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Smoke billows in southern Khartoum amid ongoing fighting between two rival generals in Sudan. Image Credit: AFP

Sudan's warring military factions agreed on Monday to a five-day extension of a ceasefire agreement, after renewed heavy clashes and air strikes in parts of the capital threw fresh doubts on the effectiveness of the truce.

Saudi Arabia and the United States, which brokered a week-long ceasefire deal and have been monitoring it remotely, announced shortly before it was due to expire on Monday evening that the parties had agreed to extend it.

Although the ceasefire had been imperfectly observed, it had allowed the delivery of aid to an estimated two million people, the two countries said in a joint statement.

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"The extension will provide time for further humanitarian assistance, restoration of essential services, and discussion of a potential longer-term extension," the statement said.

Sources with knowledge of the new deal said discussions on amendments to make the truce more effective were continuing.

Hours earlier, residents reported battles in all three of the adjoining cities that make up Sudan's greater capital around the confluence of the Nile - Khartoum, Omdurman and Bahri. The intensity of the fighting was greater than over the past three days, they said.

Sudan's army and the paramilitary Rapid Support Forces (RSF) have been locked in a power struggle that erupted into conflict on April 15, killing hundreds and driving nearly 1.4 million people from their homes.

Air strikes, which the army has been using to target RSF forces embedded in neighbourhoods across the capital, could be heard in Omdurman on Monday afternoon, residents said.

"Since yesterday evening there has been bombardment with all types of weapons between the army and the Rapid Support," Hassan Othman, a 55-year-old resident of Omdurman, told Reuters by phone. "We're in a state of great fear. Where's the truce?" On past days, the truce deal had brought some respite from heavy fighting, though sporadic clashes and air strikes have continued.

Saudi Arabia and the United States have previously said both sides had committed various violations of the truce, as well as impeding humanitarian access and restoration of essential services.

Orphanage deaths

Sudan's health ministry has said more than 700 people have died as a result of the fighting, though the true figure is likely much higher because of the difficulty health and aid workers have had in accessing conflict zones.

The government has separately recorded up to 510 deaths in El Geneina, one of the main cities in Darfur, a western region already scarred by conflict and displacement.

In Khartoum, factories, offices, homes and banks have been looted or destroyed. Power, water and telecommunications are often cut, there are acute shortages of medicines and medical equipment, and food supplies have been running low.

At Sudan's largest orphanage, Reuters reported how dozens of babies have died since the start of the conflict, which one Khartoum State official attributed mainly to staff shortages and recurrent power outages caused by the fighting.

The United Nations and aid groups say that despite the truce, they have struggled to get bureaucratic approvals and security guarantees to transport aid and staff to Khartoum and other places of need.

The head of the U.N. refugee agency told Reuters that a projection that one million people could flee Sudan by October may prove a conservative estimate.

More than 350,000 people have already fled into neighbouring countries, with most heading to Egypt, Chad and South Sudan.