Liberia - Monrovia is again in a state of chaos. Three weeks ago heavy fighting broke out between LURD rebel forces and government militias, causing hundreds of deaths and thousands to flee into the centre of town with nowhere to run or hide. Since then people have been sheltering in the football stadium, high schools and - the lucky ones - in houses of relatives; many not daring to go back to their homes or to the camps for displaced people for fear of further violence. The health services, crippled by the fighting and looting of the last few weeks, have been desperately struggling to cope with war injuries, malnutrition and rapidly increasing cases of cholera. This morning I went with Tom Quinn, an MSF nurse, up to the camps for 'internally displaced people' (a phrase which serves as a euphemism by governments and international relief agencies for people forced from their homes by violent conflict). I had been there yesterday and talked to people about their experiences over the last years and heard a catalogue of horrific stories.

• Parents who, two weeks ago, had seen their 13 year old son die instantly when he was caught in the neck by a stray bullet as the family ran to flee the fighting.
• A young mother who had to leave her sick grandmother to die when the family tried to flee across a swamp and the old woman became stuck in the mud.
• A 26 year old who had been raped when she was 14, gang raped two years later, and raped again two days ago by militia whilst collecting firewood.
• A mother of eight children who fled an attack two weeks ago and has not seen five of her children since.

Ceasefire breaking point

When we arrived at the camps again this morning the atmosphere was tense with apprehension. People had heard shooting all through the night and were beginning to panic and pack up the few possessions they have left , ready to run. It seems that the ceasefire that was agreed upon only a week ago by the government and two rebel factions - LURD and MODEL - may be reaching breaking point.

As we drove back towards the centre of Monrovia we saw thousands more people removing the precious tarpaulin from their shelters and leaving their homes in the only direction possible: away from the sound of fighting. Little children carrying sacks on their heads heavier than their own skinny bodies, old women stumbling with mattresses along the roads, mothers carrying screaming children and bundles of food.

Many of these people originally fled their homes more than two years ago, when fighting between government and rebel troops forced them to leave their homes in the north and west of Liberia. Since they fled for the first time, they have repeatedly had to move between temporary camps, as the war front moved closer and closer towards Monrovia. As they fled, they had their possessions taken from them, their homes looted and their family members killed by violence or sickness.

Since a new front opened up in the east of Liberia in March, the same story is being repeated there too. It feels like almost everybody in the country is an "internally displaced person" at the moment. Nobody knows whether the information they get is rumour, the truth or propaganda. Nobody knows which direction to head in.

As we headed back through the centre of town there was a sense of panic on the streets. People were packing up their market stalls while open trucks with young heavily armed soldiers drove beeping through the streets in both directions. During the conflict two weeks ago, two of the MSF trucks were "requisitioned" by the fighters, so we were wary at checkpoints and whilst parked on the street. When we arrived back at the MSF compound, the staff who had been working in Redemption Hospital were there too.

The hospital only re-opened four days ago and everyone is frustrated that insecurity has meant that they had to leave once more. Redemption was just getting to the point of being up and running again - the therapeutic feeding centre for malnourished children was full, the emergency department was receiving lots of patients and drug supplies and medical equipment that had been looted after the conflict two weeks ago were being restocked.

MSF was running a temporary cholera unit at the back of the hospital and had just started readying a 50 bed cholera unit to open on Thursday. Now the whole hospital has had to close again and work on the much needed cholera unit will have to wait until things calm down. Luckily, the main cholera treatment unit on the other side of the city is still functioning. Over the last couple of days the number of cholera cases has been increasing very rapidly, mainly becasue so many people have been crammed together with poor water and sanitation for several weeks - and it is likely that the outbreak will only get worse during the next days.

Now MSF has decided to open a clinic inside the MSF compound, just as we had to do during the last round of fighting, and patients are being transferred from the hospital to here. The speed at which the living room is converted by national MSF staff into a hospital is astonishing. Sofas, tables and pictures are shifted upstairs whilst blankets, drips and consultation rooms are set up in their place. Only an hour after the furniture shifting begins, the first patients from the hospital begin to arrive.

The mood here is both somber and electric. People are exhausted by the conflict that has blighted them for 13 years and there is a terrible sense of history repeating itself as ceasefires that they had prayed would hold are broken time after time. Nobody knows whether the information they get is rumour, the truth or propaganda. Nobody knows which direction to head in. Yet people somehow still find the strength to continue with their lives and work, despite their missing and dead children, despite the fact that they have nowhere safe to go home to, despite the hunger and fear and destruction. They still laugh, they still sing, they still find the time to joke with me "Welcome to Liberia!"