Hospitals and mortuaries are being "overwhelmed" while both rivals at the centre of Madagascar's political storm continue to blame each other for the violence that has now left some 130 people dead.
In the latest clashes heavily armed security forces opened fire on anti-government demonstrators marching on the presidential palace on Saturday 7 February.
"Around 50 people were killed and around 1,000 have been wounded," Claude Rakotondranja, National President of the Malagasy Red Cross, told IRIN. "The hospitals are full and very busy. They are overwhelmed and struggling to cope with the situation."
Around 80 people have already lost their lives in a number of anti-government rallies that have erupted into riots in the capital, Antananarivo, since 26 January.
An ongoing power struggle on the Indian Ocean Island has pitted the country's president, Marc Ravalomanana, against his rival, Andry Rajoelina, the main opposition leader and recently removed mayor of Antananarivo.
On Saturday protestors gathered in May 13 Square in the capital to attend an opposition rally. Spurred by Rajoelina's calls for a transitional government – to be led by himself – thousands of opposition supporters headed for the presidential palace.
The confrontation with the presidential guards was initially peaceful but a sudden surge forward by the crowd reportedly triggered the attack.
Local media headlines described the event as "carnage", "a bloodbath" and "butchery", and called the day "Black Saturday", saying it was the most tragic political atrocity since the country's independence in 1960.
Political violence is not new to Madagascar and there is no sign that the current crisis will be defused anytime soon. "To be honest I don't know if the situation will improve quickly," Jacqueline Rabesahala, a resident of Antananarivo and retired teacher, told IRIN.
"The [protests] show that people want the country to improve socially and economically," she said, noting that political battles had plagued the nation for decades.
Despite recent socio-economic improvements, Madagascar still ranks at a low 143 out of 177 countries on the United Nations Development Programme's Human Development Index.
When Ravalomanana appeared on state television after the clashes he firmly blamed Rajoelina and slammed his opponent for inciting violence in the crowd.
Rajoelina appeared on his own private television network and, according to Associated Press, said: "I condemn you, Mr Marc Ravalomanana - was there a life to protect in this palace? Did defending an office require that blood flow?" He vowed that his struggle would continue "until the final victory".
Ravalomanana himself came to power following a drawn out power struggle after both he and his opponent at the time, Didier Ratsiraka, claimed victory in a 2001 election. Ravalomanana only gained control of the country after Ratsiraka fled to France, but alleges that his former political adversary is behind Rajoelina's political drive.
Will it stop? This is a very difficult question to answer... It will depend on the government, and we have to wait
Both men initially denounced the option of negotiations, but Western diplomats have continued to push for talks. At the invitation of the Malagasy government, the United Nations Assistant Secretary-General for Political Affairs, Haile Menkerios, has engaged both Ravalomanana and Rajoelina to assess the situation and bring them to the negotiating table.
Menkerios met with both men on 9 February while Antananarivo residents were again gathering on May 13 Square - this time to mourn for those who had died in the shooting.
"Will it stop? This is a very difficult question to answer," Red Cross President Rakotondranja said. "It will depend on the government, and we have to wait."
This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information: https://shop.un.org/rights-permissions