Overview
On December 4, 2025, three drone strikes hit the town of Kalogi (also reported as Kagoli) in Sudan’s South Kordofan state, destroying a kindergarten, targeting paramedics as they evacuated victims, and repeatedly striking Kalogi Rural Hospital. The World Health Organization (WHO) now says at least 114 people were killed, including 63 children, and 35 wounded, calling the assault a "senseless" attack on civilians and protected health facilities. Sudan’s Foreign Ministry and Sudanese civil groups have blamed the Rapid Support Forces (RSF) paramilitary for the strikes, which occurred in a government‑held town amid an RSF offensive across Kordofan.
The Kalogi attack is not an isolated tragedy but part of a widening pattern: WHO has verified more than 100 attacks on health care in Sudan since fighting between the RSF and the national army erupted in April 2023, and estimates that 70–80% of health facilities in the worst‑affected states—including Kordofan and Darfur—are barely functional or closed. Sudan’s civil war has killed tens of thousands of people, displaced over 13 million (the world’s largest displacement crisis), and pushed several regions, including parts of Kordofan, into famine. As drones and airstrikes increasingly hit hospitals, clinics and ambulances, international bodies warn that the legal protections meant to shield patients and medical workers in war are eroding in Sudan and globally.
Key Indicators
People Involved
Organizations Involved
The Rapid Support Forces are a Sudanese paramilitary organization formed in 2013 from Janjaweed militias active in Darfur. Officially created to fight insurgencies, the RSF developed into a powerful actor with its own command structure, economic empire and foreign backers. As of 2025 it controls large parts of Darfur, Kordofan and central Sudan, where it operates a de facto parallel government called the Government of Peace and Unity.
The Sudanese Armed Forces are the regular military of Sudan and remain nominally the state’s primary security institution. Since April 2023 they have been engaged in a nationwide war against the RSF, relying heavily on air power and allied militias.
The World Health Organization is the UN’s specialized agency for health, tasked with promoting global health, coordinating responses to health emergencies and setting technical norms. In Sudan’s civil war it has become the primary international body documenting attacks on health facilities and workers through its Attacks on Health Care monitoring system.
Emergency Lawyers is a Sudanese network of legal professionals that has emerged as a key documenter of atrocities during the current war, compiling testimonies and casualty figures and advocating for accountability for war crimes and crimes against humanity.
Timeline
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WHO confirms 114 dead, including 63 children, in Kalogi/Kagoli drone strikes
Humanitarian UpdateWHO Director‑General Tedros announces that its Attacks on Health Care monitoring system has confirmed 114 dead and 35 wounded from the December 4 Kalogi/Kagoli strikes, including 63 children. Sudan’s Foreign Ministry blames the RSF, while rights groups call the attack a grave breach of international humanitarian law.
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Drone strikes devastate kindergarten and hospital in Kalogi/Kagoli, South Kordofan
Attack on Health CareThree drone strikes hit the army‑held town of Kalogi (Kagoli) in South Kordofan. The first destroys a kindergarten, the second hits paramedics and civilians as they evacuate the wounded, and further strikes target Kalogi Rural Hospital multiple times. Initial reports suggest at least 50 deaths, including dozens of children, and a rapidly rising toll.
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UN warns Kordofan faces Darfur‑style atrocities
UN WarningUN human rights chief Volker Türk warns that Kordofan could see atrocities similar to those in Darfur, citing an RSF drone strike that killed 45 civilians in El‑Obeid, SAF airstrikes that killed 48 in Kauda, and at least 269 deaths in North Kordofan from aerial fire and shelling.
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RSF captures El Fasher after devastating siege
Siege and Mass AtrocitiesAfter a prolonged siege of El Fasher, RSF forces take the city. Subsequent satellite analysis and testimonies indicate that tens of thousands of civilians may have been killed, with mass graves and incineration pits visible. Health facilities were decimated, and famine conditions deepened.
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SAF restructures command as war grinds on
Military DecisionBurhan reshuffles the SAF leadership and brings allied armed groups under his direct command, seeking to tighten control over the war effort. Analysts warn that centralising command does little to reduce attacks on civilians or health infrastructure by either side.
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Burhan appoints Kamil Idris as prime minister amid ongoing war
Political MoveArmy chief Abdel Fattah al‑Burhan appoints former UN official Kamil Idris as prime minister, presenting it as a step toward a transitional government even as fighting continues, attacks on civilians persist and aid agencies warn of looming famine.
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Al‑Kadaris and Al‑Khelwat massacres in White Nile State
MassacreRSF fighters kill between 200 and over 400 civilians in the villages of Al‑Kadaris and Al‑Khelwat in White Nile State, according to Emergency Lawyers and SAF. The massacres reinforce patterns of RSF attacks on non‑combatant communities and raise new alarms about ethnic targeting and impunity.
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RSF drones hit Saudi Maternal Teaching Hospital in El Fasher
Attack on Health CareRSF drone strikes hit the Saudi Maternal Teaching Hospital in El Fasher, killing around 70 people in one of the deadliest hospital attacks of the war. WHO and foreign governments condemn the strike, and it later features in ICC and UN discussions on Darfur atrocities.
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WHO: Sudan surpasses 100 verified attacks on healthcare
Humanitarian DataWHO’s Eastern Mediterranean Regional Office reports that it has verified 108 attacks on health care in Sudan since April 2023, most involving health facilities or personnel, and estimates that up to 80% of facilities in worst‑affected areas like Kordofan and Darfur are barely operational or closed.
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WHO warns of escalating attacks on health care in Sudan
Humanitarian AlertWHO issues a statement from Port Sudan condemning an increase in attacks on health care, verifying 22 incidents in eight weeks and 88 since April 2023, and warning that Sudan’s health system is 'hanging by a thread.'
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War erupts between Sudanese Armed Forces and Rapid Support Forces
Conflict OutbreakLong‑simmering tensions between General Abdel Fattah al‑Burhan’s Sudanese Armed Forces and Hemedti’s Rapid Support Forces explode into open fighting in Khartoum and other cities after talks over integrating the RSF into the army break down, marking the start of Sudan’s 2023–present civil war.
Scenarios
Escalating Drone and Air Campaigns with Near‑Total Impunity
Discussed by: UN human rights officials, WHO, Safeguarding Health in Conflict Coalition, humanitarian NGOs
Under this scenario, both RSF and SAF continue to rely heavily on drones, artillery and airstrikes in populated areas, with hospitals, clinics, schools and displacement camps repeatedly hit. The RSF consolidates control over much of Darfur and Kordofan, using terror tactics—including massacres like those in El Fasher and White Nile, and attacks on facilities such as the Saudi Maternal Teaching Hospital and Kalogi Rural Hospital—to depopulate strategic areas and control aid. The SAF, under pressure to match RSF gains, maintains or increases its own air campaign, despite international criticism for strikes on civilian and health infrastructure. Global attention remains fragmented and overshadowed by other crises; ICC investigations and UN resolutions proceed slowly, and sanctions remain limited or unevenly enforced. As a result, attacks on health care—already at record levels worldwide—become further normalised, with Sudan a central example of the erosion of medical protection in war.
Incremental Pressure Yields Local Ceasefires and Narrow Protection Measures
Discussed by: UN agencies, some Security Council members, African Union, humanitarian law advocates
Here, sustained advocacy by WHO, OHCHR, the ICC prosecutor and coalitions like Safeguarding Health in Conflict prompts a stronger diplomatic push to protect civilians, even without a full national ceasefire. The UN Security Council and regional bodies press for time‑bound humanitarian ceasefires, demilitarised zones around major hospitals, and verified corridors for medical evacuations. Some frontline commanders, responding to a mix of sanctions threats, naming‑and‑shaming, and battlefield calculations, agree to limited local arrangements—similar to prior deals in other conflicts that allowed temporary restoration of services in specific areas. While sporadic, such arrangements could reduce the frequency of high‑profile hospital massacres and allow repairs to a handful of facilities in Kordofan and Darfur. However, absent a political settlement and given both sides’ reliance on siege and starvation tactics, the broader pattern of abuse—especially in remote or besieged areas—would persist, and enforcement would hinge on fragile monitoring mechanisms.
Accountability Shock: ICC Warrants and Coordinated Sanctions Reshape Incentives
Discussed by: ICC Office of the Prosecutor, some Western governments, international human rights organisations
In this outcome, ICC investigations into Darfur expand to include emblematic attacks on health facilities, such as the El Fasher hospital strike and the Kalogi/Kagoli massacre of children and medical staff. The Court issues arrest warrants for senior RSF and possibly SAF figures, explicitly citing attacks on hospitals as war crimes. Simultaneously, a critical mass of States—including key regional actors—coordinate targeted sanctions, arms embargoes and financial measures against entities supplying drones, munitions or fuel used in Sudan’s air campaigns. If enforced, this combination could reduce the availability of precision weapons and raise the political cost of future hospital strikes, especially for RSF leaders seeking legitimacy and foreign support. However, past experience in Syria and Yemen shows that accountability mechanisms often come late and inconsistently; spoilers and external backers might try to circumvent sanctions, and commanders on the ground may continue abusive tactics despite legal risks.
Negotiated Nationwide Ceasefire and Gradual Health System Stabilisation
Discussed by: Some mediation efforts (e.g., AU‑IGAD, regional and Gulf mediators), optimistic humanitarian planning scenarios
The most optimistic scenario envisions sustained mediation—possibly combining African Union, IGAD, Gulf and Western efforts—delivering a ceasefire that both Burhan and Hemedti view as preferable to continued attrition. A deal might freeze front lines, create a power‑sharing or confederal arrangement, and explicitly include provisions protecting health care, enabling large‑scale rehabilitation of hospitals and clinics in Khartoum, Darfur, Kordofan and other regions. WHO, other UN agencies and NGOs would then be able to re‑establish a more comprehensive presence and begin rebuilding Sudan’s shattered health system. While such provisions appear in some diplomatic roadmaps, the deep mistrust between parties, ongoing mass atrocities, and competing external backers make a comprehensive settlement difficult in the near term. Analysts warn that Sudan risks fragmentation similar to Libya or Syria, which would complicate any national health‑system recovery and make consistency of protections for health facilities extremely hard to achieve.
Historical Context
Kunduz Trauma Centre Airstrike, Afghanistan
2015-10-03What Happened
On October 3, 2015, a US Air Force AC‑130 gunship repeatedly struck the Médecins Sans Frontières (MSF) trauma hospital in Kunduz, Afghanistan, killing 42 people, including patients and medical staff, and destroying the only facility providing advanced trauma care in northeastern Afghanistan. MSF reported that the hospital was clearly identified, that GPS coordinates had been shared with all warring parties, and that the main hospital building was subjected to precise, sustained fire while surrounding structures were largely untouched.
Outcome
Short term: MSF suspended operations at the hospital and demanded an independent investigation, while the US acknowledged the strike, called it a mistake, and conducted its own military inquiry. UN Security Council Resolution 2286 was later adopted, reaffirming protections for medical missions in conflict.
Long term: Despite international outrage and legal debates, no international criminal prosecution followed; the attack became a symbol of the gap between legal norms and battlefield practice. Subsequent years saw continued attacks on health facilities in other conflicts, demonstrating that high‑profile condemnation alone does not reliably deter such strikes.
Why It's Relevant
Kunduz shows that even highly capable militaries can devastate a clearly marked hospital and still avoid international prosecution. The case parallels Sudan’s Kalogi/Kagoli and El Fasher attacks in how hospitals become targets or collateral in urban battles, and illustrates the limits of post‑hoc investigations and apologies in changing behaviour without stronger accountability mechanisms.
Saudi‑Led Coalition Airstrikes on MSF‑Supported Hospitals in Yemen
2015–2016What Happened
During Yemen’s war, hospitals supported by MSF were repeatedly hit by Saudi‑led coalition airstrikes. In January 2016, Shiara Hospital in Razeh district, Saada governorate, was struck, killing six people—including MSF staff—and injuring seven. Later, in August 2016, Abs Hospital in Hajjah governorate was bombed, killing at least 19 people and wounding 24; the strike destroyed the emergency room area of the main medical facility serving more than 50,000 people in western Hajjah.
Outcome
Short term: MSF temporarily evacuated staff from several facilities and demanded changes in targeting procedures. Saudi Arabia acknowledged some errors but largely framed incidents as mistakes, and international calls for independent investigations did not lead to major legal consequences.
Long term: Yemen’s health system deteriorated sharply, contributing to one of the world’s worst humanitarian crises and a massive cholera epidemic. The Yemen experience reinforced fears that powerful coalitions can repeatedly strike hospitals with little risk of accountability, a pattern now echoed in Sudan and other conflicts.
Why It's Relevant
Yemen’s hospital bombings highlight how sustained air campaigns against armed groups often spill over into—or deliberately target—civilian health infrastructure, with devastating public‑health consequences. Sudan’s RSF and SAF air campaigns, including strikes on rural hospitals and urban maternal facilities, fit within this broader pattern of belligerents accepting or disregarding the risks of mass casualty hospital attacks.
Systematic Bombing of Hospitals in Syria (Aleppo and Idlib)
2016What Happened
In 2016, Syrian and Russian forces repeatedly bombed hospitals and clinics in opposition‑held areas such as eastern Aleppo and Idlib. WHO documented at least 126 attacks on health care across Syria that year and condemned a series of strikes on five hospitals in western rural Aleppo and Idlib in November. UNICEF and other agencies reported episodes in which multiple paediatric and maternity facilities were hit within hours, forcing doctors to evacuate babies from incubators.
Outcome
Short term: The destruction and evacuation of hospitals accelerated the depopulation of besieged areas such as eastern Aleppo and weakened medical capacity to treat war wounds and disease outbreaks.
Long term: Despite extensive documentation and outrage, sustained attacks on hospitals in Syria continued for years, with limited accountability. The Syrian case contributed to a sense among humanitarian groups that the taboo against attacking medical facilities has been badly eroded globally.
Why It's Relevant
Syria offers a precedent for systematic, repeated strikes on hospitals as part of a siege and depopulation strategy, similar to patterns emerging in Sudan’s Darfur and Kordofan campaigns. It underscores why WHO, the Safeguarding Health in Conflict Coalition and others see Sudan’s Kalogi/Kagoli and El Fasher attacks not as anomalies but as part of a global trend toward "new levels of horror" in violence against health care.