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Local Red Cross workers carry a body as they move bodies from a mass grave at a military camp in the 200 villas neighbourhood of Bangui February 17, 2014.LUC GNAGO/Reuters

Violence has become so horrific in the Central African Republic that many injured victims are too terrified to venture into hospitals for fear of attack, a medical organization says.

Armed gangs with machetes and guns are attacking sick and wounded patients near hospitals and even inside hospitals and ambulances, according to a report on Tuesday by Médecins Sans Frontières (Doctors Without Borders).

In the unusually strongly worded statement, MSF accused the world community of ignoring the Central African Republic to the point where it seems to be a policy of "deliberate neglect" to dissuade people from seeking help at camps for the homeless.

The extreme violence and targeted killings are evidence of "the utter failure of international efforts to protect the population," MSF said. It said there was a "shocking lack of engagement" by the United Nations Security Council and only a limited response from African countries.

"We see atrocities every day," said Joanne Liu, international president of MSF, which has staff in 16 towns across the country.

"This is a massive catastrophe unfolding in full view of international leaders," she said in a statement after visiting the Central African Republic.

"To not respond is a conscious and deliberate choice to abandon the people of the Central African Republic."

Since early December, MSF has treated more than 3,600 people wounded in the violence – including those with injuries caused by gunshots, grenades, machetes, knives and other weapons.

"People are too fearful to go to the hospital even if it is only a few hundred meters away," the medical organization said.

In one case, in the town of Bozoum, MSF found 17 people hiding in a courtyard. They had been injured by gunshots and machetes – yet they were too scared to go to the hospital in case they were attacked again.

"Their injuries were serious – yet they were all sitting in silence, bleeding," Dr. Liu said. "That's how terrified people are of seeking medical care. They just sat there in silence, having lost all hope."

In another attack on Feb. 12, men armed with machetes and guns entered a hospital in the town of Berberati and fired shots. They threatened patients and forced some to flee, MSF said. It said it often has to "physically intervene" in cases where armed men are attacking or threatening to attack sick and wounded patients.

"MSF teams are constantly dealing with violent attacks taking place in close proximity to or inside hospitals," it said.

It also cited a "lethal deficit" in humanitarian aid for Central Africans, including in the capital, Bangui.

"Assistance has been appalling in Bangui and practically non-existent outside the capital," it said. "One of the most egregious examples is in Bangui's Mpoko international airport, where around 60,000 internally displaced people are living in abysmal conditions with less than four litres of water per person per day and deplorable sanitation, just a few hundred metres from the airport's runway."

The conditions at the airport "raise the question of whether the slow delivery of aid is a form of deliberate neglect aimed at dissuading people from staying there," Dr. Liu said.

Another MSF aid worker, Lindis Hurum, said she witnessed an incident in which a United Nations agency caused a fight among the displaced people at the airport by tossing plastic sheeting (used for providing shelter) over a barbed-wire fence to the thousands of people inside the camp. This sparked fighting that inflicted injuries on three of them, she said. "It was an undignified and unacceptable way to deliver aid," she told a media briefing on Tuesday.

About one-quarter of the country's 4.5 million people have fled their homes because of the violent attacks. In eight places where MSF is working, about 15,000 civilians are trapped in hospitals, churches or mosques, living in fear of being killed by armed groups.

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