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The International Committee of the Red Cross (ICRC) has said that there is a "catastrophic" humanitarian crisis in northern Sri Lanka's conflict zone, where tens of thousands of civilians are trapped.
The warning comes as government forces closed in on fighters from the Liberation Tigers of Tamil Eelam (LTTE), who are defying a government ultimatum to give up or face a "final assault", saying they will not surrender.
The Red Cross said on Tuesday that about 50,000 people were still stranded in the tiny strip of land in the island's northeast, and a final offensive "could lead to a dramatic increase in the number of civilian casualties".
"The situation is nothing short of catastrophic," Pierre Kraehenbuehl, the Red Cross operations director in Sri Lanka, said.
"Ongoing fighting has killed or wounded hundreds of civilians who have only minimal access to medical care.
"I cannot remember ... as much concentrated pain and exposure to violence with very, very minimal possibilities to reach anywhere that could be called safe."
Thousands killed
The United Nations, which estimates that more than 4,500 civilians have been killed in the past three months, has joined calls for a negotiated truce to allow civilians to leave the rebel-held coastal strip.
A UN High Commissioner for Refugees (UNHCR) spokesman expressed concern about the "dramatic situation" for civilians still in the war zone.
"There are innocent civilians, women and children, caught in the middle of the conflict ... so the high commissioner is saying there should be a pause in the hostilities and the LTTE should allow civilians to leave," Ron Redmond, the spokesman, said.
Human Rights Watch (HRW) estimates those trapped at between 50,000 and 100,000.
"Both sides need to show far greater concern for civilians, or many more civilians will die," Brad Adams, the Asia director for the New York-based group, said.
The LTTE vowed to continue fighting after a 24-hour government ultimatum expired at noon (06:30 GMT) on Tuesday.
Sri Lankan government officials said there was no fighting as troops pushed further into rebel territory this week as part of a "rescue operation".
Wasantha Karannagoda, the commander of the Sri Lankan navy, said they were ready for the rebels who he said "did not have much of a capability at the moment".
"They have lost most of their boats. They had to leave some behind and some were captured inland by the army about 2-3 kilometers from the coastal belt, but the majority were destroyed by us at sea," he said.
The US government on Tuesday released satellite images showing about 25,000 tents housing civilians squeezed into the last LTTE-controlled sliver of land of about 21 sq km in the northeast of the island.
More than 52,000 civilians have escaped from the area since Monday, according to the Sri Lankan government.
The state department estimates that about 125,000 people were in the conflict zone before many of them fled.
PHOTO CAPTION
A Sri Lanka Navy photo released on April 21 shows civilians escaping on boats in north east of the island.
Al-Jazeera
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