Civilians fled Sirte on Friday as interim government forces pounded the coastal city in an effort to dislodge fighters loyal to ousted leader Muammar Gaddafi.
The prolonged battle for Gaddafi's hometown, besieged from three fronts, has raised mounting concern for civilians trapped inside the city of about 100,000 people, with each side accusing the other of endangering them.
Cars streamed out of Sirte from the early hours. Shelling and tank fire continued from both sides on the eastern and western fronts, black smoke rose from the centre of town and Nato planes flew overhead.
''There are no shops for food, everything is closed,'' a resident who gave his name only as Mohammed told Reuters on Friday. ''There is no medicine, we have a shortage of everything.''
Doctors at a field hospital near the eastern front line said an elderly woman died of malnutrition on Friday morning and they had seen other cases.
Some families leaving from the west told Reuters they had not eaten for two days.
A man with a sharpnel wound on his left arm said the hospital in Sirte had no power and few supplies. A doctor had tried to patch up his wound with the light of a mobile phone.
''I was injured in my garden at 1pm but I stayed home until the evening because of the heavy fire,'' Mohammed Abudullah said at a field hospital outside the city.
Gaddafi loyalists and some civilians blaming Nato air strikes and shelling by the forces of the National Transitional Council (NTC) for killing civilians.
Nato and the NTC deny that. They and some other civilians coming out of the town say pro-Gaddafi fighters are executing people they believe to be NTC sympathisers.
''It is not the Gaddafi people and not you people,'' one elderly man shouted, gesturing towards NTC fighters at a checkpoint as he left the city.
''It's the French planes that are hitting us night and day. They knocked the roof off our house. Is this how we're supposed to die?''
Ahmad Mohammed Yahya told Reuters street fighting was erupting in the town most nights and that pro-Gaddafi fighters were aggressively recruiting local people.
''Sometimes they offer to give you a weapon,'' he said. ''And sometimes they take people and force them to fight.''
The NTC is under pressure to strike a balance between a prolonged fight that would delay its efforts to govern and a quick victory which, if too bloody, could worsen regional divisions and embarrass the fledgling government and its foreign backers.
Aid agencies said this week that a humanitarian disaster loomed in Sirte amid rising casualties and shrinking supplies of water, electricity and food.
Libya's interim government has asked the United Nations for fuel for ambulances to evacuate its wounded fighters from Sirte, a UN source in Libya said on Thursday.
The UN is sending trucks of drinking water for the civilians crammed into vehicles on the road from Sirte, heading either towards Benghazi to the east or Misrata to the west, he added.
But fighting around the city and continuing insecurity around Bani Walid, the other loyalist hold-out, are preventing the world body from deploying aid workers inside, he said.
''There are two places we'd really like access to, Sirte and Bani Walid, because of concern on the impact of conflict on the civilian population,'' the UN source in Tripoli, speaking by telephone on condition of anonymity, told Reuters in Geneva.
The NTC says efforts to form a new interim government have been suspended until after the capture of Sirte and Bani Walid.
''There are no negotiations at the moment to form a transitional government after the NTC decided to keep the current formation to facilitate the (country's) affairs until the land is liberated,'' Libya's de facto Prime Minister Mahmoud Jibril said in Tripoli on Thursday.
''There are two fronts, Sirte and Bani Walid. I hope those two areas would be liberated soon so that we can start forming a new interim government,'' he said, ruling out any role for himself in a future government.
There has been speculation that divisions are preventing the formation of a more inclusive interim government.
More than a month after NTC fighters captured Tripoli, Gaddafi remains on the run, trying to rally resistance to those who ended his 42-year rule.