Armed fighters rampaged through a city in Sudan’s war-ravaged region of Darfur on Thursday, battling each other and looting shops and homes, residents said. The violence came despite the extension of a fragile truce between Sudan’s two top generals, whose power struggle has killed hundreds.

The mayhem in the Darfur city of Genena pointed to how the rival generals’ fight for control in the capital, Khartoum, was spiraling into violence in other parts of Sudan.

The two sides accepted a 72-hour extension of the truce late Thursday. The cease-fire has not stopped the fighting but created enough of a lull for tens of thousands of Sudanese to flee to safer areas and for foreign nations to evacuate thousands of their citizens by land, air and sea.

The cease-fire has brought a significant easing of fighting in Khartoum and its neighboring city Omdurman for the first time since the military and a rival paramilitary force began clashing on April 15, turning residential neighborhoods into battlegrounds.

Both the military, led by Gen. Abdel Fattah Burhan, and the paramilitary Rapid Support Forces, led by Gen. Mohamed Hamdan Dagalo, said that they accepted the extension of the truce. But explosions and heavy gunfire could be heard in at least one Khartoum neighborhood late Thursday.

The U.S. State Department released a statement welcoming the cease-fire and the two sides’ “readiness to engage in dialogue toward establishing a more durable cessation of hostilities and ensuring unimpeded humanitarian access.”

The joint statement named a wide array of mediators, including the African Union, an eight-nation East Africa bloc, the U.N., Saudi Arabia, the United Arab Emirates, the U.K. and the U.S. It highlighted the breadth of international peace efforts, which have thus far failed to end the fighting.

The White House meanwhile encouraged Americans to take advantage of any opportunity to leave Sudan in the next 24 to 48 hours, even as Washington has faced criticism for not mounting the kind of mass evacuation of its citizens already carried out by other nations.

“We are working continuously to create options for American citizens to leave Sudan,” White House Press Secretary Karine Jean-Pierre said, warning that the “situation could deteriorate at any moment.”

A U.S. defense official said three U.S. Navy vessels were approaching the Sudanese coast but none had received orders as yet to pick up citizens or other personnel. The official spoke on condition of anonymity to discuss ongoing military operations.

British Foreign Secretary James Cleverly urged U.K. nationals who want to leave to get to an airfield north of Khartoum for evacuation flights. “The situation could deteriorate over the coming days,” he warned. Britain said it has evacuated 897 people on eight flights to Cyprus, with operations continuing.

The fighting has continued in some parts of the capital despite the truce, and in the western region of Darfur, residents said the violence had escalated to its worst yet.

Darfur has been a battleground between the military and the paramilitary RSF since the conflict began nearly two weeks ago. Residents said the fighting in Genena was now dragging in tribal militias, tapping into longtime hatreds between the region’s two main communities — one that identifies as Arab, the other as East or Central African.

In the early 2000s, African tribes in Darfur that had long complained of discrimination rebelled against the Khartoum government, which responded with a military campaign that the International Criminal Court later said amounted to genocide. State-backed Arab militias known as the Janjaweed were accused of widespread killings, rapes and other atrocities. The Janjaweed later evolved into the RSF.

Early Thursday, fighters who mostly wore RSF uniforms attacked several neighborhoods across Genena, driving many families from their homes. The violence spiraled as tribal fighters joining the fray in Genena, a city of around half a million people located near the border with Chad.

“The attacks come from all directions,” said Amany, a Genena resident who asked to withhold her family name for her safety. “All are fleeing.”

It was often unclear who was fighting whom, with a mix of RSF and tribal militias — some allies of the RSF, some opponents — all running rampant. The military has largely withdrawn to its barracks, staying out of the clashes, and residents were taking up arms to defend themselves, said Dr. Salah Tour, a board member of the Doctors’ Syndicate in the West Darfur province, of which Genena is the capital.

The syndicate estimated that dozens of people were killed and hundreds wounded. Almost all of Genena’s medical facilities, including its main hospital, have been out of service for days, and the sole functioning hospital is inaccessible because of the fighting.

“Criminal gangs” looted the main hospital, stealing vehicles and equipment and destroying the hospital’s blood bank, the syndicate said.

“It’s a scorched earth war,” said Adam Haroun, a political activist in West Darfur, speaking by telephone with the sound of gunfire at times drowning out his voice.

Haroun and other residents said the city’s main open-air market was completely destroyed. Government offices and aid agencies’ compounds were trashed and repeatedly burned, including U.N. premises and the headquarters of the Sudanese Red Crescent.

Two major camps for displaced people have been burned down, their occupants — mainly women and children from African tribes — dispersed, said Abdel-Shafei Abdalla, a senior member of a local group that helps administer camps.

Elsewhere in Darfur, there have been sporadic clashes, particularly in Nyala, the capital of South Darfur province, where thousands have fled their homes, Abdalla said.

At least 512 people, including civilians and combatants, have been killed in Sudan since April 15, with another 4,200 wounded, according to the Sudanese Health Ministry. The Doctors’ Syndicate, which tracks civilian casualties, has recorded at least 303 civilians killed and 1,848 wounded.

Meanwhile, in Khartoum, residents reported heavy explosions and gunfire in the upscale neighborhood of Kafouri after the truce extension was announced. The military had earlier used warplanes to bomb RSF positions in the area.

Many are struggling to obtain food and water, and electricity is cut off across much of Khartoum and other cities. Multiple aid agencies have had to suspend operations. Fearing that fighting will escalate once more, Sudanese and foreigners have been rushing to escape.

Egypt has so far evacuated more than 5,300 Egyptians from Sudan and received more than 14,000 Sudanese fleeing the fighting, the Foreign Ministry said. Long lines of buses continue to form at the border, and tens of thousands more have gone to other neighboring countries or to the Red Sea city of Port Sudan, trying to get onto ferries to Saudi Arabia.

Hassan Ali, a Dutch citizen who made it to the city of Larnaca in Cyprus on an evacuation flight, told The Associated Press he had spent days trapped at home in Khartoum. Most areas had no water and only intermittent electricity.

“Most of the time we (are) locked at home unless you go for something really emergency, food, medication. That’s it,” he said. Many sought shelter in hospitals, even though “most of the hospitals get attacked as well, by both sides.”

“People, they just left everything behind,” he said of those leaving. “There is no cash, There’s no money. You just take your bag.”