MISURATA, Libya — Jinan Hussein Jweil rested on her back on a gurney inside the triage tent. Either a bullet or a piece of whizzing shrapnel had struck the 5-year-old high on the right side of her head.       

A Libyan and Italian medical team worked to save her. It was not certain they could. “Her brain is out,” said Dr. Abdullah Juwid, a surgeon.       

As the ugly math of a midsize city suffering a siege would have it, Dr. Juwid was both a doctor in an overcrowded triage tent and an uncle of this wounded child. He had no time to dwell on her case.       

A pickup truck skidded to a stop outside. Several rebel fighters carried their bullet-riddled friend through the entrance flap. The man appeared to have been in his 20s. He had been shot through both legs and squarely in his chest and mouth. His pupils were fixed.       

“Maybe he is dead,” another doctor said, as their assistants cut away the man’s clothes. The assistants stopped. There was no point in searching for more wounds. “He is killed,” one of them said.       

In the battle for Misurata, a rebel holdout city under attack by Col. Muammar el-Qaddafi’s forces for months, the tally of those killed and wounded rises daily, and often by the hour. It can be only partially assessed at one of the several treatment centers scattered around the rebel-controlled portions of the city. But where it is counted, it is grim.       

The wounded arrive at this triage tent throughout the day and sometimes deep into the night, a population formed by circumstance and number into a procession of wartime trauma.       

Mustafa Madhoun, a physiotherapist who had never seen injuries nastier than those suffered by the victims of vehicle accidents, had just participated in the amputation of the lower left leg of a fighter, Mustafa Youssif.       

Mr. Madhoun summed it up. “Yesterday was a very bad day,” he said. “I had hoped today would be different. Today is a very bad day, too.”       

In clinical terms, this triage tent has seen a catalog of the effects of modern weapons on human life — gunshot wounds, blast wounds, shrapnel wounds, the occasional burns. People arrive with wounds as mild as a bullet’s graze, to wounds as life-changing as a severed spinal cord. A few arrive dead.       

On average, 50 or 60 wounded people pass through this tent each day. About 10 of them die, according to the medical staff and the flow of patients observed.       

“Most of them, for sure, are civilians,” said Dr. Paolo Grosso, an anesthesiologist who is part of a seven-member team in Misurata from Emergency, the Italian aid organization, and was among those working to save young Jinan. The organization has been helping Misurata’s doctors.       

How many people have been fatally wounded since the siege began in February is not readily known. Rebels say more than 1,000 people have been killed. That number is not verifiable in the current conditions.       

The hospital records available so far indicate that at a minimum 313 people have been killed and 1,047 wounded through Sunday evening. But this count is most likely low, as some families do not take victims who have been killed outright to hospitals. They simply bury them instead.       

(Eight people who were killed in a rocket strike last Thursday, for example, were interred in a small public park in the Qasr Ahmed neighborhood without being tallied by any medical staff.)       

Some days, like Saturday and Sunday, in which 70 people were verified wounded each day, have been worse than others.       

Among those struck have been children, including Mohamed Hussein el-Faar, 10. He arrived at the triage tent Saturday afternoon, howling. Blood trickled from the hair beside his right ear. He fought the doctors as they tried to examine him, until several assistants held him down.       

At first it seemed he had been grazed by a bullet. But there was also a wound on the opposite side of his head. After he was stabilized and moved into a facility with a CT scanner, the images provided a fuller view: a bullet had passed through Mohamed’s skull.       

On Sunday he was still alive, though a doctor gave a discouraging prognosis. “Not good,” he said. “Never with this kind of injury is the prognosis good.”       

By late Sunday morning in the triage tent, there was little time to think of yesterday’s patients. The sounds of battle could be heard a few blocks away, and thick smoke billowed over part of Tripoli Street, one of the city’s main fronts. A hurried pace had picked up again.       

At 11:20 a.m. the medical staff cut away the shirt of a man who had been peppered by light debris in an explosive blast, his back busy with small holes. An ultrasound technician scanned his torso while doctors watched.       

“No problem,” Dr. Grosso said. “His chest is free.”       

Another ambulance arrived eight minutes later, with a man who was not so lucky. A bullet had struck him near his hip — a place where blood flow can be very difficult to stop. The crowd of men who saw him being carried off the ambulance, and saw the wide pool of blood he left behind, realized he was likely to die.       

The men immediately began to chant: “God is great,” they shouted, over and over.       

Throughout the afternoon the pace was unrelenting. At times four or five fresh patients were treated at once. As each was wheeled out of the tent, it seemed another arrived.       

The trauma center was in many ways well-provisioned. Its staff and the many volunteers who have come to support it had done the planning, and some of the necessary scrounging, to make do. (At two sinks on Sunday, the staff washed hands with powdered laundry soap — anything to stay clean.)       

Many of its principal needs have thus far been covered. It has a generator and running water, two things not available in much of the city. It serves its patients and those who work here occasional bottles of water and small portions of food.       

But it lacks some medicines, including opiates. For at least a week there has been no morphine.       

Some of the patients would in any other circumstance surely need it, including Mr. Youssif, a fighter brought down by ordnance that ruined his legs.       

Mr. Youssif watched as his bloody pants were cut away, revealing shins that had been blown open and feet that pointed in ways they were not meant to. It was obvious his lower right leg would need to be amputated. Keeping his lower left leg appeared uncertain, too. He flashed a victory sign, laid back on the gurney, and moaned.       

He began to pray.       

Later, in a lull after Mr. Youssif’s lower right leg had been removed, Mr. Madhoun paced away from the tent.       

Assistants were washing bloodied stretchers and pushing them into ambulances headed back out. The smoke over Tripoli Street was getting thicker. Some said the rebel lines risked being broken, which might allow the pro-Qaddafi forces to push unimpeded into the city.       

Asked if he was afraid, Mr. Madhoun’s answer was quick.       

“Absolutely not,” he said. He added: “We have a strong connection to God. All of us here know that some day death will come. We know we will die. And we do not care how we die.”       

He stood quietly as patients were moved by. A refrigerated truck in the lot held rotting remains collected in the morning on the street. He amended his answer. “It is an honor,” he said, “to die in defense of freedom.”       

So many, though, have been wounded or killed defending nothing, resisting nothing, just trying to stay out of the conflict’s way.       

As Sunday’s tallies rose, an aged woman joined the procession of the wounded, as did a wafer-thin 92-year-old man, who was carried into the tent with bloodied face and feet.       

He had been in his home, his son said, when a mortar or artillery round hit it, collapsing the roof.       

More and more fighters arrived, too, some in pickup trucks that now contained lakes of blood. These men were in the last moments of life. By 5 p.m. the crowd around the tent was chanting almost nonstop.       

Another Libyan fighter had died, and his body was to be carried to his grave. A gantlet of men formed, some of them weeping, and walked with the wooden casket containing him overhead toward another waiting pickup truck. The body was wrapped in a green blanket, prepared for the earth.       

Ten minutes later, the same dirge started anew. It was another man’s turn.       

Dr. Grosso watched. He had been a portrait of composure throughout the day. Now he stood among the blood-splattered ambulances.       

“It is a shame on Western nations,” he said, and slipped back inside to work.       

A short while later, the word moved from the medical staff, then through the crowd. There was another victim. Jinan Hussein Jweil, 5 years old, was dead.

Copyright. 2011. The New York Times Company. All Rights Reserved.       

TUSHKA, Okla. — The sound of chain saws filled the air in this rural town on Friday as Jessica Eldridge sifted through a pile of rubble that until last night had been her house, looking for clothing, family photos, pots and pans, any belongings she could salvage.       

Somehow her pet dachshund had survived, but she found little else, much of it destroyed or carried away as a vicious tornado destroyed dozens of homes, demolished the town school, ripped apart a tractor-trailer factory and scattered cars and trucks about as though they were toys.       

“I broke down last night,” said Miss Eldridge, 23, the mother of a newborn and a toddler. Her red-rimmed eyes were glassy and distant. “My daughter wanted to go home, and she doesn’t understand the wind took the home and it’s blown away.”       

At least two people died when the twister touched down here in Tushka, a town of 405 residents, late in the evening Thursday, leaving a trail of destruction a half-mile wide and seven miles long. The storm system moved on to Arkansas, where 80-mile-an-hour winds caused seven more deaths Thursday night. On Friday evening, three suspected tornadoes spawned by the same system touched down in Mississippi, leaving extensive damage and one person with life-threatening injuries in Clinton, about 10 miles from Jackson.       

The Oklahoma medical examiner identified the two people who died in Tushka as Ava Walkup, 75, and Sammie Dement, 80.  A neighbor said the women, who were sisters, were found buried in the debris of the house Mrs. Dement shared with her husband, who was also seriously injured.        

Most people made it to shelter, however.  The town received notice of the approaching tornado 68 minutes before it hit. “That, most likely, contributed to the minimal loss of life,” said Walt Zaleski, a warning coordinator meteorologist with the National Weather Service.        

The tornado was one of five to touch down in eastern Oklahoma on Thursday just before dusk, the National Weather Service said. Witnesses said they saw several funnel clouds descending from the darkening sky, then they appeared to merge into one twister that entered the town from the southwest.       

More than 150 residents rushed into two town shelters near the school and crowded inside, waiting as the winds tore up trees, downed power lines, tore the roofs from buildings and flipped over cars and trucks.       

Clay Cole, 53, who lives next-door to the school, said he was on his front porch when he heard the storm. “It sounded like a big locomotive,” he said. “Whoom, whoom, whoom.” He sprinted to the shelter, a 45-foot-long cellar with metal doors built 90 years ago, and stumbled down the stairs.       

“It had at least 100 or more people in it — it was full,” he said. “You could hear stuff a-ripping and a-tearing. It lasted three minutes or so until it was over. Then nothing.”       

Outside, Alfred Elliot, 64, a truck driver, was driving pell-mell to the shelter with the funnel in his rearview mirror before the tornado touched down. He watched as part of the school’s roof lifted up and disappeared into the air in front of him. The winds blew out the back window of his truck, but somehow spared him and his wife, Linda Elliot, 62. “I was half scared to death,” he said. “God had to be sitting in the pickup and watching over me.”       

The storm tore off the top floor of the original school building, built in 1927, scattering brick rubble below. An adjacent gymnasium collapsed and winds knocked down walls and ripped the roof off a newer annex. Somehow the winds left trophies in their cases and many books on shelves.       

Michelann Ooten, a spokeswoman for the Oklahoma Department of Emergency Management, said at least 50 homes were damaged. Scores of people were left without housing, and the Red Cross has set up a temporary shelter for displaced residents in the nearby town of Atoka.       

Throughout the town, trees as large as eight feet in diameter were ripped up at their roots, many falling across streets and highways. Utility poles were snapped off like toothpicks. Large pieces of sheet metal from a factory outside town were twisted up like discarded tissues. A bed rail was driven through a tree. One trailer home had been blown off its foundation and 30 yards into a neighbor’s yard. Upended tractor-trailers made many roads impassible, including the northbound lanes of Interstate 69, officials said.       

In Arkansas, most of the fatalities were caused by trees and heavy branches falling on mobile homes, state emergency management officials said. Among the victims was a 6-year-old boy, Devon Adams, of Bald Knob in White County, who was sleeping on a couch in his family’s house when an enormous tree crashed through the ceiling and crushed him, the authorities said.       

In St. Francis County, in eastern Arkansas, a double-wide trailer was sent airborne by the fierce winds, killing a woman and injuring her husband, the authorities said. In Pulaski County, the storm killed one man, James Loftis, 56, whose recreational vehicle was crushed by a tree.       

WASHINGTON — The Obama administration has begun seeking a country, most likely in Africa, that might be willing to provide shelter to Col. Muammar el-Qaddafi if he were forced out of Libya, even as a new wave of intelligence reports suggest that no rebel leader has emerged as a credible successor to the Libyan dictator.       

The intense search for a country to accept Colonel Qaddafi has been conducted quietly by the United States and its allies, even though the Libyan leader has shown defiance in recent days, parading through Tripoli’s streets and declaring that he has no intention of yielding to demands that he leave his country.       

The effort is complicated by the likelihood that he would be indicted by the International Criminal Court in the Hague for the bombing of Pan Am 103 in 1988, and atrocities inside Libya.       

One possibility, according to three administration officials, is to find a country that is not a signatory to the treaty that requires countries to turn over anyone under indictment for trial by the court, perhaps giving Colonel Qaddafi an incentive to abandon his stronghold in Tripoli.       

The move by the United States to find a haven for Colonel Qaddafi may help explain how the White House is attempting to enforce President Obama’s declaration that the Libyan leader must leave the country but without violating Mr. Obama’s refusal to put troops on the ground.       

The United Nations Security Council has authorized military strikes to protect the Libyan population, but not to oust the country’s leadership. But Mr. Obama and the leaders of Britain and France, among others, have declared that to be their goals, apart from the military campaign.       

“We learned some lessons from Iraq, and one of the biggest is that Libyans have to be responsible for regime change, not us,” one senior administration official said on Saturday. “What we’re simply trying to do is find some peaceful way to organize an exit, if the opportunity arises.”       

About half of the countries in Africa have not signed or ratified the Rome Statute, which requires nations to abide by commands from the international court. (The United States has also not ratified the statute, because of concerns about the potential indictment of its soldiers or intelligence agents.) Italy’s foreign minister, Franco Frattini, suggested late last month that several African countries could offer Colonel Qaddafi a haven, but he did not identify them.       

As the drama over Colonel Qaddafi’s future has intensified, new details are emerging of the monthlong NATO bombing campaign, which, in the minds of many world leaders, has expanded into a campaign to press the Libyan military and Colonel Qaddafi’s aides to turn against him.       

That effort has gone more slowly than some expected; after the defection of the former intelligence chief and foreign minister, Moussa Koussa, no other senior officials have broken with the man who has ruled Libya for 42 years.       

Six countries — Britain, Norway, Denmark, France, Canada and Belgium — have provided more than 60 aircraft that are conducting airstrikes against Libyan targets that attack civilians. But NATO commanders say they are still struggling to come up with at least eight more warplanes to ensure the alliance can sustain a longer-term operation and relieve strain on pilots now flying repeated combat missions.       

The United States, which carried out the largest share of strike missions before handing off control of the operation to NATO on April 4, has promised additional fighter-bombers and ground-attack planes if NATO requests them. While some European officials have privately complained that the United States should resume a leading role in the attack missions, American officials say they have not received any formal requests for additional aircraft.       

Benjamin J. Rhodes, a deputy national security adviser to Mr. Obama, asserted that in a month’s time the coalition has accomplished three major objectives: saving the de facto rebel capital of Benghazi from becoming the site of a civilian atrocity, setting up an international command to protect civilians and clear the skies of Libyan aircraft, and providing modest amounts of humanitarian assistance.       

Still, the NATO countries flying ground-attack missions operate under different degrees of caution when striking targets that could hurt civilians or damage mosques, schools or hospitals, complicating the campaign, a senior American military official said. Some pilots have refused to drop their bombs for this reason, the official said, but allied air-war planners cannot predict which pilots will be matched against particular targets.       

“Without a doubt, it is frustrating working through all this to get maximum effect for our efforts and dealing with all these variants,” said the official, who spoke on the condition of anonymity to avoid upsetting coalition partners.       

American officials concede that the rebel leaders have not settled on who might succeed Colonel Qaddafi if he is ousted, and some fear that tribal warfare could break out if there is no consensus figure who could bind the country together.       

White House officials say that while they would have liked to see Colonel Qaddafi depart already, they believe that pressure is building.       

“There are aspects  of the passage of time that work against Qaddafi, if we can cut him off from weapons, material and cash,” Mr. Rhodes said. He added that “it affects the calculations of the people around him. But it will take time for the opposition group to gel.”       

Earlier this month, an American envoy, Chris Stevens, was sent to Benghazi to learn more about the Transitional National Council. The group has pledged to work toward new presidential and parliamentary elections after Colonel Qaddafi’s ouster, uphold human rights, draft a national constitution and encourage the formation of political parties. Mr. Stevens is expected to stay as long as a month, security permitting, State Department officials said.       

The United Nations special envoy to Libya, Abdelilah al-Khatib, a former Jordanian foreign minister, is also meeting with opposition figures, as well as with members of Colonel Qaddafi’s government to explore possible diplomatic settlement.       

Perhaps the most prominent member of the government in waiting is Mahmoud Jibril, a planning expert who defected from Colonel Qaddafi’s government. Secretary of State Hillary Rodham Clinton has met twice with Mr. Jibril, who American diplomats say is the group’s most polished and savvy public figure. He also spoke to several NATO, Arab and African ministers who gathered in Doha, Qatar, last Wednesday to discuss the Libya crisis.       

Another leading council member is Ali Tarhouni, who was appointed finance minister of the rebels’ shadow government. Mr. Tarhouni, who teaches economics at the University of Washington, returned to Libya in February after more than 35 years in exile to advise the opposition on economic matters.       

“With respect to the opposition, we are learning more all the time,” Mrs. Clinton said in Berlin on Friday. “We are pooling our information. There are a number of countries that have significant ties to members of the oppositions, who have a presence in Benghazi that enables them to collect information. Our envoy is still in Benghazi and meeting with a broad cross-section of people.”       

Mrs. Clinton told NATO ministers that the coalition had acknowledged the transitional council was “a legitimate and important interlocutor for the Libyan people.” She added: “We all need to deepen our engagement with and increase our support for the opposition.”       

A 10-year-old boy escaped and swam ashore after his mother deliberately drove their minivan off a boat ramp and into the Hudson River in Newburgh, N.Y., on Tuesday night, the police said. The mother and three younger children who were trapped in the minivan died.

The police said the driver’s-side window was down when the doomed minivan was towed from the water, suggesting that the boy, identified as Lashaun Armstrong, had crawled past his mother as he scrambled to get out.

Michael Ferrara, the Newburgh police chief, identified the mother as Lashandra Armstrong, 25. Inside, along with Ms. Armstrong, were her three young children, identified by the police as Landon Pierce, 5; Lance Pierre, 2; and Lainaina Pierre, 11 months old. All had died, Chief Ferrara said.

He said the 10-year-old had been in the minivan when Ms. Armstrong steered the car off the boat ramp and into the river a few blocks from the row-house apartment where they lived. Lashaun “managed to hit the power windows,” Chief Ferrara said, and “climbed out before the vehicle sank.”

Newburgh officials described a tragedy that unfolded rapidly around dinnertime on Tuesday night. Chief Ferrara said that a relative of Ms. Armstrong’s had called the police around 7:30 p.m., “saying they believed Lashandra Armstrong was involved in a domestic dispute” with the father of three of her four children. Chief Ferrara said the caller reported hearing “tussling in the background.”

He said officers were sent to her home, but it was too late: No one was there.

The first indication of what had happened came about 20 minutes later, according to the Newburgh fire chief, Michael Vatter, when a woman and a 10-year-old boy appeared at a firehouse and said that a car had driven into the river.

The boy was soaking wet, Chief Vatter said, and firefighters “subsequently learned” that the boy had been in the minivan. The woman with him at the firehouse had picked up him after he had made it to shore and had driven him there to get help, the chief said.

Soon firefighters and state police divers were searching the river. It took about an hour to find the submerged minivan, which officials said was under eight feet of murky water about 25 feet from the shore.

Nate Schweber contributed reporting from Newburgh, N.Y.