People with albinism living in Malawi have been the victims of a surge of attacks by people seeking to use their body parts in ritual practices.

According to an Amnesty International report released on Tuesday, at least 18 people with albinism have been killed since November 2014. A spike in the killings came this April, when four people, including a 2-year-old child, were killed.

Amnesty International is now calling on authorities in the Southern African country to take more action to punish the perpetrators.

“The unprecedented wave of brutal attacks against people with albinism has created a climate of terror for this vulnerable group and their families who are living in a state of constant fear for their lives,” Deprose Muchena, Amnesty International’s director for Southern Africa, said in a statement. “The time has come for the government of Malawi to stop burying its head in the sand and pretending that this problem will just go away. Talking will not end these attacks. Concrete action is urgently required.”

The country has up to 10,000 people living with albinism and Malawi’s Police Service says more than 60 crimes related to albinos have been reported since 2014.