Sudan’s third truce is not holding and thousands of people flee.

Sudanese and foreigners fled the capital Khartoum and other war zones as fighting on Tuesday rocked a new three-day truce brokered by the United States and Saudi Arabia. Millions of Sudanese have been trapped in their homes since violence began on April 15, between forces loyal to two of the country’s top generals. 

Civilian life has come to a standstill as tens of thousands of heavily armed fighters from the military and its rival, the Rapid Support Force, clash in densely populated areas. Footage captured by the Associated Press in Khartoum shows empty streets and smoke billowing over the city’s skyline.

More than 420 people, including at least 273 civilians, have been killed and more than 3,700 injured since the fighting began. The army appears to have the upper hand in the fighting in Khartoum, but the RSF still controls many districts in the capital and neighboring Omdurman, and has several major strongholds across the country. A series of brief ceasefires last week either failed or resulted in only lulls in the fighting that has raged between forces loyal to the country’s two top generals since May 15.

The lull was enough for the dramatic evacuation of hundreds of foreigners by air and land, to continue on Tuesday. But they have brought no relief to the millions of Sudanese trapped in bullets, struggling for food, shelter and medical care as explosions, gunfire and looters loot destroy their neighborhoods. In a country where a third of the population of 46 million people need humanitarian aid, several aid agencies have had to halt operations and dozens of hospitals have been forced to close.

The United Nations refugee agency said it was preparing for the possibility that tens of thousands of people could flee to neighboring countries. Calls for talks to end the crisis in Africa’s third-largest country have been ignored. For many Sudanese, the departures of diplomats, aid workers and other foreigners, as well as the closure of embassies, are frightening signs that international powers perceive the situation The turmoil will only get worse.

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