At least 13 people have been killed after an attack on one of the last remaining hospitals in el-Fasher, a Sudanese city trapped under siege.

Sixteen others, including a doctor and nurse, were injured after the paramilitary Rapid Support Forces (RSF) shelled the Saudi hospital several times on Tuesday night, a source there told the BBC. A group of Sudanese medics has called the attack a war crime.

Pictures showed shattered windows, cracks from shrapnel, a gaping hole in the mud-brick wall, and twisted metal from hospital beds covering the floor.

The RSF has been besieging el-Fasher for more than 17 months, leaving hundreds of thousands of people stuck in the city, facing starvation.

The paramilitary group is fighting the army for full control of el-Fasher, the last military stronghold in the vast Darfur region.

This is the second strike on the Saudi hospital this year - the first in January killed three children and injured three others.

The latest shelling ripped through part of the hospital, destroying wards.

In recent weeks, the RSF has intensified its assault on el-Fasher, leading experts to believe the city could soon fall unless the army receives immediate reinforcements.

All major exit routes are now sealed by the 57-kilometre (35-mile) wall, and civilians attempting to flee have reported extortion, arbitrary detentions, disappearances, and sexual violence at RSF-controlled checkpoints.

UN High Commissioner for Human Rights Volker Türk stated that urgent measures are needed to loosen the armed vice upon the city and protect civilians.