Manama, February 19, 2011. Bahrain’s capital, Manama, descended into scenes of bloody chaos last night after the kingdom’s army opened fire on thousands of anti-government protesters near one of the city’s main hospitals.

Medics at Al Salmaniya Hospital said they were overwhelmed with the number of casualties, with over 100 people being admitted suffering gunshot wounds to the head and upper body. As doctors struggled to tend to victims, the entrance of the hospital was thronged with angry protesters denouncing King Hamad Al Khalifa and his regime.

The number of dead was put at between 10 and 30, but amid scenes of pandemonium it was difficult to establish the full extent of fatalities and injuries. There were also claims that paramedics were being prevented by state security forces from attending to the wounded as they lay on the streets in front of army tanks.

One doctor at Al Salmaniya said: “This is a massacre. We need international help. Can the world bear this? This is like a war zone, we cannot cope.” He said that the army was “shooting to kill” because most of the injured had suffered shots to the head and chest.

His pleas for international intervention were echoed by human rights activists and opposition MPs, who said that they were shocked by the brutality inflicted by state security forces.

The latest violence erupted yesterday after the funerals for four people who were killed by state forces in the early hours of Thursday at a large anti-government rally at the Pearl Monument adjacent to Manama’s financial centre.  Following the funerals, thousands of mourners were making their way to a mosque near Salmaniya Hospital for evening prayers. At around sunset, 6pm local time, the crowds were met by Bahriani Defence Force tanks that had already assembled in the vicinity. Witnesses said the mourners were proceeding peacefully when the army opened fire, with claims that snipers and soldiers using machineguns were deployed.

Najab Rajab, of the Bahrain Human Rights Centre, said all the shots fired were live rounds. No plastic bullets or tear gas were used to disperse the crowd.

“This is shame on the ruling elite who has used the army to kill their own people,” he said. “These people were peaceful and the army is killing them.”

Khalil al Marzouq, an opposition MP, called on the United Nations to intervene to protect the people. “Peaceful people are being killed on the streets like animals,” he said.

Al Marzouq asked: “What is the United States doing about this?” – pointing out that the US Fifth Fleet navy is based in Bahrain, with thousands of personnel stationed only a few kilometers from the scenes of mayhem unfolding on the streets of Manama.

Bahrain is the latest country in the Middle East to have witnessed a popular uprising against its rulers. There were protests yesterday in Yemen, Jordan and Libya, emulating the popular movements in Tunisia and Egypt, which have ousted the US-backed leaders in those countries.

But Bahrain’s violence has a foreboding element that could elicit even greater bloodshed. Already the casualties, proportionate to its small population of perhaps 600,000 indigenous people, are set to overtake those of Egypt, for example, where some 300 people out of a total population of 80 million were killed in recent anti-government protests.

The Bahraini army and police forces are largely made up of expatriates from Jordan, Pakistan, Syria and Yemen. Unlike Egypt, where the army was seen to be reluctant to turn its guns on the people, it is feared that the Bahraini Defence Forces will not display such restraint.

As many more funerals take place in Bahrain later this week from the latest violence, the Persian Gulf country is in danger of witnessing an escalation of bloodshed.