JEDDAH: More than million people have fled Sudan to neighboring states and those who remain are running out of food and dying from lack of healthcare, the UN and humanitarian groups said on Tuesday.

In a joint appeal, the heads of 20 global organisations said more than six million Sudanese people were “one step away from famine.”

Four months of fighting between the Sudanese regular army and the paramilitary Rapid Support Forces havedevastated the capital Khartoum and threatened to plunge Sudan into a protracted civil war.

“Time is running out for farmers to plant the crops that will feed them and their neighbors. Medical supplies are scarce. The situation is spiralling out of control,” UN agencies said.

The war has forced 1,017,449 people to cross from Sudan into neighboring countries, many already struggling with the impact of conflicts or economic crises, and those displaced within Sudan are estimated to number 3,433,025. The millions who remain have faced rampant looting and long cuts in power, communications and water supplies.

“The remains of many of those killed have not been collected, identified or buried but the UN estimates that more than 4,000 have been killed,” said Elizabeth Throssell, spokesperson for the High Commissioner for Human Rights.

Swaths of the country have been suffering from an electricity blackout since Sunday that has also taken mobile networks offline. Seasonal rain that increases the risk of water-borne diseases has destroyed or damaged the homes of up to 13,500 people.

The UN voiced particular concern for women and girls caught up in the conflict, amid “shocking incidents of sexual violence, including rape.”

Laila Baker of the UN Population Fund said: “We’ve seen an increase of more than 900 percent in the conflict areas of gender-based violence. Those women are incredibly at risk.” The victims of such violence, who in a number of cases end up pregnant, find themselves with little or no access to assistance and care, she said.

UN rights chief Volker Turk said his office had received credible reports of 32 incidents of sexual violence against 73 victims. “This includes at least 28 incidents of rape. Men in RSF uniform were implicated in at least 19 incidents as perpetrators. The actual number of cases is probably much higher.”

The aid agencies decried the lackluster international response to the Sudan crisis, with two appeals for aid just over 27 percent funded. “Please change that,” they said. “There is no excuse for waiting.”