Sudan’s paramilitary Rapid Support Forces have killed at least 100 people, including 20 children and nine aid workers, after launching an assault on two famine-stricken camps in the Darfur region, the latest escalation in a bitter civil war about to enter its third year.

The RSF targeted the Zamzam and Abu Shouk camps, where more than 700,000 people are sheltering from the relentless violence that has killed tens of thousands, forcibly displaced 12.7 million people, and left 24.6 million people facing acute hunger, according to the United Nations.

U.N. Humanitarian Coordinator Clementine Nkweta-Salami said Saturday that the latest attacks marked “yet another deadly and unaccepted escalation” in the conflict, and said attacks on civilians and aid workers marked “grave violations of international humanitarian law.”

“The colleagues from an international non-governmental organization were killed while operating one of the very few remaining health posts still operational in the camp,” she said. 

The war pits Sudan’s armed forces, led by the country’s de facto ruler Gen. Abdel-Fattah Burhan, against the RSF militia commanded by his former deputy, Gen. Mohammed Hamdan Dagalo. 

The two were once allies within the military junta that seized control after the spectacular collapse of Prime Minister Abdalla Hamdok’s government in 2021. But their power-sharing arrangement rapidly fell apart, sparking war in April 2023.

While both sides have been accused of extensive human rights violations, a U.N. fact-finding mission in October found that the RSF was responsible for committing sexual violence on a large scale in areas under its control, including gang rapes, abductions and sexual slavery.

In January, the United States determined that the RSF had committed genocide in areas under its control. 

A March report from UNICEF said children as young as one had been raped and sexually assaulted by armed forces, in the first comprehensive account illustrating how mass sexual violence is being wielded as a weapon of war against children in Sudan.

The agency documented over 200 cases of child rape since early 2023, although the authors stressed that this was only a small fraction of the total number of cases.

The latest attacks comes as aid groups grapple with a funding crisis after President Donald Trump enacted a 90-day freeze on all foreign aid in February.

One network of communal kitchens has had to immediately stop most of its operations due to a lack of funding, about 75% of which came from the U.S. Agency for International Development (USAID), according to their organizers.

Abuzar Osman Suliman, the coordinator of the Emergency Response Rooms in Sudan’s western Darfur region, told NBC News in February that all 40 of ERRs’ community kitchens had to close in the Zamzam camp.

U.N. agencies have been unable to get substantial amounts of food relief to the Zamzam camp and a famine was already declared in the camps in August, according to an analysis by the Integrated Food Security Phase Classification (IPC), an international system that sets a scale used by the United Nations and governments. 

Famine has since spread to four other areas of Sudan, according to the IPC, and is expected to deepen and spread in coming months due to the war and impeded access to humanitarian assistance.