Sudan’s army and a paramilitary force battled on Khartoum’s outskirts on Wednesday, undermining a truce in an 11-day conflict that civilian groups fear will tighten the military’s grip and revive the sway of an ousted autocrat’s loyalists. The army said Omar al-Bashir, the 79-year-old former dictator toppled in 2019, had been transferred from Khartoum’s Kober prison to a military hospital, along with at least five of his former officials, before hostilities started on April 15. Over the weekend, thousands of inmates were freed outright from prison, including a former minister in Bashir’s government who, like him, is wanted on war crimes charges by the International Criminal Court in The Hague. Air strikes and artillery have killed at least 512 people, wounded nearly 4,200, destroyed hospitals and limited food distribution in the vast nation where a third of the 46 million people were already reliant on humanitarian aid. The crisis sent growing numbers of refugees across Sudan’s borders, with the U.N. refugee agency estimating 270,000 people could flee into South Sudan and Chad alone. Foreigners evacuated from Khartoum have described bodies littering streets, buildings on fire, residential areas turned into battlefields and youths roaming with large knives. The White House said a second American had died in Sudan. “It was horrible,” said Thanassis Pagoulatos, the 80-year-old Greek owner of the Acropole hotel in Khartoum, after arriving in Athens to the embrace of emotional relatives. “It has been more than 10 days without any electricity, without water, and five days nearly without food,” he added, describing shooting and bombing. “Really, the people are suffering, the Sudanese people.” French evacuee and 28-year-old PhD student Leila Oulkebous was out doing interviews for her thesis when fighting broke out nearby. “I felt completely paralysed,” she recounted, after landing in Paris. “I will continue to have nightmares about it.” The World Health Organization said only 16% of health facilities were functioning in Khartoum and predicted “many more deaths” due to disease and shortages of food, water and medical services including immunization. TRANSITION PLAN DERAILED Bashir’s three-decade reign came to an end with a popular uprising four years ago. He has been in prison, with spells in hospital, on Sudanese charges related to the 1989 coup that brought him to power. “This war, which is ignited by the ousted regime, will lead the country to collapse,” said Sudan’s Forces of Freedom and Change (FCC), a political grouping leading an internationally backed plan to transfer to civilian rule. The plan was derailed by the eruption of fighting between the regular army and the paramilitary Rapid Support Forces (RSF). The two sides and the FCC missed an April deadline to launch the transition to democracy, largely over disputes about merging the security forces. Civilian groups have blamed groups loyal to Bashir of seeking to use conflict to find a way back to power. The RSF, whose leader General Mohamed Hamdan Dagalo climbed to power under Bashir but later dumped him, has strongly opposed the Islamists who backed the former army autocrat. The fighting “will not solve the main issues that civilian and military parties were trying to solve through the political process, especially the security and military reforms, which will … lead to one professional unified army”, the FCC added in its statement. In Khartoum, which together with its sister cities is one of Africa’s largest urban areas, gangs marauded and there was widespread looting. EXODUS Foreign powers have evacuated thousands of citizens and a refugee crisis was emerging. More than 10,000 people crossed into Egypt from Sudan in the past five days, Cairo said, while an estimated 20,000 entered Chad and 16,000 went to South Sudan. Some of Wednesday’s heaviest battles were in Omdurman, a city adjoining Khartoum where the army was fighting RSF reinforcements from other regions of Sudan, a Reuters reporter said. Heavy gunfire and airstrikes could be heard into the evening. The army and the RSF agreed to a three-day truce, due to end late on Thursday, after diplomatic pressure from the United States and Saudi Arabia. The army has accused its rivals of using the lull to replenish supplies of men and weapons. International bodies were pressing for a permanent ceasefire. “There is of course a real risk of region conflagration of this crisis and a form of internationalisation of the conflict,” the African Union’s peace and security commissioner Bankole Adeoye told reporters. Sudan’s army took over in a coup two years after the toppling of Bashir. The whereabouts of Bashir came into question after a former minister in his government, Ali Haroun, announced he had left Kober prison with other former officials. The ICC in The Hague has accused Bashir of genocide, and Haroun of organising militias to attack civilians in Darfur in 2003 and 2004. It declined to comment on the situation.