Civilians cowered in hospital beds on Saturday and refugees looted U.N. supplies - all of them desperate for relief from the fighting that has engulfed a northwestern valley as troops and warplanes try to drive out Taliban militants.
The prime minister, directing millions of dollars to help the residents of a region where backing for the central government has sometimes been tenuous, described the offensive launched this week as a "war of the country's survival" but said the military alone could not be victorious in the Swat Valley.
The army "can only be successful if there is support of the masses," Prime Minister Yousuf Raza Gilani, who authorized the Swat offensive on Thursday, told a news conference after an emergency Cabinet meeting.
Further south, a suspected U.S. missile strike killed nine people, mostly foreigners, in another militant stronghold near the Afghan border, officials said. The identities of the victims were not immediately unclear.
The army said it killed as many as 55 more Taliban fighters in Swat on Saturday.
Encouraged by the United States, Pakistan's leaders launched the full-scale offensive this week to halt the spread of Taliban control in districts within 60 miles (100 kilometers) of the capital. Pakistan's army is fighting to wrest Swat and neighboring districts from militants who dominate the adjoining tribal belt along the Afghan frontier, where U.S. officials say al-Qaida chief Osama bin Laden is likely holed up.
But the fighting has caused the flight of hundreds of thousands of terrified residents, adding a humanitarian emergency to the nuclear-armed nation's security, economic and political problems. The government is appealing for international aid to ease the plight of the multitude of weary, traumatized people who have abandoned their homes in search of safety.
Witness accounts indicated that scores of civilians have already been killed or injured in the escalating clashes in Swat and the neighboring Buner and Lower Dir districts.
Even the medics are gone: Only three doctors remained Saturday at the hospital in Swat's main town, Mingora - all of them working at full stretch.
Riaz Khan, a 36-year-old schoolteacher, his wife and two daughters occupied four of the beds, shrapnel wounds on their arms and their legs bandaged. Khan said his other two daughters were killed three days earlier when a mortar shell hit their home near Mingora.
"We buried our daughters on Thursday when the army relaxed the curfew," he told an Associated Press reporter. "We reached the hospital only with great difficulty."
Nisar Khan, one of the three doctors left, said about 25 war-wounded were among the 100 patients.
Taliban militants seized much of the area under a peace deal, even after the government agreed to their main demand to impose Islamic law in the region.
U.S. officials likened the deal to a surrender. Pakistani leaders said the agreement's collapse had opened the eyes of ordinary citizens to the extremist threat.
The army says it is reinforcing the 12,000 to 15,000 troops in Swat as they take on 4,000 to 5,000 militants, including small numbers of foreigners and hardened fighters from the South Waziristan border region.
On Saturday, an AP reporter saw jet fighters flying over Mingora and later heard explosions from further up the valley.
The military said its helicopter gunships attacked militant hideouts in Mingora and killed 15 fighters. An estimated 30 to 40 more died in smaller clashes elsewhere, the statement said. Four soldiers were wounded.
Provincial Information Minister Iftikhar Hussain blamed the Taliban for the deaths of innocents.
"The militants are using civilian population as a human shield and they have dug trenches in civilian areas," Hussain said at a news conference in Peshawar. He said they were firmly in control of Mingora.
However, officials have given no details of civilian casualties, apparently for fear of a public outcry that could make it hard for the army to press ahead.
South Waziristan has been the scene of numerous suspected American missile attacks in recent months, including Saturday's strike in the Tabai area.
Two intelligence officials said several missiles struck a disused hospital building, killing six foreign militants, and a tunnel in a nearby mountain, killing three local fighters.
The officials said field agents were still trying to determine the identity of the victims and whether they were affiliated with al-Qaida. The officials spoke on condition of anonymity because they are not authorized to speak publicly to the media.
Just south of the war zone, around the city of Mardan, crude camps have mushroomed. On Saturday, the desperation of the refugees was laid bare with television footage showing dozens of men making off with blankets and tins of cooking oil. A policeman thumped one looter with his rifle butt while a man wearing a T-shirt bearing a U.N. logo urged others to return their loot.
"When people are desperate, it's hardly surprising that things like this happen," said Ariane Rummery, a spokeswoman for the U.N. refugee agency.
The agency has registered some 150,000 people fleeing the latest fighting. Pakistani and U.N. officials say the total number displaced may reach half a million, reported AP.
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