Sheltering from sectarian violence: thousands flee in Central African Republic – in pictures

Tens of thousands of people have fled in a new wave of attacks and ruthless killings by armed groups and government forces in the north-west of Central African Republic Photograph: Juan Carlos Tomasi/MSF

A child inside temporary accommodation in Bossangoa. More than 30,000 people have taken refuge in locations including the Catholic mission, schools and airstrip Photograph: Juan Carlos Tomasi/MSF

Women and children cook at a camp in Bossangoa. Religious divisions have motivated many attacks, including the execution by armed men of eight people who became separated from a larger group as they fled by truck, and the targeted killing of two men in a village, which caused many others of the same religion to take flight Photograph: Juan Carlos Tomasi/MSF

A boy reads at a camp in Bouca, where about 300 people have taken refuge in a Catholic compound after houses in their village were burned down Photograph: Juan Carlos Tomasi/MSF

People take shelter in Bouca. The sudden escalation of sectarian violence has heightened the prevailing atmosphere of fear within the displaced communities Photograph: Juan Carlos Tomasi/MSF

Children rest at their camp in Bossongoa. Médecins sans Frontières is worried about the high number of displaced people living in the bush without access to healthcare. 'People have no shelter and they sleep wherever they can, inside the church, school or under trees. It is crowded and people cook, eat, sleep, wash and defecate in the same area. Under these disastrous hygienic conditions, the risk of disease outbreaks is high,' says Ellen Van der Velden, MSF head of mission in Central African Republic Photograph: Juan Carlos Tomasi/MSF

Displaced people rest at a camp in Bouca. Central African Republic was engulfed by war from 2004 to 2007, and violence broke out again in December 2012. In March 2013, Séléka rebels ousted the president and installed their own leader Photograph: Juan Carlos Tomasi/MSF

The Séléka alliance has since been officially disbanded, but its members have continued their campaign of looting, torture and rape, creating a climate of fear and violence. Many people have fled into the bush or gathered in large groups to seek safety Photograph: Juan Carlos Tomasi/MSF

Central African Republic borders the Democratic Republic of the Congo, Cameroon, Chad, Sudan, and South Sudan. The UN estimates that 260,000 people of the 4.6 million-strong population were internally displaced as of September Photograph: Juan Carlos Tomasi/MSF

'In the last month, we have treated more than 60 people in Bossangoa for injuries that are the result of violence – largely gunshot and machete wounds – including women and children,' said MSF surgeon Erna Rijinierse, above. 'More than 80% of surgeries have been for wounds that are conflict-related. MSF is horrified by what we are seeing, including burnt villages and appalling scenes of murder. Those who are fleeing are in desperate need of assistance, as well as the sense of protection that the presence of aid agencies brings' Photograph: Juan Carlos Tomasi/MSF