COLOMBO, Sri Lanka — As the country's long-running civil war appears to be reaching its climax, a picture of desperation is emerging from that roughly 4-square-mile spit between a lagoon and the sea where rebels from the ethnic Tamil minority are making their last stand.
The United Nations' top humanitarian official arrived in Sri Lanka to seek access to some 50,000 civilians trapped in the country's war zone, while the Tamil Tiger rebels warned Saturday of imminent starvation among noncombatants.
As the Sri Lankan military pushes forward with its offensive to destroy the separatist insurgency and end the Indian Ocean island nation's bloody quarter-century civil war, stories of suffering have streamed out of the area in recent days along with the tens of thousands of civilians who were able to break through the front lines.
Tim Pruchnic, an American surgeon working at a hospital in the northern town of Vavuniya, said many of his patients were so weak they were dying after operations that would not normally be life-threatening.
The rebels have also forced some civilians to take up arms, the United Nations says. The government has ignored appeals from the United Nations, India, the United States and other nations for a cease-fire until all the civilians are out of the combat zone.
Aid workers have been barred from the region since fighting escalated last year.
"The situation of those people is very dire," said John Holmes, the U.N. undersecretary-general for humanitarian affairs, who began a three-day mission to the island.