The medical humanitarian organization Doctors Without Borders, also known as MSF, says more than 220 people have so far been killed in fighting in the city of El-Fasher in Sudan’s Western region of Darfur.

According to the MSF, fighting in El-Fasher killed at least 226 people and wounded 1,418 others.

Fierce fighting reignited in El-Fasher, the last state capital in the western region of Darfur not under the control of the paramilitary Rapid Support Forces (RSF), and a key humanitarian hub for a region on the brink of famine, on May 10, prompting a siege by the RSF that has trapped hundreds of thousands of civilians.

The overall death toll from the fighting is believed to be much higher, however, with the wounded unable to get treatment amid ongoing air raids, shelling and ground fighting.

“The situation in El-Fasher is chaotic,” Michel-Olivier Lacharite, head of MSF’s emergency program, said.

The closure of the last operating hospital in the city has also complicated the situation.

Over the weekend, the group announced that “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.”

On Thursday, the UN Security Council passed a resolution demanding an end to the siege of El-Fasher.

It calls for “an immediate halt to the fighting” and “withdrawal of all fighters that threaten the safety and security of civilians.”

The paramilitary Rapid Support Forces (RSF) has been fighting the army, led by Gen. Abdel Fattah Burhan, for control of the North African country since April 15 last year in a war that has killed tens of thousands of people and displaced nearly eight million.