Sudan’s capital of Khartoum has been dealing with violent fighting between rival factions going on five days. Both sides had agreed to a 24-hour cease-fire Tuesday under U.S. pressure, but the military factions failed to quit fighting.

“We have not received any indications here that there’s been a halt in the fighting,” United Nations spokesperson Stephane Dujarric said, per Reuters.

According to Abdalla Hussein, Doctors Without Borders operational manager, 50% of the hospitals in Khartoum have gone out of commission because either the hospital has “been subject to shelling or bombing” or because staff workers do not feel safe enough to go into the hospital, per CNN.

What led to the fighting in Sudan?

The Sudanese army, led by Gen. Abdel Fattah al-Burhan, and the Rapid Support Forces, led by Gen. Mohamed Hamdan Dagalo, started fighting on Saturday, and it’s unclear who started the battle. The fighting is taking place in heavily populated cities and has killed at least 270 people, CBS News reported.

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The conflict in Sudan, explained

Up until recently, the two leaders were allies, and had “worked together in 2019 to overthrow Sudan’s brutal dictator Omar al-Bashir,” per CBS News. But tensions rose when the two were going through negotiations and making plans for how to return to civilian rule, rather than military rule.

Both sides argue they are “fighting for all Sudanese people,” and both claim control over key cities and sites, CNN reported.

The region’s “strategic location and agricultural wealth have attracted regional power plays, complicating the chances of a successful transition to civilian-led government,” according to The Guardian.

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