The United Nations has said that there were alarming reports about civilian deaths in the Syrian enclave of Afrin, where Kurdish forces were said to be blocking civilians from leaving the city.

The UN rights office said it had been receiving "deeply alarming reports from Afrin in northwestern Syria about civilian deaths and injuries due to air strikes and ground-based strikes," adding that the area is under a siege and civilians could be being used as "human shields" by the Kurdish forces there.

Spokesperson Ravina Shamdasani in particular decried "reports that civilians are being prevented from leaving Afrin city by Kurdish forces ... (and) are being held to be used as human shields."

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Turkish-led forces launched an air and ground offensive on the Kurdish-majority region on January 20.

The Syrian Observatory for Human Rights (SOHR) estimates that at least 245 civilians, including 41 children, have been killed.

The Observatory said Thursday more than 30,000 people had fled the city in 24 hours, with civilians still trying to slip out on Friday before Turkish-led forces cut the last exit road.

"Hundreds of thousands of civilians are at risk including those recently displaced from other areas captured by Turkish-led forces," Shamdasani said.

'Humanitarian situation worsens'

She said her office had been informed that "only those civilians who have contacts within the Kurdish authority or the Kurdish armed forces have been able to leave."

However, she stressed that "even they have to make a treacherous path through, risking shelling and explosive hazards only to reach checkpoints manned by government-backed armed groups where they may only be permitted to cross after paying money."

A Turkish air raid hit the main hospital in Syria's Afrin town on Friday night, killing nine people, the Syrian Kurdish fighters and the SOHR said.

Turkey's military has denied hitting civilians in its offensive on the Afrin region, which it launched in January. On Saturday, the army said that 3,567 "terrorists" were killed since the operation was launched.

"There was an air strike on Afrin's general hospital, it's the only big hospital," said Rojhat Roj, a YPG media official in Afrin. "The air and artillery strikes are ongoing on the town."

She voiced concern at the worsening humanitarian situation, pointing to the "tremendous pressure on Afrin hospital, the only medical facility equipped for major operations."

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"There is also a severe water shortage due to the reported destruction of a pumping station as well as the control of other water resources by Turkish-led forces," she said.

Shamdasani said civilians on the ground were expressing fear over their safety, due among other things to fighters placing rocket launchers in residential areas.

"We are deeply concerned about the high risk of civilians, who are effectively trapped, being killed, injured, besieged, used as human shields or displaced as a result of the fighting," she said.

"We remind all parties to the conflict that they must permit civilians wishing to leave combat areas to do so in safety, and to ensure the protection of those who remain," she insisted.