At least 381 civilians have been killed by Islamist terror group Boko Haram in the past five months in Nigeria and Cameroon, an international human rights watchdog said on Tuesday.

In a report, Amnesty International attributed the rise in the death toll to a spike in suicide bombings, mostly carried out by women and girls, in northeastern Nigeria as well as northern Cameroon, Efe news agency reported.

“Boko Haram is once again committing war crimes on a huge scale, exemplified by the depravity of forcing young girls to carry explosives with the sole intention of killing as many people as they possibly can,” said Alioune Tine, AI’s West and Central Africa Director.

Boko Haram’s attacks in Nigeria have caused the death of at least 223 civilians since April, while the death toll in August alone has reached 100.

“This wave of shocking Boko Haram violence… highlights the urgent need for protection and assistance for millions of civilians in the Lake Chad region,” Tine added.

Tine stressed that the governments of Nigeria and Cameroon “must take swift action to protect” these people.

Millions of civilians are in need of urgent humanitarian aid due to the current situation in the Lake Chad region, where at least 2.3 million people have been displaced.

More than seven million people across Lake Chad, including five million in Nigeria and 1.5 million in Cameroon, suffer a severe shortage of food.

Amnesty added that the recent increase in insecurity had made humanitarian operations “difficult, or even impossible”, leaving areas like northeastern Nigeria totally inaccessible.