Mogadishu, Somalia ? A missile hit a hospital ward packed with civilians wounded in fighting between Islamic insurgents and Ethiopian troops allied to the Somali government, but it was not immediately clear whether it caused additional casualties, an official said.

The ward already was housing 20 to 30 wounded adults, said Wilhelm Huber, regional director for the SOS Children’s Villages. The children had been evacuated earlier, he said.

Five missiles had actually hit the grounds in the lunchtime attack, but only one struck a ward, Huber said. People were wounded, but he did not have details because of the chaotic situation and because there already were wounded in the ward at the time.

“What is happening now cannot go on,” Huber told The Associated Press.

He said he did not believe the hospital had been deliberately targeted, but that it clearly came from government forces because of the flight path of the missiles.

“People are desperate,” he said. “This is a tragic situation.”

At least 13 shells have hit the grounds of the hospital and children’s orphanage in the last six days, including the latest attack, he said.

Earlier in the day, civilians were caught in the crossfire as the Somali government’s Ethiopian backers used tanks and heavy artillery to pound insurgent strongholds, witnesses said.

Analysts said U.S. and Ethiopian military intervention in Somalia has destroyed a fragile stability in this battle-scarred nation, as more than a week of unrelenting violence trapped desperate civilians in their homes with gunfire and artillery shells raining down outside.

The leaders of an Islamic movement that was driven from power in December by the government and its Ethiopian backers are still active, and popular support for the group is unlikely to melt away, according to a report by the British-based think tank Chatham House.

The Council of Islamic Courts ruled much of southern Somalia for six relatively peaceful months in 2006 before being ousted by Somali troops and their Ethiopian allies, along with U.S. special forces. Radicals in the council rejected a secular government and have been accused of having ties to al-Qaida.

“Whatever the short term future holds, the complex social forces behind the rise of the Islamic Courts will not go away,” said Cedric Barnes and Huran Hassan of Chatham House.