At least seven people have been killed and another 20 injured in an attack on a town in South Sudan, the medical charity Doctors Without Borders, known by its French initials MSF, has said, as fears grow that the world’s youngest nation will relapse into all-out civil war.

MSF said on Saturday that the attack destroyed the last remaining functioning hospital and pharmacy in Old Fangak in the north of the country.

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MSF urged in an X post: “Stop the bombing. Protect civilians. Protect healthcare” and said the attack was “a clear violation of international law.”

It was not immediately clear why the facility was targeted. A spokesperson for South Sudan’s military could not be reached for comment, according to The Associated Press news agency.

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Additional strikes occurred hours later near a market in Old Fangak, causing widespread panic and displacement of civilians, according to several witnesses.

Tensions between forces allied with President Salva Kiir and those of First Vice President Riek Machar have boiled over.

Old Fangak is one of several major towns in Fangak county, an ethnically Nuer part of the country that has been historically associated with the opposition party loyal to Machar, who is now under house arrest for alleged subversion.

The United Nations has warned in recent weeks that South Sudan is on the brink of a renewed civil war as violence between rival factions escalates.

South Sudan fell into a bloody civil war soon after gaining independence in 2011, as forces aligned with Kiir, an ethnic Dinka, fought those loyal to Machar, an ethnic Nuer.

The conflict killed more than 40,000 people before a 2018 peace deal saw the pair form a government of national unity.

The hospital attack is the latest escalation in a government-led assault on opposition groups across the country. Since March, government troops backed by soldiers from Uganda have conducted dozens of air strikes targeting areas in neighbouring Upper Nile State.

Multiple Western embassies, including the US, said in a statement Friday that the political and security situation in South Sudan has “markedly worsened” in recent days.

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The embassies urged Kiir to free Machar from house arrest, and called for a “return to dialogue urgently aimed at achieving a political solution”.

An election, which was supposed to be held in 2023, has already been postponed twice and is now not scheduled until 2026.