They came in the middle of the night with little warning. A gang of youths armed with bush knives, machetes and metal rods stormed the entrance to Vunapope Hospital in Papua New Guinea's East New Britain.
Under the cover of darkness, they quickly overpowered the few guards at the Rabaul hospital, before charging into the emergency department and rampaging into the outpatients' ward.
There, they shouted and intimidated, marching from bed-to-bed, searching for members of a rival clan. Patients and the few night watch nurses were terrified, said Felix Diaku, the hospital's director of medical services.
A tribal fight had yet again spilled into the hospital. It wasn't until nearby residents rallied and chased them out that calm was restored, Dr Diaku said.
"I think it was the prompt response from those close by that stopped them from causing further damage or harm to anyone," he added.
But for the hospital's staff, it was the final straw.
Most of Vunapope Hospital was closed last week. Its staff protesting the rampage, one of several in the past year, but also a string of thefts and acts of vandalism that has seen the hospital lose vital equipment and much-needed medicine.
"This was a threat to those providing a service, our patients and our staff," said Dr Diaku in an interview. "So we decided to close down."
There was still a skeleton staff and a limited range of clinical consultations during the day, Dr Diaku said, but the staff wanted to send a message that would finally prompt the provincial authorities to act to ensure their safety.
When the hospital encountered thefts or rampages previously, Dr Diaku said it was hard to get a police response. They would show up but there would be little in the way of investigation. On some occasions, there would be an arrest, but the suspect - despite clear evidence - would later be released without charge.
The hospital would get a few days of community support, "then nothing would happen afterwards," he said. "The suspects would just be released again."
Then the thefts got more brazen. Medical equipment, furniture, and medicines were all stolen in targeted attacks which "absolutely" affected patient safety, Dr Diaku said.
"When drugs are stolen, or equipment is stolen, it's becoming difficult to obtain those supplies again," he said.
"Those common drugs we give always run out frequently so when they get stolen it's a bit difficult."
His staff provided a vital service, he said, and it was outrageous that they were not being afforded proper protection.
"This time, we're shut down until things are done," he said.
Were things being done? Dr Diaku said the shutdown may just be working. He had already had meetings with police chiefs and provincial officials about what could be done to improve things.
Three arrests had been made in relation to the rampage of a fortnight ago. But Dr Diaku said the hospital wouldn't reopen until charges are laid and until there were concrete assurances that things would change.
In the meantime, there was one silver lining. "We've used the shutdown to do some vital renovations," he added.