Aid agencies are launching multi-million dollar appeals for Sri Lanka where tens of thousands of traumatised civilians are streaming out of the war zone as the army seeks to crush the Tamil Tiger rebels.

Camps are bursting at the seams, with one aid worker saying some families are living in a space the size of a sofa. Hospitals are also overflowing as doctors work round the clock to treat civilians emerging from the conflict area with horrific blast injuries.

Neil Buhne, U.N. resident coordinator for Sri Lanka, said the system is overwhelmed and funds are desperately needed to provide basic relief.

"I saw infants with dysentery, malnourished children and women, untended wounds, and people dressed in the ragged clothing they've been wearing for months," said Buhne who has just returned from the camps in Vavuniya, southwest of the war zone.

"Many of these people were forced from their homes by fighting more than a year ago, and it is something of a miracle that they have survived such a terrible ordeal."

The United Nations says its appeal for Sri Lanka is still less than a third funded. Aid agencies helping feed and shelter civilians are also short of money.

More than 100,000 people have fled the tiny war zone in northeast Sri Lanka this week after troops smashed through rebel fortifications. The government says 196,000 have escaped since the beginning of the year.

Most have been put in government-run camps in Vavuniya. Others displaced earlier in the war are in camps in Mannar to the west and Jaffna in the far north. The United Nations has urged the government to identify and prepare new sites for camps as soon as possible.

One aid worker said the government had been slow to drain suitable land and that the authorities had unrealistic expectations of how much aid groups could afford to spend on infrastructure for temporary camps.

APPEALS

Many people have escaped with just the clothes they are wearing, and are hungry and thirsty after surviving on minimal food and water. Some are deeply traumatised after seeing loved-ones killed in front of them.

Medecins Sans Frontieres (MSF) medical co-ordinator Lisabeth List said one elderly man had died from dehydration shortly after reaching a camp, and she believed others had also perished while making the journey to Vavuniya.

"Survivors are dehydrated, hungry and exhausted after being trapped for months in one of the worst conflicts in the world today," said a spokesperson for aid agency CARE which is appealing for $9 million. It is putting up tents and building emergency shelters and latrines.

Save the Children, which is providing food, clothes, bedding, hygiene kits in Vavuniya and Mannar, has launched a $3.65 million appeal.

"These families have lost everything, including their crops and livestock. Children will be hugely traumatised by their experiences," country director Prasant Naik said.

Christian Aid says funding is very limited and is urging the public to dig deep into their pockets.

"The need is massive. We are talking about generations here who have been affected by this conflict. We need to help them start rebuilding their lives," a spokesperson in Sri Lanka said.

Immediate needs include shelter, food, water, sanitation, clothing, bedding, mosquito nets and psychosocial support for trauma.

The United Nations, government and around 40 aid agencies have requested $155 million to assist up to 200,000 people. But U.N. spokesman Gordon Weiss said only $48 million - 31 percent - has been received.

Weiss said food assistance is well funded at 60 percent. But there is a shortage of funding for shelter (18 percent covered), water and sanitation (16 percent) and health (15 percent).

He was optimistic donors would want to fund immediate humanitarian needs, but said they have already expressed reluctance to fund long-term "internment camps".

People are not allowed to leave government-run camps, which the Tamil Tigers have branded "internment camps". But the government says this is only a temporary measure allowing them to weed out rebel infiltrators.

TRAUMA

Aid workers are also looking beyond people's immediate needs.

"Even for those who do manage to either escape, or who are released, major difficulties are in store. They will face, months if not years, in camps while their own lands are de-mined," said Pauline Taylor-McKeown, head of international programmes for CAFOD.

"Having gone through such traumatic experiences of displacement and untold hardships, mental health problems - including suicidal incidents - will increase."

MSF co-ordinator List said there was "a huge, overwhelming need for psychological support".

"I've talked to a lot of people in the camps. Many have lost family members who have been killed right in front of them. Many have been displaced multiple times. I don't think you could find someone who hasn't actually witnessed something really horrific," she explained.

Many families have become split up in the chaos, which is increasing people's distress. Aid workers say reuniting them must be a priority.

MSF wants to bring in more doctors and nurses to plug gaps in areas such as mental health, first aid and surgery, but says red tape is hindering plans to scale up operations.

"There's only so much we can do with the people we have and unless the authorities are willing to expedite visas we won't be able to respond effectively to all the needs," List said.

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