A government doctor in Sri Lanka’s war zone said Sunday that 378 civilians were killed and more than 1,100 were wounded during intensive shelling of the tiny remaining piece of land controlled by Tamil rebels.

The Sri Lankan military and Tamil Tigers rebels traded accusations over who was responsible for the shelling, which the government doctor, V. Shanmugarajah, said was the worst carnage he had witnessed so far in the intensifying campaign to wipe out the rebels.

“We are doing the first aid and some surgeries as quickly as we can,” Dr. Shanmugarajah, who works from a field hospital in the combat zone, told the Associated Press. “We are doing what is possible. The situation is overwhelming; nothing is within our control.”