The last operating hospital in western Sudan's El-Fasher has been closed after an attack by paramilitaries trying to seize the key Darfur city, medical charity Doctors Without Borders has said.

War has raged for more than a year between the regular military under army chief Abdel Fattah al-Burhan and the paramilitary Rapid Support Forces led by his former deputy Mohamed Hamdan Daglo.

El-Fasher in North Darfur is the only state capital in the vast western region not under RSF control, and is a key humanitarian hub for a region on the brink of famine.

"On Saturday, MSF and the ministry of health suspended all activities in South Hospital, El-Fasher, North Darfur, after RSF soldiers stormed the facility, opened fire and looted it, including stealing an MSF ambulance," said the NGO in a statement posted late Sunday on X.

El-Fasher has seen sporadic clashes since the war broke out in April 2023, but fierce fighting reignited on May 10 in what UN chief Antonio Guterres has called "an alarming new chapter" in the conflict.

Since then, "at least 192 people have been killed and more than 1,230 wounded" in the city, according to a conservative estimate by the medical charity.

MSF said that "intensified fighting" around the hospital earlier this week had triggered its evacuation, and by the time of the paramilitary attack "there were only 10 patients and a reduced medical team" there.

"Most patients and the remaining medical team... were able to flee the RSF shooting," MSF added.

It noted that "due to the chaos, our team was unable to verify if there were any killed or wounded" in the latest attack.

Michel-Olivier Lacharite, head of emergencies at MSF, said it was "outrageous that the RSF opened fire inside the hospital".

"Warring parties must halt attacks on medical care," he added. "Hospitals are closing. Remaining facilities can't handle mass casualties."

The war across Sudan has killed tens of thousands of people, including up to 15,000 in a single West Darfur town, UN experts say.

Nearly nine million people have been forced from their homes.

Both warring sides have been accused of war crimes including deliberately targeting civilians, indiscriminate shelling of residential areas and blocking humanitarian aid.

Rights groups and the United States have also accused the paramilitaries of ethnic cleansing and crimes against humanity.