Rape and sexual violence remain part of everyday life in areas of Sudan even when fighting in the country's civil war has moved elsewhere, according to a new report by medical charity Médecins Sans Frontières (MSF).

Calling rape a defining feature of the conflict, it says sexual assault is overwhelmingly carried out by armed men and is often accompanied by acts of brutality and humiliation. But MSF says rape persists as an insidious part of life for communities in the western region of Darfur that are no longer on the front line.

The report is the most comprehensive account yet on sexual violence in Sudan's nearly three-year war and is based on testimonies from 3,396 victims who sought treatment in MSF-supported facilities across North and South Darfur.

The warring parties - Sudan's army and the paramilitary Rapid Support Forces (RSF) - are both accused of sexual violence. However, Darfur is the stronghold of the RSF and the vast majority of perpetrators identified by survivors were their fighters.

Many of the cases reported occurred in North Darfur following the RSF takeovers of the displaced persons camps of Zamzam and Abu Shouk, and the city of el-Fasher last year, which MSF calls one of the most shocking iterations, unfolding the most unimaginable brutality. More than 90% of victims treated by MSF were attacked while traveling to safety in the town of Tawila.

These attacks often involved multiple rapists and included other forms of extreme violence and intimidation, such as beatings and the murder of relatives. Victims shared harrowing accounts of their experiences, revealing a horrifying reality where sexual violence happens routinely.

The report highlights that the persistence of such violence is rooted in a heavily militarized environment with entrenched gender inequalities, which has fostered a sense of impunity among perpetrators. In South Darfur, a staggering 68% of victims reported being assaulted by armed men, while a considerable number also identified civilians and intimate partners as perpetrators.

This disheartening situation affects a wide demographic, with one in five survivors being under the age of 18, including some as young as five. MSF insists that its data represents only a fraction of the true scale of the abuse due to barriers to care, ongoing insecurity, displacement, stigma, and lack of functioning protection services.

The charity is calling for increased accountability and action to address these horrific violations and meet the needs of survivors.