Mogadishu, Somalia ? Artillery fire and mortar shells rained down on Somalia’s capital Saturday, killing and wounding untold numbers of civilians as government and Ethiopian troops tried to wipe out Islamist insurgents.

The offensive, which started Thursday, has sparked the heaviest fighting in Mogadishu since the early 1990s. On Friday, insurgents shot down an Ethiopian helicopter gunship and mortar shells slammed into a hospital, leaving corpses piled in the streets and wounding hundreds of people.

“The victims are the civilians, only civilians are dying and getting wounded in this fighting,” said Khadijo Farah Warsame, 45, a mother of seven.

The International Committee of the Red Cross said dozens of people have been killed since Thursday and more than 220 wounded, most of them civilians with bullet, grenade and other war wounds. But the fighting is so severe and widespread that bodies were not being picked up or even tallied. Hospitals were overwhelmed, with patients sleeping on floors.

“All the commercial areas have closed, all the markets, all the stores, and now the people are looking for food. Where can we buy food?” said Farah Hassan, a 50-year-old resident.

Ethiopia says its forces have killed more than 200 insurgents since the assault started.

Somali presidential spokesman Hussein Mohamoud Hussein on Saturday blamed the violence on foreign terrorists, saying al-Qaida had sent fighters to battle government and allied troops.

“These elements were behind the downing of the helicopter yesterday,” he said.

The insurgents are linked to the Council of Islamic Courts, which was driven from power in December by Somali and Ethiopian soldiers, accompanied by U.S. special forces. The U.S. has accused the courts of having ties to al-Qaida.

The Islamic courts stockpiled thousands of tons of weapons and ammunition during the six months they controlled Mogadishu. The insurgency will likely last until that stockpile is depleted, or key leaders are killed.