Already crammed with 45,000 residents, the Badawi refugee camp is struggling to cope with a sudden influx of 15,000 fellow Palestinians who have fled the fighting between Lebanese troops and Islamic militants.

The narrow winding streets of Badawi, on the northern outskirts of Tripoli, were overflowing yesterday with a heaving throng of people – head-scarved women scolding errant toddlers, young men standing in groups talking animatedly and grizzled old men sitting on stools and leaning on sticks watching the scene with rheumy eyes.

“The scale of this disaster is more than Badawi can cope with,” said Sheikh Walid Abu Hait, a Sunni cleric from Nahr al-Bared, the refugee camp nine miles (15km) to the north where militants from the extremist Islamic Fatah al-Islam faction are besieged by Lebanese troops.

Residents of Badawi have thrown open their homes to the newcomers and the overflow are staying in schools and any open space in the camp.

Aid agencies have been distributing foam mattresses but there are not enough to go around.

Sheikh Abu Hait said: “People are sleeping on the ground, the young, the old and the sick with no blankets or sheets.”

Virginia de la Guardia, the spokeswoman for the International Committee of the Red Cross, which has been coordinating the relief effort, said that 20 tonnes of food had been provided for Badawi and another 200 tonnes was en route from Jordan. “The situation really is very serious,” she said.

So far the Safad hospital in Badawi has managed to cope with the flow of casualties from Nahr al-Bared. Most of the casualties were suffering from shrapnel and gunshot wounds.

“Five babies were born prematurely because of the fighting,” said Dr Ahmad Hajj.

One woman was hit in the stomach by shrapnel and spent two days lying untreated in Nahr al-Bared before being taken to the Safad hospital. A doctor unwrapped a blood-stained bandage revealing a jagged piece of shrapnel about the size of a 50p piece. “We took this out of her stomach. It’s from a 155mm artillery shell,” he said.

Sitting on his bed and swathed in bandages, Jassem Saadi, 35, said that he was standing with two friends in Nahr al-Bared on Monday morning discussing how to distribute packs of Arabic bread to the refugees. A mortar shell exploded behind them, killing Mr Saadi’s two friends instantly and badly wounding him in the arm and leg.

“I was in a state of shock,” he said. “One moment I was talking to them and the next moment they are lying dead in front of me.” He said that he was taken to one of the small clinics in the camp where medics bandaged his wounds by the light of candles and cigarette lighters because there was no electricity. The streets of the camp are so narrow and the buildings so tightly packed that almost no natural light is let in through the windows.

Rihan Khodr, a deathly pale 20-year-old woman wearing pink pyjamas and a blue head-scarf, was hit in the chest by shrapnel from an exploding mortar round while hurrying with her family into a basement apartment. “I thought I was dreaming. I was in great pain,” she whispered.

Outside her room, a doctor said quietly: “Her father was killed in the blast but we haven’t told her yet. Her mother was also wounded and is in the hospital but we haven’t told her she is a widow.”

Many of the patients and relatives staying with them in hospital wards vented their anger at the Lebanese Army for what they said was indiscriminate shelling of the camp.

“The Israelis are harsh enemies for us but they are better than the Lebanese Army,” said Khalil Awad, 29. “The Israelis select their targets but the Lebanese Army fired everywhere.”

Several Palestinians claimed that they had been shot at while leaving Nahr al-Bared by pro-government militiamen. Armed supporters of Saad Hariri, the political leader of Lebanon’s Sunni community, as well as former fighters from the Sunni Mourabitoun militia of the civil war era have deployed with Lebanese army units surrounding the camp. They say that they are simply providing support to the Lebanese troops, carrying water and ammunition to frontline positions.

The exodus of refugees from Nahr al-Bared ended on Wednesday and the tense calm continued yesterday as both sides prepare for what could be a bloody final clash.

The Fatah al-Islam leadership has vowed to fight to the death but some of the militants appear to have had second thoughts. A Lebanese army officer said that seven militants were caught on Wednesday trying to slip out of the camp among the fleeing refugees. Several others were killed by the Lebanese Navy when attempting to escape by sea in dinghies.

Last refuge

1955: year the Badawi camp was established by the UN Relief and Works Agency

16,198: registered refugee population

45,000: people actually living there

Source: Nicholas Blanford

Times Recommends

• 'I was amazed by the fact I had been wounded'
• The great pilgrimage to Inauguration Day
• Robot fails to survive the credit crunch