CAIRO (AP) — A drone attack Sunday on an open market south of the Sudanese capital, Khartoum, killed at least 23 people, activists and medical workers said, as the military and a powerful paramilitary group battle for control of the country.

At least three dozen others were injured in the attack in Khartoum’s May neighborhood, according to an activist group known as the Resistance Committees and two health care workers at the Bashair University Hospital, where the casualties were treated.

The activist group posted footage on social media showing bodies wrapped in white sheets in an open yard at the hospital.

It was not immediately clear which side was behind Sunday’s attack.

Sudan has been rocked by violence since mid-April, when tensions between the country’s military, led by Gen. Abdel Fattah Burhan, and the paramilitary Rapid Support Forces, commanded by Gen. Mohamed Hamdan Dagalo, burst into open fighting.

The clashes have since spread to several parts of the country, reducing Khartoum to an urban battlefield.

In the western Darfur region — the scene of a genocidal campaign in the early 2000s — the conflict has morphed into ethnic violence, with the RSF and allied Arab militias attacking ethnic African groups, according to rights groups and the United Nations.

The conflict has killed more than 4,000 people, according to August figures from the United Nations. However, the real toll is almost certainly much higher, doctors and activists say.

Over 5 million people have been displaced within Sudan or have fled the country to escape the violence, according to the International Organization for Migration.