The Sudanese Doctors’ Union says fighters for the paramilitary Rapid Support Forces raped at least 47 people, including three minors, in the eastern Al Jazirah state as part of a retaliation campaign against the Sudanese army. An 11-year-old girl died from her bleeding.

This comes amid a spate of recent reports on widespread sexual assault as the devastating civil war in Sudan rages on. A U.N. report has accused militia fighters of using rape as part of a genocidal campaign in Darfur to eliminate non-Arab ethnic groups like the Masalit. One survivor said her attacker told her, “We will make you give birth to Arab children.” Aid groups are reporting an increase in suicides among rape survivors and women who fear being raped.