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The cease-fire failure suggested the two rival generals fighting for control of the country were determined to crush each other in a potentially prolonged conflict.
READ: Sudan Conflict: Sudanese army, rival forces agree to 24-hour cease-fire
With no sign of respite, desperate and terrified Sudanese who have been trapped for days in their homes by the violence began to flee, witnesses said.
Residents of multiple neighbourhoods of Khartoum told The Associated Press they could see hundreds, including women and children, carrying luggage, some leaving by foot, others crowding into vehicles.
"Khartoum has become a ghost city," said Atiya Abdalla Atiya, secretary of the Doctors' Syndicate, who is still in the capital.
[bsa_pro_ad_space id=1]The generals' fight for power has caught millions of Sudanese in the crossfire, as their forces have battled it out since Saturday with heavy machine guns, artillery and airstrikes in residential neighbourhoods of Khartoum, its neighbouring city Omdurman and other major towns of the country.
At least 270 people have been killed in the past five days, the UN said, but the toll is likely higher, since many bodies have been left in the streets, unreachable because of clashes.
A 24-hour cease-fire was to have been in effect from sundown Tuesday to sundown Wednesday. It was the most concrete attempt yet to bring a pause that it was hoped could be expanded into a longer truce.
It came after US Secretary of State Antony Blinken spoke separately by phone with the two rivals the leader of the armed forces, Gen. Abdel Fattah Burhan, and the head of the paramilitary Rapid Support Forces, Gen. Mohammed Hamdan Dagalo.
Egypt, which backs the Sudanese military, and Saudi Arabia and the United Arab Emirates, which have close ties to the RSF, have also been calling on all sides to stand down.
But fighting continued after the intended start of the truce and through the night. Each side blamed the other for the failure.
Fierce clashes between the army and RSF were reported Wednesday morning around the military's headquarters in central Khartoum and the nearby airport, as well as around the state television building across the river in Omdurman.
Bombs and artillery could be heard around the city.
[bsa_pro_ad_space id=1]A high-rise in the city centre was on fire with burning debris falling from its top floors, according to footage by the Al Arabiya news network.
"The battles intensified in the morning after sporadic gunfire over the night," said Tahani Abass, a prominent rights advocate who lives close to the military headquarters. "Bombing and explosions are shaking our houses."
Mahasen Ali, a tea vendor, said many in her south Khartoum neighbourhood have left their homes to take refuge in open areas, hoping to be safe from shelling hitting buildings.
Others fled the city to stay with relatives elsewhere, she said.
Armed men were roaming the streets, storming shops and houses. "They take whatever they can, and if you resist, they kill you," she said.
Meanwhile, 89 students and staffers at Khartoum University who had been trapped in the engineering department since the start of fighting were rescued by the military Tuesday, said Mohammed Al Faki, one of the freed students.
Online footage showed students crawling through a small hole in the university's perimeter wall, helped by men in uniforms.
The battles, with heavy machine guns, artillery and airstrikes, have wreaked extensive damage, playing out in the streets of Khartoum and the city of Omdurman on the opposite bank of the Nile River, as well as in other key towns around Sudan.
Dozens of health care facilities in Khartoum and around the country have stopped functioning because they are close to clashes, the Sudanese Doctors' Syndicate said Wednesday.
At least nine hospitals were bombed and 16 were forcefully evacuated, it said.
The director-general of the UN's World Health Organisation, Tedros Ghebreyesus, said Wednesday that at least 270 people have been killed and more than 2,600 wounded since fighting began, without offering a breakdown of civilians and combatants killed.
The Doctors' Syndicate, which monitors casualties, said Tuesday that at least 174 civilians have been killed and hundreds wounded.
Blinken had described the proposed one-day humanitarian cease-fire as a building block for a longer truce and a return to eventual negotiations.
Their failure to pause fighting for even a day, despite high-level diplomatic pressure, suggests the generals remain bent on pursuing a military victory.
The conflict between the military and the RSF has once again derailed Sudan's transition to democratic rule after decades of dictatorship and civil war.
A popular uprising four years ago helped depose long-time autocrat Omar al-Bashir, but Burhan and Dagalo allied to carry out a 2021 coup.
Both generals have a long history of human rights abuses, and their forces have cracked down on pro-democracy activists.
Under international pressure, Burhan and Dagalo recently agreed to a framework agreement with political parties and pro-democracy groups.
But the signing was repeatedly delayed as tensions rose over the integration of the RSF into the armed forces and the future chain of command tensions that exploded into violence Saturday.