COLOMBO, Sri Lanka A mortar shell struck the only functioning medical facility in Sri Lanka's northern war zone Tuesday, killing 49 patients and bystanders, a government health official said. It was the second time this month the hospital was hit.
The attack, which also wounded 50 people, came after a weekend of heavy shelling that killed hundreds of civilians trapped in the tiny war zone. The military denied shelling the coastal strip under rebel control, which is packed with an estimated 50,000 civilians.
Dr. Thurairaja Varatharajah, the top government health official in the war zone, said a single mortar shell hit the admissions ward in the makeshift hospital Tuesday morning. The death toll was expected to rise, he said.
Shells were still hitting the area hours later, including one that landed about 150 yards (meters) from the hospital, Varatharajah said.
Just outside the admissions ward little more than a corrugated tin roof with blue tarp walls bloody bodies were strewn about in the dirt while health workers hooked up the wounded to IV lines, according to photographs taken after the attack. Later, nearly two dozen dead bodies were lined up in rows in a sandy courtyard.
Other photographs showed civilians fleeing the area. One man running away was carrying a child with a bandaged head.
Two other hospital officials, who spoke separately on condition of anonymity because they were not authorized to speak to the media, confirmed the attack and said a hospital administrator was among those killed.
It was the second time this month the facility has come under heavy fire. On May 2, 64 civilians died when the hospital was hit by artillery.
Meanwhile, army troops broke through a sand fortification the Tamil Tigers had built in the area, killing dozens of insurgents and advancing further into what little remains of rebel-held territory, military spokesman Brig. Udaya Nanayakkara said.
Reports of the fighting are difficult to verify because the government bars journalists and aid workers from the war zone.
Rebel spokesman Seevaratnam Puleedevan blamed the attack on hospital on the government, and said civilians were fleeing in all directions inside the tiny war zone, seeking safety.
"There's no place to seek shelter or protect themselves," he said.
Sri Lankan defense spokesman Keheliya Rambukwella denied the army had launched the attack and reiterated the government's promise not to launch any airstrikes or artillery into the densely populated area.
The shelling came as a Red Cross boat sent to deliver food aid and evacuate the wounded waited off shore, the health officials said.
"There is fighting going on and we need a more quiet environment to land," said Paul Castella, the head of the Sri Lanka office for the International Committee of the Red Cross.
Castella said if the fighting did not soon subside, the boat would be forced to turn back.
The rebels called on the international community to force the government to stop its offensive against the violent separatist group, which has been fighting for a homeland for the ethnic Tamil minority for more than a quarter century.
"We are really afraid that if the Sri Lankan government is not being pressured to stop the carnage, that many more civilians will die in the hundreds," Puleedevan said.
U.N. Secretary-General Ban Ki-moon said Monday that he was "appalled at the killings of hundreds of civilians in Sri Lanka over the weekend. Thousands of Sri Lankans have already died in the past several months due to the conflict, and more still remain in grave danger."
In a statement, Ban reiterated his call for both parties to cease using heavy weapons and accused the rebels of "reckless disrespect" for the safety of civilians. Human rights groups accuse the rebels who are listed as a terror group by the U.S. and EU of keeping the civilians hostage for use as human shields.
Two artillery barrages pounded the area over the weekend, with several shells landing inside newly demarcated "safe zone," where the government had urged civilians to gather, according to Dr. V. Shanmugarajah, another doctor at the hospital.
A total of 430 ethnic Tamil civilians, including 106 children, were either brought to the hospital for burial or died at the facility after those attacks, he said. But the death toll was likely closer to 1,000 because many of those killed would have been buried in the bunkers where they were slain, and many of the gravely wounded never made it to the hospital for treatment, he said.
The shelling attacks which the U.N. labeled a "bloodbath" marked some of the worst violence in this Indian Ocean island nation since the civil war flared up again more than three years ago.
In New York, the British, French and Austrian foreign ministers urged the U.N. Security Council to take action to prevent more killings of civilians. Sri Lanka is not on the Security Council agenda because Russia, China, Japan and Vietnam consider the fighting an internal matter.
U.N. figures compiled last month showed that nearly 6,500 civilians had been killed in three months this year as the government drove the separatist rebels from their northern strongholds and vowed to end the war.