Page last updated at 10:06 GMT, Thursday, 16 October 2008 11:06 UK

'The intolerable noise of shells'

Heavy fighting is continuing around the key rebel-held town of Kilinochchi in northern Sri Lanka, according to the army.

Last month, the government told foreign aid agencies to leave areas held by the Tamil Tigers (LTTE) because it could not guarantee the security of aid workers.

The BBC News website has spoken to a doctor in the town who describes the fear as people wait for the war to arrive.

People fleeing Kilinochchi town
People are leaving Kilinochchi town as the fighting gets closer
In the town, there are less people now. Most of the shops are closed, shop owners are moving their goods to other areas.

The shelling started around two weeks ago. We underwent several aerial attacks. Slowly, people took their belongings, household items - including the roofs of houses - and moved about 10km away from the town.

They are in the places between Kilinochchi and Mullaitivu [another rebel-held town to the east]. But in the villages around, there are still people. They just wait.

'Heavy shelling'

They are scared about the situation. With heavy shelling and aerial attacks they will move from this area and they will go far. Most of these people have been displaced several times from areas like Mannar and Vavuniya. As the military forces advance, they displace and scatter.

Once they reach the borders of the town there will be heavy fighting. If there is heavy fighting, there will be a mass disaster
Most of the people I can tell, hundreds, are psychologically affected. The degree of mental illness is varied because everyone has the fear of the war and everyone is taking risks.

Shelling is here and there, aerial attacks are here and there. Just one aerial attack can hit many civilians' houses. One week ago, there was an aerial attack and one teacher and one student died and several others were injured. I attended to them and I had to deal with their relations.

If a family member is killed that leaves sorrow but people have to manage. They don't really have any choices. This is a long-term war. They believe that if they are unfortunate, they will die and if they are fortunate people they will escape death. Today [Wednesday 15 October] there were no civilian casualties in Kilinochchi. Last week the war was quite silent but before that many civilians were killed.

'Intolerable noise'

Most of the civilian areas have bunkers in case of aerial attack. There is a lot of danger and noise. The intolerable noise of shells upset people. It is not just blast noises but Kfir [fighter aircraft] noises that are also intolerable.

At such a time, many children are crying. Women and the elderly become very scared. Even in my hospital, people go under tables and hide. People run, going here and there. The sounds are beyond my explanation. Even my heart rate doubles.

Once, after a Kfir, people standing outside rushed inside the hospital. They went right into rooms even where people were working. I saw people sitting and lying on the floor.

I haven't seen any soldiers. The LTTE seem to be around and moving normally. We heard that army soldiers are past Murukandy. Once they reach the borders of the town there will be heavy fighting.

If there is heavy fighting, there will be a mass disaster. Many deaths, LTTE, army soldiers and civilians - it will be a big human disaster. I don't know if that will bring the end of the war or if a solution will come after that.

Supplies restricted

Ever since the foreign NGOs were ordered to leave, we have noticed a difference.

Deserted Kilinochchi town
Kilinochchi town is quiet as people are leaving the area
Resettlement programmes for internally displaced people, rehabilitation programmes have all been reduced. Now more than half of the displaced population don't have proper healthcare.

And people are scared. When the foreigners went, people were worried about a really heavy attack on civilian areas.

In the last month, supplies from Vavuniya were restricted. Three times our medicinal lorries were sent back from the checkpoint. The government agent here says there is also a food shortage. All I can do is carry on with my work.

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