Smoke was still rising from the embers of a roadside shop and from the burned-out cars in the hospital yard. In a ward lay two wounded men, one of them motionless and bloody on the mattress.
The grim-faced hospital doctor led the way to the morgue. Inside, the bodies of four men had been placed on stretchers. One had a bullet wound on his temple. Lying on the floor of a neighbouring room were the bodies of a family of eight. The arms of a baby and a child were intertwined with a woman. They had been shot and slashed to death with machetes.
"The man with the bullet through his head is our anaesthetist", said Dr Hilaire Ninteretse. "When the rebels came they went to his home, asked his wife to leave, then executed him. We're waiting for more bodies to arrive. I heard one or two more families were also massacred".
The attack on Makamba, a town in southern Burundi, came at dawn on Wednesday. It was made - of this there is no doubt among the populace - by one of the Hutu militias which have terrorised the region since the middle of last month.
In addition to attacking the hospital and looting the pharmacy, the guerrillas vandalised the governor's office and municipal buildings. The family in the morgue was from the minority Tutsi group, though locals said some of the dead were Hutus. Why Makamba's garrison had not fought back is unclear. Perhaps they were afraid. It was rumoured the rebels had been heard singing in the hills before swooping on the town.
"After the attack they went off into the mountains," said the governor, Jean-Baptiste Gahimbari, pointing at the hills to the east. "My position is very difficult. The politicians come down here talking of pacification and all sorts of things. But when there's an attack they're nowhere to be seen."
The governor looked helplessly at the vast crowd which had gathered at the crossroads. There were about 1,500 men in silent groups and women with bewildered children.
An armoured car and trucks full of soldiers raced past on the road. The townspeople stared back at the governor, waiting for him to tell them what to do. Most had suitcases or hastily packed bundles of clothes. Some carried mattresses.
This week's raid on Makamba is part of a series of attacks launched by the so called bandes armees, Hutu rebels, in southern Burundi over recent weeks. The incidents mark a significant escalation of the insurgency, which hitherto was confined mainly to the northern half of the country. They demonstrate the growing ability of the Hutu militias to strike at will and push deep into areas regarded as the heartland of the Tutsi-led army.
The capital, Bujumbura, now all but "cleansed" of Hutus, is quiet, although it may only be a matter of time before the rebels fire rockets from the surrounding hills. The countryside is more insecure than ever, with many roads off- limits to all but the army.
The hills around Makamba are filled with displaced people. Some have fled the marauding Hutu rebels, others the military, whose campaign against the insurgents is often indiscriminate in its ferocity.
Two and a half years after the outbreak of fighting triggered by the assassination of Burundi's first elected Hutu president, the conflict shows no signs of resolution. The rebels seem better organised than before. Chief among the Hutu extremist groups is the Force for the Defence of Democracy, led by a former interior minister, Leonard Nyangoma, an exile in Zaire.
The government, a fragile coalition of parties headed by the mostly Hutu Frodebu and the mostly Tutsi Uprona, appears paralysed. There is little common ground between Uprona and Frodebu,diplomats say. Hope that the moderates can hold their own is fading.
There is growing international pressure on the government to talk to the extremist factions. But Uprona is against talking to Nyangoma and other Hutu hardline groups. Many fear Burundi could suffer the same fate as Rwanda, where genocide broke out two years ago this weekend.Reuse content