As fresh reports come in of civilian deaths from shelling in the "no-fire zone" on Sri Lanka's northeastern coast - where the military has confined Tamil Tiger rebels - the U.N. aid chief has warned of a "bloodbath".

In a commentary for Britain's Guardian newspaper, John Holmes, the U.N. under-secretary-general for humanitarian affairs, wrote on Wednesday that "a bloodbath on the beaches of northern Sri Lanka seems an increasingly real possibility".

According to the United Nations and Red Cross, about 150,000 civilians are trapped inside the island's rapidly shrinking "no-fire zone", a strip of land just 7 km long and 2 km wide (4 miles by 1.2 miles) along the northeastern coast. The government says there are less than 100,000 there.

"As a full-scale, long-term ceasefire is unlikely to be agreed now, the only way to get the civilians out of harm's way is a temporary humanitarian lull, during which aid workers and relief supplies must be allowed into the conflict zone, and those who want to leave must be given the chance to do so," wrote Holmes.

He argued both sides have a duty to protect civilians, calling on the Liberation Tigers of Tamil Eelam (LTTE) to allow people to leave the zone if they wish, and the government to stick to its promise not to use heavy weapons and to hold off from a final attack in the conflict zone while a humanitarian pause is negotiated.

Reports from the BBC and in the Guardian on Thursday said tens of civilians had been killed by shelling in the no-fire zone in the past 24 hours.

According to a senior health official in a BBC report, at least 60 civilians died, two health facilities were hit and more than 300 people were injured.

The military has denied responsibility for the casualties, saying it had not fired any shells towards the "safe zone", and suggesting the explosions may have been mortar fire from the Tigers, according to the media reports. The rebels have not responded.

Dr T Varatharaja told the BBC shells landed inside one health facility in the Ambalavanpokkanai area as people were waiting to collect milk powder for children.

The Guardian also reported that people were killed and injured on Wednesday while queuing at a mother and baby clinic to receive milk powder and food rations. It is unclear whether the articles refer to the same health facility.

The regional director of Kilinochchi health service, Dr Thangamutha Sathiyamorthy, told the newspaper that 22 people - including an 18-month-old child and a medical worker - died and 283 were injured in a shelling attack at a clinic in Putumattalan soon after dawn. He said later attacks killed more people.

HUMANITARIAN CONDITIONS WORSEN

Sathiyamorthy described increasingly desperate humanitarian conditions in the no-fire zone, with 13 people dead from hunger and nearly 70 percent of children below the age of five showing signs of malnutrition.

Food from the U.N. World Food Programme has been delivered by ship to the no-fire zone with the help of the International Committee of the Red Cross (ICRC), but the United Nations says this is only around a quarter of what is needed.

Sathiyamorthy told the Guardian he is seeing growing signs of hunger among the displaced population in the zone. "Of course the food supply is inadequate. Many children are at risk. Yesterday we distributed milk powder and I saw very thin children coming to the clinic," he is quoted as saying.

The doctor also said 75 percent of those trapped in the zone were living in closely packed tarpaulin shelters, and estimated 100 people were being injured each day, with about 20 of these dying in hospital and more outside.

The United Nations says more than 2,800 civilians may have been killed and 7,000 injured in fighting in the last two months, according to the BBC.

In his opinion piece, the U.N.'s Holmes called for an end to the war - Asia's longest-running conflict - and rapid political progress to address the underlying issues through devolution of power and long-term reconciliation.

"With thousands of lives in the balance and the clock ticking, the time for decisive action by the government, the LTTE and the international community is now, before it is too late," he concluded.

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