Bodies littered the road out of El Geneina, a town in western Sudan, as Dr. Rodwan Mustafa and his family sped down a bumpy road that led to the border with Chad and, they hoped, safety.
A day earlier, rampaging Arab militiamen had grabbed Dr. Mustafa by the neck, accusing him of giving medical care to enemy fighters. That was his signal to run.
Racing toward the border with his family in a car, he saw chickens clucking over the bloodied corpses of those who hadnтАЩt fled in time. A camp for displaced people stood empty, burned to the ground. He spotted a dismembered hand on the roadside.
тАЬThe smell of death was everywhere,тАЭ said Dr. Mustafa, who made it to a refugee camp in Chad and spoke by phone from there.
Seven months into SudanтАЩs disastrous civil war, new horrors have accompanied the latest fighting in Darfur, a sprawling region in the west of the country where a powerful paramilitary group, the Rapid Support Forces, has scored a succession of sweeping victories over SudanтАЩs regular military in recent weeks.
After capturing three of DarfurтАЩs five state capitals, including El Geneina on Nov. 4, the paramilitary group is on the verge of seizing the entire region, according to residents, analysts and United Nations officials interviewed in recent days.
Although that tilts the war in favor of the paramilitary groupтАЩs commander, Lt. Gen. Mohamed Hamdan, neither side looks capable of outright victory, according to African and western officials тАФ a stalemate that has deepened civilian suffering. The R.S.F.тАЩs recent victories have also come at the cost of ethnic violence that recalls the genocidal massacres that brought global attention to Darfur just over two decades ago.
Last week, more than 800 people were killed as R.S.F. and allied Arab fighters overran the army garrison in El Geneina, according to the United Nations refugee agency. Homes were razed and United Nations supplies looted, the agency said. Routed Sudanese soldiers fled across the border into Chad, carrying stores of ammunition.
Aid workers and witnesses also reported sexual violence, torture and killings of members of the Masalit, an ethnic African group with a long history of conflict with ethnic Arabs.
тАЬThey came to massacre us,тАЭ said Ahmed Sharif, a schoolteacher who fled El Geneina on Nov. 5 and walked 13 hours to reach Chad.
Filippo Grandi, the head of the United Nations refugee agency, said: тАЬTwenty years ago, the world was shocked by the terrible atrocities in Darfur. We fear a similar dynamic might be developing.тАЭ
The dire situation is not yet a full repeat of the early 2000s, when the scorched-earth tactics of Arab militiamen caused the International Criminal Court to file charges of genocide against Sudanese leaders, including the former president, Omar Hassan al-Bashir, who was deposed in 2019.
This time, diplomats and analysts say, the ethnic violence is more a byproduct of the national battle between forces loyal to the army chief, Gen. Abdel Fattah al-Burhan, and General Hamdan, rather than a coordinated campaign of slaughter.
The R.S.F. wants to present itself as a responsible group that could one day govern Sudan. In an emailed response to questions, it blamed SudanтАЩs army for the recent deaths in El Geneina, accusing it of shelling civilian neighborhoods. A formal investigation of possible abuses is underway, the group said.
But promises of transparency from a paramilitary group that grew out of the feared militias known as the Janjaweed that terrorized Darfur in the 2000s are viewed with wide skepticism. In private, R.S.F. officials conceded that undisciplined fighters have carried out abuses, diplomats say. And in July, the International Criminal Court opened a new investigation into possible war crimes in Darfur.
Still, the dynamic could quickly change if other armed groups in Darfur, currently sitting on the fence, decide to join the fray.
After months of grinding battle in SudanтАЩs capital, Khartoum, where fighting first erupted in April, the Rapid Support Forces have turned their focus back to Darfur, the region where most of the groupтАЩs fighters are originally from. It captured in quick succession Nyala, SudanтАЩs second-largest city, Zalingei in Central Darfur and El Geneina.
Now, battle rages in El Fasher, the last stronghold of the army in Darfur. If that falls, experts say, most of Sudan west of the Nile will be in R.S.F. hands.
тАЬEl Fasher is the last big domino yet to fall,тАЭ said Alan Boswell, an analyst at the International Crisis Group.
The battleтАЩs outcome depends in part on decisions taken by Minni Minnawi, the regional governor of Darfur, whose armed forces are concentrated around El Fasher. So far, they have avoided taking sides in the war. And although Mr. Minnawi is a longtime R.S.F. rival, many doubt that his fighters have the strength to confront the paramilitary group now.
тАЬFighting looks like a bad proposition for them,тАЭ Mr. Boswell said.
The changes highlight how much ground SudanтАЩs military, long seen as the backbone of the state, has lost in this war. Unable to dislodge the R.S.F. from Khartoum, the military has been forced to shift most government functions to Port Sudan, on the Red Sea, in the countryтАЩs far east. Aid groups and U.N. missions are also working from there.
International efforts to broker a cease-fire, led by the United States and Saudi Arabia, have failed to find compromise. The latest talks last week in Jeddah, Saudi Arabia, produced little. And the humanitarian cost is soaring.
So far, at least 10,400 people have died, mostly in Khartoum and Darfur, according to the Armed Conflict Location and Event Data Project, although Sudanese health workers say the real toll is most likely much higher.
Nearly five million people тАФ about one-tenth of SudanтАЩs population тАФ have been internally displaced, and an additional 1.2 million have fled into neighboring countries, mostly Chad, South Sudan and Egypt.
Half of SudanтАЩs 46 million people need aid to survive, the United Nations says.
A handful of aid groups have trickled back into West Darfur in recent months after reaching agreements with the R.S.F. and Arab militias. Their employees describe massacres of civilians, dozens of reported rapes, orphaned children and refugee-filled schools.
Will Carter, the Sudan director of the Norwegian Refugee Council, blamed the world for turning its back on Sudan. тАЬThe sheer number of deaths, the scale of the devastation in Darfur and the lack of attention show how the international system is failing right in front of our eyes,тАЭ he said.
Ali Salam, an aid coordinator with the Sudanese American Physicians Association, said he had seen тАЬunbelievableтАЭ things during a recent visit to refugee camps in Chad near the Sudanese border. One woman arrived at a camp with a dead child strapped to her back, unaware that the child had died along the way, he said.
тАЬPeople are dying like insects in Darfur,тАЭ he said.
As events in the Middle East preoccupy the United States, for years a major influence in Sudan, there is even less scrutiny of foreign powers accused of fueling SudanтАЩs war, like the United Arab Emirates. An investigation showed the Emiratis are smuggling arms to General Hamdan from a base in Chad, or Egypt, which backs SudanтАЩs military.
Two decades ago, the cause of peace in Sudan was embraced by Western celebrities and activists who held marches in Washington under the тАЬSave DarfurтАЭ banner. This time, many in Sudan feel that the world has turned its back on them.
тАЬHow many more lives will it take for the world to step in, for people to care?тАЭ said Omnia Mustafa, a 21-year-old Sudanese woman (not related to Dr. Mustafa) who appealed on TikTok this week for outsiders to take notice of her countryтАЩs plight.
тАЬIтАЩm sick and tired of our suffering falling into deaf ears,тАЭ she said. тАЬWe are also people, like everyone else.тАЭ