Medical humanitarian aid group Doctors Without Borders (MSF) slammed the “utter failure of international efforts to protect the population” of the Central African Republic, saying that the unprecedented violence civilians are confronting provides a “damning indictment” of how the international community has abandoned this nation’s people.

“The human crisis we are witnessing today is unprecedented in the Central African Republic, a country that has been neglected for years,” said Dr. Joanne Liu, MSF international president, who recently returned from the country.

Ongoing violence has caused tens of thousands to flee to neighboring countries, thousands have been killed, and those internally displaced face potential brutal attacks—even within hospitals—and minimal shelter with unsafe sanitation levels.

MSF stated that in in some areas humanitarian assistance has been “appalling” or non-existent.

1.3 million people are estimated to be in need of food assisatnce. “As well as forcing people out of the country, violence and insecurity are stopping food from coming in, and people are unable to get enough food for their families. Many of those who have fled the attacks in [the capital of] Bangui were the backbone of the local economy,” explained Philippe Conraud, Country Director of Oxfam in CAR.

UN High Commissioner for Human Rights Navi Pillay said Wednesday, “The level of cruelty and disregard for life and dignity is horrifying,” and warned that some of the human rights violations taking place may amount to crimes against humanity. Describing what he saw during a visit to Bangui, UN High Commissioner for Refugees António Guterres called it “a humanitarian catastrophe of unspeakable proportions.”