Aid workers allowed into Sudan’s el-Fasher for the first time since it fell to militants described traumatized civilians living on the verge of famine, characterizing the largely deserted city as the “epicenter of human suffering.”

After a 500-day siege, the city — which once held more than a million people — is “a ghost of its former self,” a UN aid official told AFP, with most fleeing the Rapid Support Forces, a paramilitary group accused of carrying out ethnic cleansing of Sudan’s Black population.

Almost three years since the start of the Sudanese civil war, there are few signs of the hostilities ending soon, with experts fearing the world’s gravest humanitarian crisis could yet worsen.