NAIROBI, Kenya — As two rival generals, each with his own army, grappled for power in Sudan on Monday, even hospitals trying to tend to the swelling numbers of wounded were no longer havens.

At one overwhelmed medical center, the morning began with shelling. Then, members of a paramilitary force barged inside, ordered newborns and other patients to be evacuated, and began taking up positions, one doctor said.

“The hospital turned into a battlefield,” said the doctor, Musab Khojali, an emergency room physician at the Police Hospital in Burri, northeast of the capital, Khartoum.

Many other hospitals were also reported to have come under attack on Monday, the third day of fighting in Sudan.

The death toll has risen to at least 180, with about 1,800 others injured.

The two generals, who together seized power in a coup in 2021, have now turned against each other — rebuffing all attempts by mediators who for months had been pressing them to unite their fighting forces under one umbrella, relinquish power and allow a transition to civilian rule.

Amid growing reports of random violence and looting, concerns grew that the fighting might embroil other nations in the region, including Egypt, which has troops in the country, as well as Chad, Ethiopia and Libya. Russia has also been trying to make inroads in Sudan, and members of the Kremlin-affiliated Wagner private military company are posted there.

Leaders from around the world called for a cease-fire, but it was not clear who, if anyone, was in control of Sudan, Africa’s third-largest country, by area.

In Khartoum, where many have lost power and water, residents watched warplanes and military helicopters circling ominously, and homes shuddered with the sound of shelling. Those few who dared venture out from their homes found the streets dangerous and desolate.

“Everyone is afraid,” said Ahmed Abuhurira, a 28-year-old mechanical engineer who went out to try to charge his cellphone. “You can see it in their eyes. People are panicking.”

The fighting began on Saturday, when forces loyal to Lt. Gen. Mohamed Hamdan, the head of the paramilitary group called the Rapid Support Forces, began clashing with forces loyal to the Sudanese army chief, Gen. Abdel Fattah al-Burhan.

Only the army has aircraft, and on Monday, General Hamdan accused his rival of “bombing civilians from the air.” The Sudanese Army said in a statement that it was “operating within the rules of conflict and international humanitarian law.”

The turn of events has worsened a crisis in a nation where one-third of its 45 million people were already in need of food aid. Now, the violence has forced aid groups to suspend operations. The United Nations World Food Program says three of its workers were killed.

And on Monday, the U.N. envoy to Sudan, Volker Perthes, said gunmen had been looting and burning warehouses holding critically needed aid, as well guesthouses and offices of agencies like the World Food Program and UNICEF.

António Guterres, the U.N. secretary general, said he had spoken with both warring generals and expressed deep concern. “The humanitarian situation in Sudan was already precarious and is now catastrophic,” he said.

The American secretary of state, Antony J. Blinken, called for an immediate cease-fire, and said General Hamdan and General al-Burhan must “ensure the protection of civilians and noncombatants, as well as people from third countries, including our personnel who are located in Sudan.”

But for now, even the much more modest goal of a cease-fire appears elusive.

Mr. Perthes said that he was talking to the leaders of both military factions daily, and that they had made it clear that they had no intention of ending the fighting. They are, however, receptive to the idea of a “pause” to allow humanitarian access, he said.

Although the toll on civilians has been most evident in Khartoum, aid workers say they are also concerned by the situation outside the capital, and especially in the western Darfur region.

Save the Children, an aid organization, said on Monday that looters had stolen medical supplies for children, as well as a refrigerator, laptops and cars in a raid on one of its offices in Darfur. The group’s Sudan director, Arshad Malik, called on the combatants to safeguard humanitarian services.

“For the past three days,” he said in a statement, “people across Sudan have been gripped by fear, not knowing if it is safe to leave their homes, and now having to make the choice between facing that fear and starving to death.”

Cyrus Paye, a coordinator for Doctors Without Borders in North Darfur, said in a statement that most of the wounded there were “civilians who were caught in the crossfire — among them are many children.”

He painted a dire picture of the conditions for medical workers.

“The hospital is rapidly running out of medical supplies to treat survivors,” Mr. Paye said. “It is running out of medicines and blood. There has also been a power outage in the city since the beginning of the fighting, and fuel supplies for the hospital generator are also running low.”

The Central Committee for Sudanese Doctors said that more than a dozen hospitals had been forced to close. “Hospitals in Sudan are under bombardment,” the group said.

American diplomats are sheltering in place, and a White House spokesman said that “all U.S. government personnel are accounted for.”

But Western officials reported that the European Union ambassador to Sudan, Aidan O’Hara, had been assaulted at his home in Khartoum after armed men broke in, threatened him at gunpoint and stole money.

The assailants were members of the Rapid Support Forces paramilitaries, identified by their uniforms, several officials said, speaking on the condition of anonymity for security reasons.

“This constitutes a gross violation of the Vienna Convention,” Josep Borrell Fontelles, the top diplomat for the bloc, said on Twitter. “Security of diplomatic premises and staff is a primary responsibility of Sudanese authorities and an obligation under international law.”

With concern growing that the conflict may entangle other nations, observers were paying close attention to Egypt, which has enmeshed itself deeply into the affairs of its neighbor.

Since 2019, when pro-democracy protesters forced Sudan’s autocratic president to step down, Egypt has been eager to keep a civilian-led democracy from taking root on its southern doorstep, analysts have said. Ruled by a military-backed government that came to power after its own antigovernment uprising in 2011, Egypt has sought to replicate similar leadership in Sudan.

Egyptian officials see a strongman as the best way of keeping its neighbor stable — and off a democratic path that could inspire Egyptians — and they have embraced General al-Burhan as an ally, especially after one Rapid Support Forces faction captured Egyptian soldiers and seven Egyptian warplanes over the weekend.

The fighting has made transit in and out of the country difficult. At the main airport in Khartoum, airplanes were targeted again on Monday as the rival military factions fought for control over critical infrastructure.

The New York Times, using satellite imagery, has identified 20 planes that have been destroyed or badly damaged at the airport since the conflict erupted.

On Monday evening, residents of the city of Omdurman, northwest of the capital, said the situation was quiet, with many people coming out of their homes and traffic gradually building in some shopping areas. Many households, however, still lacked water or electricity.

In the capital, many residents found it safest to stay home. Mr. Abuhurira, the electrical engineer who went out to charge his phone, said that in the half-hour he spent on the street, he encountered almost no one.

The few people he did run across, he said, looked “like a zombie — without a soul or spirit.”

Reporting was contributed by Vivian Yee from Cairo, Farnaz Fassihi and Christoph Koettl from New York and Edward Wong from Karuizawa, Japan.

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