Hundreds of people, including dozens of children, have been killed in Sudan in recent days, according to civilian witnesses, medical workers and the United Nations, as fierce clashes have escalated in an internal conflict that is approaching its third year.

The war between the Sudanese Army and the paramilitary Rapid Support Forces has unleashed a wave of devastation across Sudan, killing tens of thousands of people, forcing millions to flee their homes and pushing parts of the vast nation deeper into famine.

“Everywhere you look, death is near,” Mustafa Ahmed, 28, a painter who lives in Omdurman, across the Nile from the capital, Khartoum, said in a phone interview.

He and his family, he said, were very worried about the continued shelling and were devising ways to leave the city. “I am working hard to leave and keep my family safe from dying,” he said.

In the capital and adjoining cities, the region of Darfur in the west, and across several other states, the ruinous war is escalating as the warring parties strive to solidify their territorial claims, regain new ones and secure strategic military and civilian sites.

The conflict has been marked by gross atrocities and ethnically motivated killings, prompting investigations from the International Criminal Court and accusations of genocide from the United States.