COLOMBO, Sri Lanka - Doctors and patients fled a hospital Wednesday in northern Sri Lanka -- closing the last medical facility in the war zone -- after days of artillery attacks by government and rebel forces, aid groups said.
With concern growing for the estimated 250,000 ethnic Tamils trapped in the conflict zone, the UN said cluster munitions appeared to have hit near the hospital and that 52 civilians were killed elsewhere Tuesday.
As fighting raged, President Mahinda Rajapaksa presided over an Independence Day celebration and reasserted that the government was on the brink of destroying the Tamil Tiger rebels and ending the 25-year-old civil war.
"I am confident that in a few days we will decisively defeat the terrorist force that many repeatedly kept saying was invincible," he said.
The rebels have been fighting since 1983 for a separate country for the Tamil minority on this island off the southern coast of India. About 70,000 people have been killed.
An all-out government offensive has forced the rebels out of their strongholds across the north in the past few months and boxed them and the mass of civilians into a sliver of land along the northeastern coast.
The United States, Britain and Canada urged both sides to agree to a temporary ceasefire to allow civilians and the wounded to leave the conflict zone and asked that humanitarian agencies be given access. Sri Lanka barred nearly all aid groups from the war zone last year.
Foreign Affairs Minister Lawrence Cannon said a ceasefire was needed for "the delivery of much-needed humanitarian assistance to civilians."
And Canada "strongly condemns recent shelling attacks on the hospital in Puthukkudiyiruppu and firing into the government-designated safe area," Cannon said. "All efforts must be made to avoid civilian casualties."
He said Ottawa believes that the conflict can only be resolved "through a durable political solution that meets the legitimate aspirations of all the people of Sri Lanka."
On Wednesday, hundreds of Canadian Tamils rallied on Parliament Hill to protest the deaths of civilians in the offensive.
With the military pounding the area with artillery and air strikes to finish off the rebels -- and the rebels hitting back with their own artillery -- there have been more reports of heavy civilian casualties.
UN spokesman Gordon Weiss said 52 civilians were killed and 80 wounded Tuesday in and around a government-designated "safe zone," an area of rebel territory that the government had pledged not to strike.
After days of artillery fire killed at least 12 people at the Puthukkudiyiruppu hospital, patients began fleeing. On Wednesday, the Red Cross evacuated the staff and remaining 300 patients.
"The last remaining medical facility inside the Vanni pocket (in the war zone) has been effectively closed," Weiss said.
The doctors and patients went to a coastal area deeper inside the war zone where there was no reliable source of drinking water, said Sarasi Wijeratne, spokeswoman for the International Committee of the Red Cross.
Aid workers were trying to find them a better place to stay or get the two sides to grant them safe passage out of the conflict zone, she said.
Weiss said 15 UN staffers and 81 family members who were trapped near the hospital also fled after the area was pounded for more than 16 hours by artillery fire, including what appeared to be cluster munitions.
That was the first public accusation of the use of cluster bombs in the conflict since a ceasefire broke down three years ago, though Weiss said they had been used at least once before in recent weeks.
Cluster munitions are controversial because of their ability to cause damage over a wide area. Many of the bomblets do not explode immediately and pose a danger to civilians long after fighting ends.
Military spokesman Brig. Udaya Nanayakkara denied firing them. "We don't have the facility to fire cluster munitions. We don't have these weapons," he said.
Weiss said the UN accepted the government's assurance it did not have the weapons. The rebels were not available for comment; most communications to the war zone have been cut.
The UN workers and their families had been huddled in trenches they dug across the street from the hospital, Weiss said. The group tried to leave the war zone two weeks earlier, but the rebels refused to let them out, he said.
The 96 civilians had four UN trucks. The rebels commandeered two of the vehicles and later tried to take the other two, but the workers stood firm and the gunmen backed down, Weiss said.
The workers and families then crammed into the large trucks and headed north, deeper into rebel territory, Weiss said. At one point, artillery landed in front of the vehicles, blocking them from heading into the "safe zone" that itself has come under repeated attack, Weiss said.
When the trucks drove near the blast site, the workers saw bodies in a field, Weiss said. Later, the UN group reached the beach to the east and were trying to find somewhere safe to go, he said.
In recent months, Sri Lankan troops have routed the rebels from much of the once-sizable de facto state they controlled in the north and the east.
Dr. Thurairajah Varatharajah, the top health official in the war zone, estimated last week that more than 300 civilians had been killed in recent fighting. Varatharajah has not updated his estimate. The government denies any civilians have been killed.
In addition to the protest in Ottawa on Wednesday, about 12,000 people protested in Geneva and 4,000 in Berlin.
-- With files from The Canadian Press
