The execution of scores of hospital patients in the midst of South Sudan's violent civil war is the worst to be seen in decades and is an "affront to human dignity," Doctors Without Borders said Tuesday. The world's youngest country has witnessed thousands killed since the raging conflict began in mid-December.

Four hospitals have seen 58 people get killed on the grounds over the last six months, Agence France-Presse reported. "The conflict has at times seen horrific levels of violence, including against healthcare facilities," said Raphael Gorgeu, South Sudan chief for Doctors Without Borders (Medecins Sans Frontieres, MSF). "Patients have been shot in their beds, and lifesaving medical facilities have been burned and effectively destroyed. These attacks have far-reaching consequences for hundreds of thousands of people who are cut off from medical services."

"The violence carried out against the wounded and sick, and against those seeking shelter in hospitals and against medical facilities themselves, are not only violations of international laws and humanitarian principles, but an affront to human dignity," MSF said in a report that examined the situation over the last six months.

South Sudan was plunged into violence in December when President Salva Kiir accused former Vice President Riek Machar of attempting a coup. Thousands have died and more than 1.5 million people have fled their homes since the conflict erupted, often pitting Kiir's Dinka tribe against Machar's Nuer community.

MSF, which has earned a reputation for working in some of toughest war zone conditions across the world, claimed the situation was even worse than the two decades long war that paved the way for South Sudan's independence from Sudan three years ago. "Throughout its 30-year history in the country, MSF -- as well as other humanitarian organizations and healthcare providers -- has repeatedly witnessed violence against staff, patients, vehicles, compounds and healthcare facilities," MSF said. "What has been particularly alarming in the current conflict, however, has been the scale and breadth of the violence."

If fighting between forces of Kiir and troops loyal to rebel chief Macharhas continues, aid agencies warned that the world's youngest nation might be pushed to the brink of famine, in addition to the spread of cholera.

On June 10, Kiir and Machar agreed to forge a transitional government within 60 days and committed themselves to a third ceasefire deal. However, the crisis continues until then.