Dozens of people were killed in the besieged Sudanese city of El Fasher early Friday when paramilitary forces fired a missile into a mosque during morning prayers, local medics and aid workers said.

The strike was among the deadliest in months in El Fasher, in the western region of Darfur, where the paramilitaries have intensified a brutal, nearly 18-month siege by bombing neighborhoods where tens of thousands of hunger-stricken civilians are sheltering.

At least 84 bodies had been pulled from the wreckage of the mosque, including several women and children, said Suleman, a senior doctor at the nearby Al Saudi hospital, who spoke by phone after visiting the site.

“The scene was harrowing beyond description,” said the doctor, who asked to be identified by one name to protect his family from reprisals.

A missile hit the Al Jamia mosque during early morning prayers, when it was packed with worshipers, the doctor said. Videos circulating on social media of the aftermath, showing bloodied bodies trapped under rubble and steel girders, were accurate, he said.