The mass of Tamil women and children struggling to walk out of Sri Lanka's war zone were so emaciated that an aid worker thought he was seeing a horror movie.
Some of them had become so thin that their bones could be seen under the thin layer of fleshless skin. They were in bloodstained, dirty and torn clothes that had not been washed for several weeks.
Many had untreated festering wounds. Some were so sick that they could not stand on their feet. At the first opportunity, they collapsed on bare earth.
Barring a few who were willing to speak, most were too weak to even utter a few words. When they did, they had only one wish: water.
And they were famished. Most of them had not had a proper meal for a long time. Their eyes begged for food.
Countless others never made it out of the shrunken territory the Tamil Tigers still hold in Sri Lanka's war-battered northern coast.
These were people who had retreated along with the Tigers as the military rapidly advanced from January this year, raining shells and mortars, at times tearing apart civilians fleeing with the rebels.
Those who have interacted with the civilians undergoing treatment in hospitals in Sri Lanka's north quote them as saying that innumerable people died like flies as they tried to escape the military's far superior firepower. These sources said on the strict condition of anonymity.
To add to the Tamil misery, the Tigers also fired from their midst, inviting ferocious reaction from the army.
One survivor described horrific scenes she saw in the rebel land. "People were blown up. People lost legs or hands. Families got separated. There was no one to care for the seriously injured and dying."
Two small hospitals in Tiger territory inundated with the dying ran out of life saving medicines.
The injured included those shot by the Tigers as they tried to escape.
Food was in short supply. What little was available was prohibitive. A population cowed down by armed combatants lived in bunkers, praying they would live.
The wounded tore parts of their clothes to dress themselves up. If the bleeding did not stop, then they would throw a lump of sand and then do the bandaging. Wounds festered.
Some who barely made it out of the war zone died in buses while being transported.
No one appears to know for certain how many civilians have died since the dawn of 2009 when the military seized Kilinochchi, the former political hub of the Liberation Tigers of Tamil Eelam (LTTE).
The toll ranges from measly figures put out by Colombo to a few thousand. Diplomats otherwise sympathetic to Sri Lanka believe the higher statistics.
The blood and gore have driven a handful insane. One Tamil woman has been tied to the hospital bed because she keeps running in the ward topless.
The human avalanche has overwhelmed Sri Lankan authorities, forcing them to seek international help.
By all accounts, the refugees are still in distress.
About 70,000 of the over 100,000 refugees have been sent to schools and detention centers in Vavuniya, whose main town is located 254 km north of Colombo.
The Vavuniya hospital can accommodate 600 patients. But it has over 1,500. Many are yet to get new clothes.
Some volunteers who managed to go there have said that many patients cannot do anything on their own because they are barely living. NGOs have stepped in because the hospital is unable to supply meals.
Bottled water, biscuits and glucose are in short supply in Vavuniya.
Thousands are still in Omanthai in the north that was the gateway to the once sprawling LTTE territory. NGOs in Mannar district were initially told to be ready to receive some 30,000 refugees.
But that plan has been spiked because some officials feared that the Tamils might sail away from Mannar to neighbouring India.