Police opened fire on stone-throwing protesters in Burundi on Tuesday, a day before regional heads of state are due to meet to try to defuse the worst unrest the tiny east African country has seen in a decade.
At least 19 people have been killed and hundreds wounded in nearly three weeks of protests against plans by President Pierre Nkurunziza to extend his rule by a third term, a move that contravenes the terms of the country's peace deal as well as domestic constitutional limits.
Regional leaders and diplomats say the violence in the fragile, impoverished country, which emerged from ethnic civil war only 10 years ago, risks destabilising a volatile region where war, genocide and ethnic conflict have killed millions since the 1990s.
More than 50,000 people have already fled Burundi since April, according to the UN, most of them to neighbouring Rwanda and Tanzania. The African Union, South Africa and the US have all urged Mr Nkurunziza to step aside and possibly to delay polls to quell the violence. "The continued civil unrest in Burundi is not only a threat to the country's stability but the whole of the east African region," said Kenya's President Uhuru Kenyatta over the weekend. Burundi relies on aid for more than half its budget. Belgium has already suspended some aid and the EU is considering whether to withhold some election aid.
Since Mr Nkurunziza announced his attention to seek re-election on April 25, police have repeatedly opened fire on protests banned by the government, which has also tried to block social media and radio broadcasts. Human rights workers say some protesters' homes have been daubed in red paint, potentially earmarking them for violence.
Insiders say regional leaders are expected to deliver an unprecedented blunt warning to Mr Nkurunziza on Wednesday at their meeting in Tanzania, urging him to "get a grip" on violence or step aside, according to a person familiar with the discussions.
The situation is complicated by the fact several presidents in the region, including the Democratic Republic of Congo's Joseph Kabila and Rwanda's Paul Kagame, also appear to be considering running for a third term. "All the neighbours were quite careful at first because they all have their own baggage on third terms," said a senior western diplomat, adding they have since hardened their line amid fears of regional conflict.
Burundi is still recovering from an ethnic-based civil war that pitted Hutus against Tutsis, an ethnic mix similar to that in neighbouring Rwanda, where genocide by Hutu extremists killed close to 1m Tutsi and Hutu sympathisers in 1994. Mr Nkurunziza is an ethnic Hutu and former rebel fighter who leads a government constituting both Hutus and Tutsis, in line with the provisions of a power-sharing peace deal. The current clashes are not divided on ethnic lines.
"At the moment this is an argument mostly between Hutu power elites, including within the ruling party...But Tanzania and Rwanda are now really worried there will be a real breakdown and it terrifies them that it could reignite those old ethnic divisions and they want to try to get a grip on refugee flow," said the diplomat.
John Kerry, US secretary of state, said last week the US was "deeply concerned" by Mr Nkurunziza's decision to stand again. Mr Nkurunziza has secured court backing for his decision but this has not appeased the opposition.
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