WAD MADANI, Sudan, Dec 21, 2023 (BSS/AFP) - Mohamed Ibrahim had barely settled into life in Sudan's second city, months after he fled fighting in the capital Khartoum, only to discover the war had again reached his doorstep.

"Seven months ago, when the battles intensified in Khartoum, I was displaced with my family to Wad Madani" 180 kilometres (110 miles) south, the 53-year-old said.

Thousands of families had made the same move, and Wad Madani, the capital of Al-Jazirah state, quickly became a haven and a crucial hub for aid operations.

Now with the city under attack, Ibrahim is on the move yet again, with his family in tow.

Over half a million people had sought shelter in Al-Jazirah state before the paramilitary Rapid Support Forces began advancing on the villages lining the highway between Khartoum and Wad Madani.

By Tuesday, the fourth day of fierce battles in the state capital, at least 250,000 people had fled Al-Jazirah, "many in panic and with no other option than fleeing on foot," according to the United Nations.

But with the country's already-fragile infrastructure destroyed by eight months of war between Sudan's army chief Abdel Fattah al-Burhan and his former deputy, RSF commander Mohamed Hamdan Daglo, many were running with nowhere left to go.

On Wednesday, the UN's World Food Programme said the spread of fighting southwards had forced it to suspend food assistance in parts of Al-Jazirah, calling it a "major setback".

In Sennar, 100 kilometres (62 miles) south of Wad Madani, Ibrahim's family can't find housing.

"It's the same thing we went through in our first days in Wad Madani," he said.

Others, like 44-year-old Abdel Rahim Mohamed Imam, headed east to Al-Faw, 120 kilometres (75 miles) away, where his family "is now staying at a friend's house," he told AFP.

- Fleeing on foot -

By early December, the war between the army and the RSF had killed 12,190 people, according to a conservative estimate by the Armed Conflict Locations and Event Data project.

It has also displaced 5.4 million people inside the country, according to the UN, and sent over 1.4 million fleeing abroad.

In a bitter reminder of the first days of war in Khartoum, those who had tried to make a home in Wad Madani watched the city devolve over the week into the same violence they hoped they had left behind.

As both forces battled, fighter jets flew overhead, shops were boarded shut for fear of looting and families grew desperate to protect women and girls from sexual violence.

Paramilitary fighters pressed deeper into the city, and transportation quickly became near impossible to find.

Those already displaced were reliving the days they spent queueing in Khartoum, begging for bus tickets that multiplied in price as they waited.

At a loss, 65-year old Omar Hussein took to Wad Madani's streets with his family and what little they could carry, walking 10 kilometres on foot until they found a driver willing to take them along.

"We're just trying to get to Gedaref," 240 kilometres (150 miles) east, Hussein told AFP.

"We have family there we can stay with."

But in both Gedaref and Sennar, "the humanitarian situation is dire," the UN refugee agency's spokesman William Spindler said Tuesday, warning of a "deepening forced displacement crisis".

With over 70 percent of hospitals in conflict-affected areas out of service and "facilities in non-conflict-affected states overwhelmed by the influx of displaced people," the UN has said the country's "health care is already stretched to the limit".

Gedaref is already facing multiple disease outbreaks, including cholera and dengue fever.

- 'Liberation' -

On Tuesday, Daglo released a statement celebrating the "liberation" of Wad Madani "from the remnants of the old regime," on the fifth anniversary of "the glorious December Revolution".

Mass pro-democracy protests which began on December 19, 2018, led to the ouster of longtime autocrat Omar al-Bashir the following April.

A painstakingly negotiated transition to democratic rule was then derailed in October 2021, when Daglo and Burhan orchestrated a coup, installing themselves in power and ousting civilians.

The two later fell out in a bitter power struggle, with Daglo accusing Burhan and his entourage of trying to return Bashir's regime to power.

Five years after they first took to the streets in what American ambassador John Godfrey called "a clarion call for freedom, peace and justice", civilians have once again paid the heaviest price.

Yet "the conflict has not diminished (civilians') aspirations to restore Sudan's democratic transition under a civilian government," Godfrey said in a statement.

While thousands scramble to find safety once again, the RSF on Tuesday "invited citizens who have been displaced to return to their homes".

Amid mounting accusations of violations against civilians by both the army and the paramilitaries, the RSF promised support and protection -- both largely nonexistent for the past eight months.