In a Medical Tent in Libya, a Grim Procession

A Libyan and Italian medical team worked to save her. It was not certain they could. “Her brain is out,” said Dr. Abdullah Juwid, a surgeon.

As the ugly math of a midsize city suffering a siege would have it, Dr. Juwid was both a doctor in an overcrowded triage tent and an uncle of this wounded child. He had no time to dwell on her case.

A pickup truck skidded to a stop outside. Several rebel fighters carried their bullet-riddled friend through the entrance flap. The man appeared to have been in his 20s. He had been shot through both legs and squarely in his chest and mouth. His pupils were fixed.

“Maybe he is dead,” another doctor said, as their assistants cut away the man’s clothes. The assistants stopped. There was no point in searching for more wounds. “He is killed,” one of them said.

In the battle for Misurata, a rebel holdout city under attack by Col. Muammar el-Qaddafi’s forces for months, the tally of those killed and wounded rises daily, and often by the hour. It can be only partially assessed at one of the several treatment centers scattered around the rebel-controlled portions of the city. But where it is counted, it is grim.

The wounded arrive at this triage tent throughout the day and sometimes deep into the night, a population formed by circumstance and number into a procession of wartime trauma.

Mustafa Madhoun, a physiotherapist who had never seen injuries nastier than those suffered by the victims of vehicle accidents, had just participated in the amputation of the lower left leg of a fighter, Mustafa Youssif.

Mr. Madhoun summed it up. “Yesterday was a very bad day,” he said. “I had hoped today would be different. Today is a very bad day, too.”

In clinical terms, this triage tent has seen a catalog of the effects of modern weapons on human life — gunshot wounds, blast wounds, shrapnel wounds, the occasional burns. People arrive with wounds as mild as a bullet’s graze, to wounds as life-changing as a severed spinal cord. A few arrive dead.

On average, 50 or 60 wounded people pass through this tent each day. About 10 of them die, according to the medical staff and the flow of patients observed.

“Most of them, for sure, are civilians,” said Dr. Paolo Grosso, an anesthesiologist who is part of a seven-member team in Misurata from Emergency, the Italian aid organization, and was among those working to save young Jinan. The organization has been helping Misurata’s doctors.

How many people have been fatally wounded since the siege began in February is not readily known. Rebels say more than 1,000 people have been killed. That number is not verifiable in the current conditions.

The hospital records available so far indicate that at a minimum 313 people have been killed and 1,047 wounded through Sunday evening. But this count is most likely low, as some families do not take victims who have been killed outright to hospitals. They simply bury them instead.

(Eight people who were killed in a rocket strike last Thursday, for example, were interred in a small public park in the Qasr Ahmed neighborhood without being tallied by any medical staff.)

Some days, like Saturday and Sunday, in which 70 people were verified wounded each day, have been worse than others.

Among those struck have been children, including Mohamed Hussein el-Faar, 10. He arrived at the triage tent Saturday afternoon, howling. Blood trickled from the hair beside his right ear. He fought the doctors as they tried to examine him, until several assistants held him down.

At first it seemed he had been grazed by a bullet. But there was also a wound on the opposite side of his head. After he was stabilized and moved into a facility with a CT scanner, the images provided a fuller view: a bullet had passed through Mohamed’s skull.

On Sunday he was still alive, though a doctor gave a discouraging prognosis. “Not good,” he said. “Never with this kind of injury is the prognosis good.”

By late Sunday morning in the triage tent, there was little time to think of yesterday’s patients. The sounds of battle could be heard a few blocks away, and thick smoke billowed over part of Tripoli Street, one of the city’s main fronts. A hurried pace had picked up again.

At 11:20 a.m. the medical staff cut away the shirt of a man who had been peppered by light debris in an explosive blast, his back busy with small holes. An ultrasound technician scanned his torso while doctors watched.

“No problem,” Dr. Grosso said. “His chest is free.”