Islamic State is increasing its attacks on the civilian population of western Mosul as its hold on the northern Iraqi city weakens, Sky News has been told.
Medical workers said they were seeing even larger numbers of people who have been targeted by the insurgents.
Dr Noori Tuma, who treats patients at a clinic in the Qayyarah refugee camp, described the city "as the most dangerous place in the world".
He said IS was holding hundreds of thousands of people hostage and was using them as human shields against an advancing Iraqi army.
He said: "Most people are injured when they leave Mosul. A shell or bullet injury by IS.
"Most injuries are in the extremities in the upper and lower limb. Or there is shell injury in the abdomen. So most of them need operations."
The refugee clinic was desperately short of X-ray equipment, which is vital for the correct diagnosis.
We saw dozens of patients being treated, including children like three-year-old Kafeer who has had one operation but still has shrapnel lodged in her body and is in constant pain.
Among the other victims of the unfolding humanitarian catastrophe was seven-year-old Alhan, who was brought in cradled in a medic's arms after collapsing from exhaustion following her Mosul escape.
Everyone fleeing Mosul is traumatised.
British volunteer, Shaun Ellis, a front-line paramedic, said he was seeing a large number of patients who have been hit by shrapnel from mortars or rockets.
He said: "We had a few people last week. A mother and child...had amputations after they were hit in their home and we took care of them. Other civilians, sniper rounds, same as soldiers they get shot in the head. IS are very good marksmen."
Fatima was injured after an IS sniper's bullet skimmed her side.
She was still wearing the gown she had on when she was shot and she showed me the hole where the round went through. But her grief was not so easy to treat.
With tears rolling down her cheeks, she told me that when she fled she had to leave her disabled daughter behind because she could not get her out.
The flow of refugees is slowing for the moment because at this stage in the battle it is so dangerous for people to move.
As we entered the city by car, it was clear that nowhere was safe. Well before the front line a mortar round landed barely 10 metres from our vehicle. It was followed by two more.
How this war chooses its victims is something many are struggling to comprehend?
It is a question Abu Mohammed, who we meet on the outskirts of the city, is now asking.
He has minor injuries he tells me but his wife and brother were killed when a mortar landed on their house.
The battle to retake the West from Islamic State is nearing the end.
Iraqi forces are winning but they are suffering large numbers of casualties. And even with supremacy in the air, they face a determined enemy.
The damage in the western part of the city though is far worse than in eastern Mosul, which government troops have already taken back.
Mosul is a major humanitarian crisis, with the number of displaced people overwhelming.
When Iraqi forces enter the old city properly there will be another flood of refugees - perhaps hundreds of thousands, says the United Nations.
And many more families will know grief before this conflict is over.