LONDON, Aug 11 (AlertNet) - Relief groups are struggling to get aid to thousands of people caught up in clashes between Georgian, Russian and Ossetian troops in Georgia's breakaway region of South Ossetia.

The International Committee of the Red Cross (ICRC) says it is receiving reports of a growing number of civilian casualties and widespread displacement throughout the region. "The humanitarian situation remains very serious," said Dominique Liengme, ICRC head of delegation in Georgia.

Aid agencies are unable to travel into or around South Ossetia while shells continue to pound towns and villages. They are calling for a humanitarian corridor to be established to deliver relief supplies to residents left behind and allow ambulances to reach the dead and wounded. In the meantime, the Red Cross is flying out medicines and water treatment equipment to provide clean water for 20,000 people.

The fighting began on Aug. 7 when Georgian troops and warplanes began attacking separatist forces in the capital in a bid to retake control of the territory. Russia responded by sending in troops and bombers to repel Georgia.

Civilians in the capital Tskhinvali were trapped for days in basements without electricity and clean water, as their homes were shelled. On Aug. 10 Russian troops gained control of the city and began transporting people to safe areas.

Shocked residents emerged onto the streets to find bodies uncollected and wrecked buildings. Doctors at a local hospital had to move patients into a cellar when the building came under fire. They told Reuters they lacked medical supplies, food and fresh water to treat 200 injured.

However, the fighting has not ceased, and Georgian forces continue to shell the capital. In neighbouring villages, people have fled into the woods.

The numbers of displaced are very fluid. The Russian migration service registered 24,032 people fleeing South Ossetia between Aug. 8 to 10, according to Human Rights Watch (HRW) observers. Nearly 11,200 of them have already returned, many to join the volunteer militias of South Ossetia, HRW quoted the Russian migration service as saying.

Many people have been separated from their relatives in the flight. "I was so scared - I just started running away and left my family behind. Now no one can tell me what happened to my two sons, my daughter and my two grandchildren," one elderly man who was hurt by shellfire after leaving his building told HRW.

Thomas Hill, Caucasus director for the International Rescue Committee (IRC), said he had spoken to several distressed women who had received calls from family members still trapped in rubble or cut off by fighting and begging to be rescued.

Unable to access the region, most aid agencies have focused on helping the newly displaced. The majority are fleeing across the mountains to the north into Russia where local authorities have housed them in schools, colleges and tents.

IRC says it is concerned that they will not be able to cope if the numbers of refugees grow significantly. And it warns that those sheltering in schools will need to be rehoused when the new school term begins in September. "Authorities are considering tent camps, but with cold weather on the horizon, that can only be a temporary solution," said Hill.

Human Rights Watch observers visited the only field hospital in North Ossetia, Russia, where staff said 90 percent of the 52 wounded it treated on Aug. 9 and 10 were military personnel. Most of them were from the South Ossetian capital of Tskhinvali and neighbouring villages.

A smaller number have fled to other parts of Georgia. World Vision says there are thousands of displaced people in the capital Tbilisi, where they are receiving food and medical supplies.

Some aid agencies say that once they gain access to the region, they will be able to help the needy reasonably easily. The total population of South Ossetia is about 70,000 and distances are small.

However, the situation will become much more serious if the conflict spreads beyond South Ossetia to Georgia's other breakaway region Abkhazia, where tensions have been rising steadily in recent months, or if it spreads to the Georgian capital Tbilisi.

Meanwhile, an estimated 245,000 are still displaced within Georgia, having fled fighting in the 1990s when Abkhazia and South Ossetia broke away from Georgia. They are living in precarious conditions in former hotels and public buildings, dependent on meagre state benefits, according to the Internal Displacement Monitoring Centre.

Tensions over South Ossetia and another breakaway province, Abkhazia, have grown since 2004, when a new Georgian government began to end the country's dependence on Russia. In recent months Russia has accused Georgia of wanting to annex the two provinces by force and warned it would use military force to protect its citizens there if war broke out.

To find out more:

Georgia, Abkhazia, S. Ossetia briefing - AlertNet backgrounder

Georgia and Russia: Clashing over Abkhazia - International Crisis Group June 2008 report

Read and listen to the stories of those displaced by the 1990s wars - Panos Institute and Internal Displacement Monitoring Centre

Georgia: New IDP strategy awaits implementation - Internal Displacement Monitoring Centre October 2007 report

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