NEW DELHI (AlertNet) - Tens of thousands of civilians in northwest Pakistan need protection from fighting between government forces and Taliban militants and dozens are being injured by shelling and bombardments every day, aid workers said on Thursday.

The army assault in the ethnic Pashtun tribal region of South Waziristan on the Afghan border has so far forced almost 200,000 people from their homes, most of whom have fled since the fighting officially began on Oct. 17.

But aid workers -- who have no access to the conflict zone -- estimate there are still around 100,000 people residing in the area of fighting who are at risk and need assistance.

"My major concern is about the civilians who are being exposed to the violence right now," Manuel Bessler, the head of the U.N. Office for the Coordination of Humanitarian Affairs (OCHA), told Reuters AlertNet by phone from Islamabad.

"They need protection, they need safety, they need the possibility of freedom of movement to leave the area of conflict," he added.

International aid agencies are not permitted to work in the area due to the threat of retaliation attacks by the militants, who on Wednesday killed 105 people when a car bomb exploded in the busy market city of Peshawar, the deadliest attack in two years.

But Pakistan's humanitarian community insist they need access to the conflict area where they believe the plight of trapped populations is worsening.

DWINDLING FOOD, WAR-WOUNDED

Aid workers say those who remain in the conflict area are mainly the poorest communities who cannot afford the extortionate rates being charged by the few transporters bold enough to offer transport out of the insecure region.

They say the imposition of curfews and check points mean many of those who want to flee the fighting in the Mehsud area of South Waziristan are not actually able to.

Curfews also mean that food, medical and other supplies cannot get into the area and there are reports that basic services such as local markets are not functioning with provisions dwindling.

Civilians are being exposed to shelling and bombardments and the International Committee of the Red Cross (ICRC) says that eight hospitals and clinics where they are supplying medical equipment, medicine and bandages are treating two to three casualties daily per facility and the actual numbers of injured people could be much greater.

"They are casualties with weapon or shrapnel-related wounds," said Sebastien Brack, spokesman for the ICRC, in Islamabad. "But the medical facilities which we are supporting actually say that many patients cannot reach them due to curfews, so this figure actually understates the scale of the problem," he added.

COMBATANTS OR CIVILIANS?

The underdeveloped mountainous region has long been a stronghold for militants and the population is considered to be suspicious of the government, say activists, adding that this makes them more susceptible to discrimination by the army.

There are fears that civilians may be targeted by government forces who are looking to weed out Taliban sympathisers and there are reports of arbitrary arrests by the security forces.

"We have to have access as our concern is for all those taking part in the fighting to respect the difference between civilians and combatants," said Bessler.

"We have to have the ability to speak directly to affected populations in order to verify concerns, rumours, allegations and, only based on direct statements, can we make a credible case with authorities and others concerned."

The operation in South Waziristan is part of an on-going campaign by the Pakistani army to tackle Islamists responsible for a string of attacks against government and other targets.

A military assault which began in May in the neighbouring former tourist beauty spot of Swat valley resulted in one of the biggest internal displacements in recent times with more than two million people fleeing their homes.

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