Thousands of people fleeing Sri Lanka's war zone are arriving at hospitals with horrific injuries and severe trauma, doctors say.
Aid workers are also warning there could be a "bloodbath" as the war between the government and Tamil Tiger rebels enters what appears to be the final days.
The military says at least 100,000 civilians have poured out of the battle zone since Monday when troops blasted through a massive earthen wall built by the Tigers. But the United Nations says tens of thousands more could still be trapped there.
Some of the wounded are dying in buses on their way to hospital, according to doctors working round the clock to treat injuries from shelling and gunfire. Many patients are also deeply traumatised after seeing loved-ones killed in front of them.
"Almost everyone has left someone behind in the conflict area," said Karen Stewart, a mental health officer with medical agency Medecins Sans Frontieres.
"Probably 85 percent of the people I've talked to have witnessed horrific things, like being in a bunker, and suddenly a shell goes and it's killed half the people in the bunker. Someone else I spoke to told me how she went out to find some water and when she came back
everyone in her bunker was dead."
Many of the injured are being treated at a field hospital in Pulmoddai in the military-controlled area outside the war zone after being evacuated by Red Cross ship.
"Blast injuries from shells are very common," said E G Gnanakunalan, a Red Cross doctor at the hospital. "Some people have lost limbs, some have abdominal injuries, some have head injuries."
He said three to four ships had been arriving every week from the war zone Â? a narrow strip of land on the northeast coast. Each ship brought about 500 patients.
"One lady came and she had been eating with her husband and children. A shell fell in the house and her husband and some of the children died and she lost both her legs. She was crying and asking what would she do in future. There are a lot of sad stories," Gnanakunalan said.
"They need some kind of psychological support. They are mentally and physically tortured."
Gnanakunalan said the field hospital had received more than 6,400 patients since mid-March.
TRAUMA
The government is putting people arriving from the war zone into temporary camps in Vavuniya which are fast reaching maximum capacity.
MSF which is working at the 400-bed hospital in Vavuniya said doctors were overwhelmed, with close to 2,000 patients needing treatment.
"The buses are still coming and they're actually unloading dead bodies at times as some wounded people died on the way," Stewart said.
"It's chaotic. The beds have been pushed together so it's like one massive bed. Instead of having one person per bed you have two, it's just like one huge bed across the ward. Then there's a whole other layer on the ground, we have people under every bed."
Injured people are also lying in corridors and under trees outside.
The government says the camps at Vavuniya are a temporary measure to weed out Tamil Tiger infiltrators. MSF said in some cases an entire family was living in the space of a sofa.
Aid workers said there was a pressing need to reunite families who had got split up during the chaos.
"This is one of the biggest causes of mental health distress," Stewart added. "They arrive, wounded, lost and skinny and then they are put in a camp where they can't leave and they can't call their family. There can be a husband and wife in two separate camps and they would never know."
A U.N. spokesman in Sri Lanka, Gordon Weiss, said people coming out of the war zone were in "very poor condition".
He said a recent U.N. survey of the camps found a quarter of young children had severe malnutrition and he expected children emerging from the war zone now to be in even worse health.
Weiss also called for both sides in the conflict to spare further civilian casualties.
"Our eyes are still very closely focussed on those people left inside the combat zone. The fear is of a bloodbath in the final days of this confrontation," he said.
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