CAIRO (AP) — Fighters from Sudan’s notorious paramilitary group looted homes and shops and took over the main hospital in a central city, forcing tens of thousands to flee, residents said Sunday, as a new front opened in a a 14-month war that has pushed the African country to the brink of famine.

The paramilitary Rapid Support Forces began its offensive against Sudan's military in Sennar province earlier this week, attacking the village of Jebal Moya before moving to the provincial capital of Singa, where fresh battles have erupted. The fighting forced about 57,000 people to flee their homes, according to the United Nations.

RSF fighters in pickup trucks mounting automatic rifles rampaged through Singa, about 350 kilometers (217 miles) southeast of the capital, Khartoum, over the weekend, according to residents and a local rights group. They looted houses, shops in a local market and took over the city’s main hospital, they said.

The group claimed in a statement Saturday it had seized the military’s main facility, the 17th Infantry Division Headquarters, in Singa. Local media also reported the RSF managed to breach the military’s defense.

However, Brig. Nabil Abdalla, a spokesperson for the Sudanese armed forces, said the military regained control of the facility, and that fighting was still underway Sunday morning. Neither claim could be independently verified.

The paramilitary group has been repeatedly accused of gross rights violations across the country since the war started in April last year, when simmering tensions between the military and the RSF exploded into open fighting in Khartoum and elsewhere.

The devastating conflict has killed more than 14,000 people and wounded 33,000, according to the United Nations, but rights activists say the toll could be much higher.

The Sudan Conflict Monitor, a group of experts and rights activists, said the RSF seizure of Singa will likely have “severe humanitarian consequences" with potential future disruption of large-scale agricultural programs in the nearby provinces of Blue Nile, White Nile and Jazira, which was once Sudan's breadbasket.

The U.N.’s International Organization for Migration said in its latest update Sunday that the clashes displaced about 55,440 people in Singa and neighboring village. Another 1,455 people fled their homes in Jebal Moya, it said. “The situation remains tense and unpredictable,” it said in a statement.

Residents reported widespread looting of homes and shops in Singa by RSF fighters who seized private vehicles, mobile phones, jewelry and other valuable possessions.

“They did like what they did in (the capital) Khartoum and other cities,” said Abdel-Rahman al-Taj, a Singa resident who fled Saturday to Blue Nile province. “Many people were killed, wounded or detained.”

The Sennar Observatory for Human Rights, a local rights group, said the RSF attacked Singa Educational Hospital, detaining dozens of patients and medical staff as “human shields.” The fighters turned the hospital into a military center in a “clear violation of the international human material law.”

A physician at the hospital said RSF fighters, some in vehicles, swarmed the facility's courtyard and corridors. “The situation is extremely dangerous,” said the physician who spoke on condition of anonymity for his safety. “We are working under gunpoint.”

He added that the hospital has received dozens of wounded people over the past three days from Singa and the surrounding areas.

The RSF didn’t immediately respond to a request for comment.

The fighting in Sennar comes while attention has been focused on al-Fasher, a major city in the sprawling region of Darfur that the RSF has besieged for months in an attempt to seize it from the military. Al-Fasher is the military's last stronghold in Darfur.

Sudan's conflict has created the world’s largest displacement crisis with over 11 million people forced to flee their homes. International experts warned Thursday that that 755,000 people are facing famine in the coming months, and that 8.5 million people are facing extreme food shortages.

The conflict has been marked by widespread reports of rampant sexual violence and other atrocities — especially in Darfur, the site of a genocide in the early 2000s. Rights groups say the atrocities amount to war crimes and crimes against humanity.

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