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The Russian president appeared before the cameras on Monday night with bloodshot eyes and a grave decision to make. Armed gangs were slaughtering the Uzbek community in the south of Kyrgyzstan — a region that Russia still considers part of its geopolitical backyard — and the interim Kyrgyz government was pleading with Moscow to send in troops. Its leaders said that many of the ethnic Kyrgyz soldiers were refusing to shoot at their own people, allowing the marauders to systematically kill Uzbeks and burn their homes. But President Dmitry Medvedev has refused to intervene. Russia's cherished claim to being the big brother in the former Soviet Union is badly tarnished, and experts say that the nation's other allies could now start questioning the point of their relationship with Moscow.

For the hundreds of thousands of Uzbek refugees who have fled the violence, Russia's inaction is little short of betrayal. "The people are screaming for someone to help them," Felix Kulov, the former prime minister of Kyrgyzstan, told reporters by phone from Bishkek on Wednesday. "They are scared to return home and try to rebuild, because it's impossible to know who will attack them and whether the police will protect them. We need outside peacekeepers, and only the Russians make sense for this crisis." If neighboring Central Asian countries sent in peacekeepers, he added, the troops would likely take sides in the ethnic clashes, while western forces wouldn't be much help because they have no experience in the area and don't know the language.

The hope that Russia might intervene stems from the precedent of 1990, when Moscow sent in troops to the same area in Kyrgyzstan to stop clashes between the Kyrgyz and Uzbeks that cost 300 lives. That was in the final years of the Soviet Union, when Kyrgyzstan was still one of Russia's vassal states. Recently, however, Russia has been struggling to regain some of the influence it lost after the Soviet collapse. To this end, it created the Collective Security Treaty Organization (CSTO) in 2002, a military alliance of seven ex-Soviet countries, including Kyrgyzstan. In 2005, the organization even created a rapid-reaction force, which is funded and equipped almost entirely by Russia to deal with sudden flare-ups of violence and natural disasters. And, yet, Russia and the other CSTO members are reluctant to send their troops into the fray.

"Now we see the main problem with this force — the political squeamishness of the CSTO's leadership, meaning above all Russia," says retired General Leonid Ivashov, former head of foreign military cooperation at Russia's defense ministry. "[Russia] has shown indecision, wavering at an absolutely critical time, when urgent action is needed to save lives and restore order," he tells TIME. The Kremlin did not even respond to the violence — which began on June 10 — until Saturday, when around 80 people had already been killed and two Kyrgyz cities were in flames. Then it announced through a spokeswoman that the killings were an internal Kyrgyz matter and that Russia "saw no conditions for taking part in its resolution."

Medvedev did call an urgent meeting of the CSTO to discuss a joint aid mission, but by the time he learned of its outcome in a televised briefing on Monday night, the situation had grown much worse. The official death toll had reached almost 150, and the threat of a cross-border conflict was growing as tens of thousands of refugees fled to Uzbekistan, where there is a large Kyrgyz minority. "This situation is intolerable," Medvedev told the officials who had come to propose an aid package. "People have died, blood is still being spilled, and there is mass unrest of an ethnic nature, which is extremely dangerous in Central Asia. So we need to take absolutely all measures to stop these kinds of actions, measures that are in line with the law but tough."

He took a long pause before giving his orders, which turned out to be not so tough. He said the members of the CSTO should vote on whether to send humanitarian aid and military equipment, such as helicopters and personnel carriers. "If the situation gets worse, I don't exclude the possibility of having the CSTO meet again to draft new proposals…or even calling a meeting of the heads of state of the CSTO," Medvedev said. No mention of sending in troops was made and the leaders of the CSTO member states are still considering the President's proposal to vote.

Reached by TIME on Wednesday, CSTO spokesman Vladimir Zaynetdinov brushed off claims that Kyrgyzstan, as a member of the alliance, deserved to get a peacekeeping mission when its country was on the brink of civil war. "Our actions do not violate our charter or any of our other agreements," he said. He declined to comment on how quickly the members would be able to vote to approve the aid package, or whether the alliance would finally intervene if the clashes spilled over into Uzbekistan: "Let's not talk about hypotheticals. For now we are waiting."

But the international community is getting impatient. The Obama Administration's top Central Asian diplomat, Robert Blake, will be traveling to Kyrgyzstan on Friday to assess the need for assistance. Meanwhile, the death toll continues to climb, reaching 187 on Wednesday, according to the Kyrgyz Health Ministry. The Red Cross insists the number of dead is much higher, and the United Nations refugee agency says around 275,000 people have already fled the violence.

So what is holding Russia and the CSTO back? Some analysts believe the young military alliance is just not ready to take on its first international peacekeeping mission, and in any case, Russia knows it would have to foot the bill and provide most of the troops. An intervention could also be hugely unpopular for Russia at home, as it risks getting the military enmeshed in protracted conflict. An online survey conducted on Monday by the Ekho Moskvy radio station suggested that vast majority of Russians want to keep their troops out of Kyrgyzstan. But for Russia's traditional partners in the region, this crisis could be a rude awakening. It suggests that Russia is happy to buy up oil and gas from Central Asia, or team up on issues of mutual benefit. But when things go wrong, its neighbors are on their own.

• Simon Shuster / Moscow
• As ethnic clashes rage on in Kyrgyzstan, and the death tolls continues to rise, international eyes are turning to Russia and asking why it won't send in troops to stop the massacre of the area's Uzbek community