PHOTO ESSAY: Refugees flee Mali as region is the world's deadliest for extremism

DOUANKARA, Mauritania (AP) — A makeshift village in the Mauritanian desert shelters thousands of refugees who have fled Mali in recent weeks as fighting intensifies against militants linked to al-Qaida.

Strips of fabric tied between sticks serve as homes. Tree branches double as storage. Many people fled without their livestock, the source of their livelihoods. There is little protection from the Sahel’s punishing heat and wind. Still, refugees say it is safer than Mali.

The Associated Press obtained rare access to the border area, where refugees said they were caught between combatants in what has become the world’s deadliest region for extremist violence, according to the Global Terrorism Index.

Some refugees described alleged abuses by the newest actor in the conflict, a Russian military unit named Africa Corps that replaced the Wagner mercenary group six months ago. They said they witnessed beheadings, burnings and other abuses by the unit that is under Moscow’s direct command.

The military governments of Mali, Burkina Faso and Niger have turned to Russia for counterterrorism support after pushing away traditional allies including the United States and France.

Russia’s Defense Ministry did not respond to AP questions.

But the danger isn't just from Africa Corps. Refugees, aid workers and analysts say Mali's army and militants also commit abuses against civilians. The world sees little of this as access to the country becomes more difficult for journalists, watchdogs and others.

In a clinic near the border, the family of a 14-year-old girl described her rape by the “white men” in an attack that left her so near death and traumatized that she remembers nothing of it. Like others, they spoke on condition of anonymity for fear of retaliation.

A woman in one tent held a photo of her late daughter. Armed men had stormed their village, killing men, looting homes and shooting at those trying to flee. At the sound of gunshots, the 18-year-old daughter had a seizure.

What happened next, the woman said, “stays between God and me.”

This is a documentary photo story curated by AP photo editors.

A donkey stands in the makeshift refugee camp near Douankara, Hodh El Chargui Region, Mauritania, on the border with Mali, Nov. 6, 2025. (AP Photo/Caitlin Kelly)

A man, whose shop was destroyed when Africa Corps burned his village in the Mopti region of Mali, poses on his motorcycle in Douankara, Hodh El Chargui Region, Mauritania, Nov. 7, 2025. (AP Photo/Caitlin Kelly)

Cooking pots are hung from a wooden post in the makeshift refugee camp near Douankara, Hodh El Chargui Region, Mauritania, on the border with Mali, Nov. 6, 2025. (AP Photo/Caitlin Kelly)

A woman from Mali carries her belongings in a makeshift refugee camp near Douankara, in the Hodh El Chargui Region, Mauritania, Nov. 6, 2025. (AP Photo/Caitlin Kelly)

Afay, a Malian refugee, shows pictures of her burned village after Africa Corps razed the marketplace to the ground, from Douankara, Hodh El Chargui Region, Mauritania, Nov. 7, 2025. (AP Photo/Caitlin Kelly)

Bakary Bah sits for a portrait in the Mbera Camp, Mauritania, Nov. 4, 2025, after fleeing Mali in 2023, when multiple people, including his brother, where killed in his village. (AP Photo/Caitlin Kelly)

Herders move their livestock through Mbera Refugee Camp, Mauritania, Nov. 3, 2025. (AP Photo/Caitlin Kelly)

People who fled violence in Mali stand in front of the Bassikounou hospital in the Hodh El Chargui Region, where they found refuge in Mauritania, Nov. 7, 2025. (AP Photo/Caitlin Kelly)

A young Malian woman is treated for her dangerously high fever and infection by doctors at the Douankara health clinic in the Hodh El Chargui Region, Mauritania, Nov. 7, 2025. (AP Photo/Caitlin Kelly)

The mother of a young Malian woman, treated for her dangerously high fever and infection, cries at the Douankara health clinic in the Hodh El Chargui Region, Mauritania, Nov. 7, 2025. (AP Photo/Caitlin Kelly)

A mother holds the hand of her daughter, which has not unclenched in the eight months since fleeing mercenaries in Mali and finding refuge in Douankara, Hodh El Chargui Region, Mauritania, Nov. 8, 2025. (AP Photo/Caitlin Kelly)

A Fulani woman who fled violence in Mali and found refuge in Fassala, Hodh El Chargui Region, Mauritania, sits in the camp, Nov. 9, 2025. (AP Photo/Caitlin Kelly)

Nurse Mohamed Ag Tidaba holds a malnourished baby from Mali at the health clinic in Douankara, Hodh El Chargui Region, Mauritania, Nov. 7, 2025. (AP Photo/Caitlin Kelly)

Fatma holds a photo of her daughter, who died when they fled their village, in Mali in Douankara, Hodh El Chargui Region, Mauritania where they found refuge, Nov. 6, 2025. (AP Photo/Caitlin Kelly)

Donkeys walk past a tent occupied by two women who were attacked and assaulted by Africa Corps in Mali in Douankara, Hodh El Chargui Region, Mauritania, Nov. 6, 2025. (AP Photo/Caitlin Kelly)

Moyme, who fled Mali in fear of the Malian Army and its Russian allies, poses for a portrait in the Mbera camp, Mauritania, where she found refuge, Nov. 4, 2025. (AP Photo/Caitlin Kelly)

PRAIA, Cape Verde (AP) — Three patients with suspected hantavirus infections were being evacuated from a cruise ship to the Netherlands on Wednesday, the U.N. health agency said, as the vessel at the center of a deadly outbreak remained off Cape Verde with nearly 150 people on board waiting to head to Spain’s Canary Islands.

Associated Press footage showed health workers in protective gear heading to the ship for the evacuation that included the ship's British doctor, who Spain's health ministry said had been in “serious condition” but has improved. An air ambulance later departed.

Three people have died, and one body remained on the ship, the World Health Organization said. Eight cases have been recorded in all, three of them confirmed by laboratory testing. Hantavirus usually spreads by inhaling contaminated rodent droppings and can spread person-to-person, though the WHO calls that rare.

Contact tracing had begun on two continents, Europe and Africa, in search of infections around people who earlier left the ship, which departed over a month ago from South America for stops in Antarctica and several remote Atlantic islands.

Two Argentine officials investigating the origins of the outbreak said the government's leading hypothesis is that a Dutch couple contracted the virus while bird-watching in the city of Ushuaia before boarding.

They said the couple visited a landfill during the tour and may have been exposed to rodents. The officials spoke on condition of anonymity because they were not authorized to brief the media, with the investigation ongoing. Authorities previously said Ushuaia and surrounding Tierra del Fuego province had never recorded a hantavirus case.

The Dutch foreign ministry said the three people evacuated were a 41-year-old Dutch national, a 56-year-old British national and a 65-year-old German national who would be "immediately transferred to specialized hospitals in Europe.” A Dutch hospital confirmed it would take one. German authorities were preparing for a second.

Two remain in "serious condition," Dutch ship operator Oceanwide Expeditions said, and the third had no symptoms but was “closely associated” with a German passenger who died on the MV Hondius ship on May 2.

Health officials said passengers and crew members still on the ship are without symptoms; the WHO said passengers represent 23 nationalities. Their journey to the Canary Islands will take three or four days, Spain’s health ministry said, adding that the arrival “won´t represent any risk for the public."

Meanwhile, authorities said testing in Switzerland, South Africa and Senegal had shown positive for the Andes strain of the virus. The WHO says the species of hantavirus is found in South America, primarily in Argentina and Chile, and can spread between people, though that’s rare and only through close contact.

The World Health Organization’s top epidemic expert told The Associated Press the risk to the public is low, and the Andes variant is known even if WHO has never seen a hantavirus outbreak on a ship.

“This is not the next Covid, but it is a serious infectious disease,” Maria Van Kerkhove said. “Most people will never be exposed to this.”

For those on the ship, access to clinical care is important, she said, because infected people can develop severe acute respiratory distress and need oxygen or mechanical ventilation. The hantavirus incubation period can be one to six weeks, or more, she said.

The ship left Argentina on April 1. The WHO has said the itinerary included stops across the South Atlantic, including mainland Antarctica and the remote islands of South Georgia, Nightingale Island, Tristan da Cunha, St. Helena and Ascension.

The ship is now in the Atlantic off West Africa's island nation of Cape Verde. The WHO said passengers were isolating in their cabins.

Two Dutch infectious diseases experts were joining the ship, Van Kerkhove said.

Spain’s health ministry said it would receive the ship in the Canary Islands after a request from the WHO and the European Center for Disease Prevention and Control. The Canary Islands regional president , Fernando Clavijo, said he worried about the risk to the population and demanded a meeting with Prime Minister Pedro Sánchez.

Authorities in Switzerland said a former passenger was being treated at a Zurich hospital after testing positive for the Andes strain. South African authorities earlier said two passengers who were transferred there tested positive for the strain. One, a British man, was in intensive care and the other collapsed and died in South Africa.

Swiss health office spokesperson Simon Ming said the patient there had left the ship during its St. Helena stop. It was not clear when or how he traveled to Switzerland.

The patient’s wife hasn’t shown symptoms but is self-isolating as a precaution, a statement by the office said.

“There is currently no risk to the Swiss public," the office said, while looking into whether the patient had come into contact with others.

At St. Helena, the body of the Dutch man suspected to be the first hantavirus case on board was taken off the ship. His wife flew to South Africa, where she collapsed at the Johannesburg airport and died.

Later, a British man was evacuated at Ascension Island and taken to South Africa.

The ship's operator has not said if other people left at those or other locations.

The South African health ministry says officials have traced 42 out of 62 people, including health workers, they believe had contact with the two infected passengers who traveled there. The 42 tested negative for hantavirus.

But 20 people still need to be traced, including five people who may have been on flights to South Africa with some of the passengers as well as flight crew members.

Some may have now traveled overseas, the ministry said.

DeBre reported from Buenos Aires and Keaten from Geneva. Chinedu Asadu in Abuja, Nigeria. Gerald Imray in Cape Town, South Africa; Mark Banchereau in Dakar, Senegal; Renata Brito and Joseph Wilson in Barcelona; Geir Moulson in Berlin; Mike Corder in The Hague, Netherlands and Michelle Gumede and Mogomotsi Magome in Johannesburg contributed to this report.

This version corrects to say the evacuated doctor is British.

An air ambulance takes off with evacuated patients from the MV Hondius cruise ship from the airport in Praia, Cape Verde, Wednesday, May 6, 2026. (AP Photo/Misper Apawu)

An air ambulance takes off with evacuated patients from the MV Hondius cruise ship from the airport in Praia, Cape Verde, Wednesday, May 6, 2026. (AP Photo/Misper Apawu)

The MV Hondius cruise ship is anchored at a port in Praia, Cape Verde, Wednesday, May 6, 2026. (AP Photo/Misper Apawu)

Health workers in protective gear evacuate patients from the MV Hondius cruise ship into an ambulance at a port in Praia, Cape Verde, Wednesday, May 6, 2026. (AP Photo/Misper Apawu)

Health workers in protective gear arrive to evacuate patients from the MV Hondius cruise ship at a port in Praia, Cape Verde, Wednesday, May 6, 2026. (AP Photo/Misper Apawu)

Health workers in protective gear evacuate patients from the MV Hondius cruise ship at a port in Praia, Cape Verde, Wednesday, May 6, 2026. (AP Photo/Misper Apawu)

Health workers in protective gear evacuate patients from the MV Hondius cruise ship at a port in Praia, Cape Verde, Wednesday, May 6, 2026. (AP Photo/Misper Apawu)

Health workers in protective gear evacuate patients from the MV Hondius cruise ship at a port in Praia, Cape Verde, Wednesday, May 6, 2026. (AP Photo/Misper Apawu)

Health workers in protective gear evacuate patients from the MV Hondius cruise ship at a port in Praia, Cape Verde, Wednesday, May 6, 2026. (AP Photo/Misper Apawu)

A night view of the MV Hondius cruise ship anchored at a port in Praia, Cape Verde, Tuesday, May 5, 2026. (AP Photo/Misper Apawu)

An aerial view of the MV Hondius Dutch cruise ship anchored in the Atlantic off Cape Verde, Tuesday, May 5, 2026. (AP Photo/Arilson Almeida)

An aerial view of the MV Hondius Dutch cruise ship anchored in the Atlantic off Cape Verde, Tuesday, May 5, 2026. (AP Photo/Arilson Almeida)