Hungry, exhausted and traumatised, thousands of civilians have been pouring into Afmadow, a Somalian town near the Kenyan border, having fled the “hell on earth” of their embattled capital, some 630 kilometres to the north.

Among them was Hawo Ali, who arrived in Afmadow on 15 November, five days after escaping Mogadishu with 20 of her relatives and neighbours, including a 10-month-old baby. Ali said she saw troops in the city killing 21 people, including women and children.

"Snipers just shot at anyone who came to the market. That is when we left with only what we could carry," she said, describing life in the capital as “hell on earth”.

"No one is safe and even if you are safe you may die of hunger or thirst since you cannot go out for fear of being killed," she said. "We had to walk the last 50km [to Afmadow] because the truck got stuck in a muddy section of the road. The elders have given us some food to eat and now they are looking for shelter for us.”

According to Hassan Mursal, a clinical officer at Afmadow hospital, some 2,000 families from Mogadishu, about 12,000 people in all, had travelled to the town.

Local residents, he said, were helping to accommodate the new arrivals, but the price of basic commodities had almost doubled.

"We have people staying in the hospital, mosques and other people's compounds. Every family is hosting two or three families. But the host families are not much better off than the displaced and both need help."

Fighting has dogged Mogadishu since Ethiopian troops arrived in the country in December 2006 to help the country's Transitional Federal Government drive out the Union of Islamic Courts, which had seized control of much of the south of the country.

More than 1,000 people have reportedly been killed and more than 450,000 displaced since February.

According to the UN Refugee Agency, an estimated 173,000 Mogadishu residents have fled the latest upsurge of violence, which began in early November.

Sultan Abdi Ali Sonkor, a senior traditional elder in Afmadow, told IRIN that displaced people were scattered across the Juba valley, from Marerey and Afmadow to Dobley (on the Kenyan border) - a distance of 247km.

Sonkor said more people were arriving every day: “Most want to leave the country, but the roads are impassable due to the rains, and the border is closed, so they are stuck here for the time being.”

He said the most urgent needs were food and shelter material.