At least 22 people, mainly civilians, were killed in clashes between mainly Muslim rebels and Christian militia in the Central African Republic earlier this week, the local Red Cross said on Wednesday.
The clashes took place on Monday in Grimari, about 300 km (190 miles) northeast of Bangui, and coincide with a push into the interior by French and African forces struggling to contain violence that experts warn has pushed the country to the verge of genocide.
"There are 22 dead, four of whom were women killed by stray bullets," Michel Sefionam, head of Grimari's medical centre and a member of the local Red Cross, told Reuters by telephone.
Violence between Muslims and Christian simmers despite the deployment of 2,000 French and over 5,000 African peacekeepers, and international pressure which forced Seleka rebels to abandon the capital they seized in a rebellion last year.
Abuses during Seleka's nine-month rule triggered reprisal killings by local militia. The cycles of violence have forced nearly a million people from their homes and raised the prospect that the country could be split in two as Seleka retreat north.
"There were five Seleka and two 'anti-balaka' killed. Most of the (other) people killed were civilians," Sefionam said of the violence in Grimari.
There were conflicting versions of both the origins and the outcome of the fighting in Grimari.
Sefionam said most of the town's population had fled into the bush or were sheltering in the Catholic mission, leaving some French soldiers and a handful of Seleka fighters in the streets.
Wendy Rappeport, a spokeswoman for the Africa office at the U.N. Refugee Agency, UNHCR, said anti-balaka forces appeared to have taken the town from Seleka.
Captain Ahmat Nidjad Ibrahim, a senior Seleka officer in the region, said his forces had killed 95 enemy fighters and lost one in clashes since April 11.
Ibrahim said anti-balaka fighters had attacked Seleka positions in the town as French troops approached.
A French defence ministry spokesman said French troops had reported worsening tensions between Seleka and anti-balaka fighters in Grimari but he was not able to confirm any toll.
"What we are trying to do is to contain the violence," he said.
Paris rushed troops to its former colony last December as an African peacekeeping mission failed to prevent violence from spiralling out of control and anti-balaka fighters mounted an assault on Bangui in a bid to oust Seleka from power.
French troops were meant to quickly secure the capital and then move up-country but Paris has admitted it underestimated the levels of violence it would face.
Complicating matters, Chadian troops, at the heart of the African peacekeeping force, have left the country after being accused of abuses and siding with Seleka.
The United Nations Security Council last week authorized the creation of a nearly 12,000-strong U.N. peacekeeping force in the Central African Republic in a bid to end the violence, although it is not due to be deployed until mid-September.
In the meantime, as the weak transitional government fails to prevent a de-facto split between a Christian south and a Muslim north, many are frustrated at the inability of foreign troops to restore order.
"We wonder what the (French) have really come to do here and why they did not intervene?" Sefionam, the health worker, asked.