In November 2012, the UN Refugee Agency (UNHCR) spoke of a "forgotten crisis." More than 400,000 people in Mali were fleeing even then. Around half of them sought shelter within the country, while the other half had already crossed the borders to neighboring nations like Mauretania, Niger, and Burkina Faso.

But the story did not make the news. The world's media was concerned with other conflict zones at the time, and the humanitarian crisis in one of the world's poorest countries hardly registered.

Center stage

That all changed with France's military deployment in Mali earlier this month. "Since the military intervention by the French forces on January 11, about 18,000 refugees have fled Mali," said UNHCR spokesman William Spindler, who has been observing the situation from the Malian capital Bamako for a week.

But UN workers are not allowed to travel freely in the country - in the past few days, they have finally been allowed into the towns of Segou and Mopti, north of the capital, but northern Mali remains out of bounds.

"The situation in the north of Mali is critical," said Spindler. "There is not enough food for people. We have heard that the markets are empty, because the roads have been cut by the conflict. And the border with Algeria, from where some of the products come, is closed. So markets have been looted, electricity services have been disrupted, there is no public transport, and telephone lines have also been cut."

Refugees who make it to southern Mali might have reached safety, but their situation is still dire. There are no central camps for them to stay in - the refugees simply scatter across Bamako, looking for shelter with relatives, or they sleep inside mosques.

Traumatized

The non-governmental organization Doctors of the World, which has been present in Mali for several years, is providing medical care where it can. It is one of the few NGOs still active in the north of the country, but the refugees have significantly affected its work.

"We have to treat a lot more people," said Andreas Schultz, director of Doctors of the World Germany. "The malnutrition, particularly among children, has got worse. The refugees are exhausted and dehydrated, they have sores on their feet from the long marches. Many are traumatized by what they have seen and experienced."

Overburdened neighbors

Camps have been set up in Mali's neighboring countries, which have already taken in tens of thousands. According to the UNHCR, most have fled to Mauretania, Burkina Faso and Niger. "A lot of refugees have settled just beyond the border," said Spindler. "But since we see a danger that the conflict could spread into neighboring countries, we're trying to bring the people away from the borders, further into the interiors."

He also fears that those countries will become overstretched by the flood of refugees. "The countries in the region are all suffering under an extreme drought," he said. "They are not stable states, and if they don't get a lot more help, there will be a further destabilization in these countries too." As far as the UNCHR is concerned, an investment of money and action now would have a pre-emptive benefit for the security situation - and might even avert the necessity of a further military operation.