Desperate search for food and medicine as Gbagbo fights on

Civilians in Ivory Coast's largest city are risking death on the streets as they look for aid. Daniel Howden reports from Abidjan

The hospital director is elaborately polite and determined to say nothing. Treichville University Hospital would usually be one of Abidjan's busiest but yesterday it seemed to be empty.

The director was under "strict instructions" from Laurent Gbagbo's government not to say anything. Even though the Ivory Coast strongman is surrounded in his bunker, facing investigation for crimes against humanity while troops loyal to his presidential challenger Alassane Ouattara advance on his position, Gbagbo is still feared. "I have been told by the health ministry not to reveal anything about the conditions here," the director said.

The battle for Abidjan has taken a brutal toll on civilians in the lagoon city. But as long as its hospitals remain cut off and its roads impassable, no one knows how many people have been killed or injured.

But out of earshot of the director, there are doctors who do want to talk. A young surgeon in a white coat leads the way through the hospital via a corridor of empty rooms.

The reason the hospital is empty is not because there are no sick and injured people in Abidjan; it's "la crise" he keeps saying. "There's no way to get here, there's no transport out there."

When an ambulance does appear, the driver stops to explain that he's not allowed out of the hospital complex. He can fetch the walking wounded only from the front entrance and take them to the emergency room.

"The last one to go out was car-jacked so since then no one goes outside," he says of the restriction.

Dozens of taxis are parked inside the hospital, where the owners have left them to escape looters. At the surgical wing a nervous doctor ushers us to come inside quickly: "People are dying in their homes," he protests. "They are being hit by stray bullets." A young man who gives his name as Manu was hit while hiding from the fighting in his house. The bullet lodged in his thigh on 31 March but he had to wait until yesterday for the Red Cross to get to him to the hospital.

Manu's leg has swollen to twice its normal size and will have to be amputated. Two other boys share his room: one was hit by a stray bullet in his bedroom while the other was shot by pro-Gbagbo soldiers as he was trying to get home.

"Since the beginning of the month we've had 100 patients hit by stray bullets," the surgeon said. "We would have had many, many more but most have died where they were shot. They can't reach us here."

The hospital morgue is full, he adds, and bodies are having to be stacked on the floor. The pharmacy has run out of antibiotics, HIV sufferers have no drugs, and kidney-dialysis machines have been switched off.

"If this keeps going, it will be a catastrophe," the surgeon warns.

Only 500 metres from the hospital gates, four burnt bodies lie on the forecourt of the Michelin depot. The charred skeletons seem to wrapped in wire – the metal mesh is all that's left of the tyres that were put over their heads, filled with petrol and set alight. Yet over the weekend, more and more people have emerged into this wasteland unable to wait any longer for a ceasefire.

Dina Mafouz has chronic arthritis but walked for nearly two hours yesterday from the Koumassi neighbourhood to the Prix supermarket in Zone 4 when she heard it re-opened.

"My legs are hurting but I have no choice, we are hungry," she says sitting heavily on the kerb. Between her feet are two spent shotgun cartridges.

No one has been able to withdraw money in Ivory Coast since the banks were closed over a month ago. Mrs Mafouz says that she is not just feeding her two daughters but many of her neighbours too.

"This is Africa," says the 50-year-old. "we have to share."

As she talks, other women gather round shouting that they are hungry and angry. Prices have doubled or quadrupled for most basics. A kilo of potatoes that cost 500 Cifa (about 70p) now costs 1,200; cigarettes have gone up from 600 Cifa to 2,500.

There used to be plenty of money in this district. The supermarket is flanked by a car dealership and a complex of cinemas and restaurants, all shuttered up. Advertising hoardings display iPads and jewellery.

But the popular assumption that Ivory Coast's large and worldly middle class would save it from the chaos has been painfully exposed. At the petrol station opposite there are two cars stripped of their wheels and one upside down with a concrete block smashed through its windscreen. The pumps have been ripped off and the empty cashier's office ransacked. It's as though a human tsunami has washed though Abidjan.

A single traffic light has been left standing at the junction with the Boulevard Giscard D'Estaing but cars take no notice. The few vehicles that are driving do so at speed with their hazard lights on and white plastic bags tied to their windows in an appeal to gunmen not to shoot.

As the supermarket closes, a black 4x4 screeches up to the entrance and four armed men jump out. When they re-emerge they have a trolley stacked high with food and alcohol. They are fighters loyal to Ouattara, the man recognised internationally as the new president of Ivory Coast.

A tattooed man wearing a vest and plastic sandals and with an assault rifle slung over his shoulder points at the groceries and says: "People give us things. We are fighting for the people and we are not paid."

He vows that the Ouattara forces will "finish the job" soon. "We are hunting for pro-Gbagbo soldiers to kill them."

As the soldiers speed away, a wretched line of women marches past carrying impossible loads of wood picked from the debris. Bintou Toure, a mother of four, says she has been out collecting firewood for six hours.

"I am taking it home now," she says. "Then I will go to look for food to cook on it." She admits that she has no idea where to find it.