Heavy fighting near numerous South Sudanese towns and refugee camps displaced hundreds of civilians, many for the second time, aid organization World Vision said on hursday.

The country’s second city, Malakal, had been completely razed and plundered, according to World Vision staff member Katharina Witkowski.

“Malakal is a ghost town today. People were shot in their hospital beds, and you see human skeletons lying all over the town,” said Witkowski.

The start of the rainy season in about two weeks’ time could cause flooding and an outbreak of waterborn illnesses, World Vision warned, especially since many refugee camps were now overcrowded.

Earlier this week, the United Nations said South Sudan was at risk of famine.

An armed conflict in the world’s youngest nation that has left thousands dead and displaced more than 700,000 people since a power struggle between President Salva Kiir and his former deputy Riek Machar turned violent in mid—December.

A further 123,400 have fled to neighbouring countries including Uganda, Kenya, Sudan and Ethiopia.

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