Fierce fighting continues in Sudan after a ceasefire between the military and a paramilitary group broke down, raising concerns for worsening humanitarian conditions.

Clashes erupted on Saturday, as the paramilitary Rapid Support Forces grew discontent with talks designed to steer the African country toward civilian rule following a coup in October 2021. Agendas of the talks include reorganizing the military.

Media outlets reported that the two sides agreed to stop fighting for 24 hours from Tuesday afternoon after accepting an appeal from the United States as well as European and Arab countries.

But gunshots and shelling could be heard in the capital Khartoum after the ceasefire was due to take place.

A local doctors' association says the violence has killed 144 civilians and many medical institutions have become unusable due to attacks or power cuts.

World Health Organization Director-General Tedros Adhanom Ghebreyesus told reporters that "there are disturbing reports of some health facilities being looted and others being used for military purposes."

He said, "It's also reported that some hospitals are already closed or on the brink of closure due to attacks and the lack of medical personnel and medical supplies."

The World Food Programme has suspended operations in Sudan after three staff members died in the fighting.