers, we continue to endure.

“We get our strength from the people of El-Fasher – we are its children and graduates of el-Fasher University.”

Aid agencies warn that one of the worst crises for women and children is taking place in Darfur, where some areas are also facing military airstrikes.

The World Health Organization (WHO) has called for an end to protests at hospitals and for compliance with international humanitarian law.

“The sanctity of health must be respected even in war,” WHO’s Sudan director general Loza Mesfin Tesfaye told the BBC.

Dr Mohammed, who is from Sudan’s White Nile State but came to El-Fasher to study medicine in 2014, also pays tribute to his team, which has ignored many opportunities to escape.

“Our lives refused to leave the people of this city – especially because of the challenges we face every day.”

All the doctors, who communicate through chat and voice on WhatsApp, were heard to be very focused.

“We are determined to continue saving lives, wherever we can, even in secret or under the shade of a tree, we pray that this war will end and that peace will prevail,” said Dr Ibo.

Additional reporting by Sudanese correspondent Mohammed Zakaria