SMOKE was still rising from a roadside shop and from the burned out cars in the hospital yard. In a ward lay two wounded men, one of them motionless on the mattress.
The hospital doctor led the way to the morgue. Inside, the bodies of four men had been placed on stretchers one had a bullet wound to his temple. In a neighbouring room were the bodies of a family of eight. The arms of a baby and a child were intertwined with those of a woman. These people 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. At the moment we're waiting for more bodies to arrive. I heard one or two more families were also massacred."
The attack on Makamba, in southern Burundi, was made by one of a number of Hutu militias which have been terrorising the region since the middle of last month.
The family in the morgue was from the minority Tutsi ethnic group, though the locals said some of the dead were Hutus. Why Makamba's garrison had not fought back is unclear.
"After the attack they went off into the mountains", said the governor, Mr Jean Baptiste Gahimbari. "What are we to do now? 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. At a guess they numbered about 1,500 people men in silent groups and women with bewildered children at their sides.
The townspeople stared back at the governor, waiting for him to tell them what to do next. Most had suitcases or packed bundles of clothes by their sides.
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 the area, regarded as the heartland of the Tutsi dominated army.
The capital, Bujumbura, now all but "cleansed" of Hutus, has been quiet of late. The countryside, however, is more insecure than ever.
Two and a half years after the outbreak of fighting, the conflict shows no signs of resolution. Indeed, the rebels seem better organised than before.
Chief among the Hutu extremist groups is the Force for the Defence of Democracy, the armed wing of the National Committee for the Defence of Democracy which is led by former Interior Minister, Mr Leonard Nyangoma, an exile in Zaire.
The government, a fragile coalition of parties headed by the largely Hutu, Frodebu and the largely Tutsi Uprona, appears paralysed by the escalating violence.
There is mounting international pressure on the government to enter into dialogue with the extremist factions. But for the moment, Uprona remains resolutely opposed to talking to Mr Nyangoma and other Hutu hardliners. Without their participation, there seems little hope that the much trumpeted National Debate, due to begin in July, will be anything but a forum for empty words.