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A man lies on a hospital bed in the Maiduguri State Specialist Hospital on January 18, 2017.STEFAN HEUNIS/AFP / Getty Images

As the death toll climbs to more than 230 in a Nigerian military attack on a refugee camp, new accounts from witnesses and satellite photos are revealing the full horror of the disaster.

The Nigerian air force has apologized for the attack, calling it an accident. But witnesses say a Nigerian warplane circled twice and dropped two bombs in the middle of the town of Rann, Nigeria, where as many as 40,000 refugees have sought shelter from Boko Haram, the radical Islamist militia.

Nigerian officials now say that 236 people were killed in the attack last week. Most were women and children. At least nine humanitarian workers were among the dead and more than a dozen others were injured.

Read more: Nigeria mistakenly bombs refugee camp, killing more than 50

"There are no words to describe the chaos," said Alfred Davies, a field co-ordinator with Médecins sans frontières (Doctors Without Borders), in an interview released by the agency. "I saw the bodies of children that had been cut in two."

Human-rights groups say the attack could be considered a war crime, even if it wasn't deliberate. Early estimates said 52 people were killed, but the toll has climbed rapidly as more reports filter out from the remote town near Nigeria's border with Cameroon. At least 120 were injured in the bombing attack, many critically.

So far, only a panel of Nigerian air-force officers is investigating the disaster. No larger independent inquiry has been appointed. Journalists are barred from the bombing site, and the air-force panel has been ordered to finish its report by the end of next week.

Nigerian President Muhammadu Buhari issued a brief statement expressing "regret" for the disaster, and then went on vacation in a luxury hotel in London.

Satellite photographs show that at least 35 structures – including shelters for displaced people – were destroyed by "multiple air-dropped munitions" at two sites in the town of Rann, according to a report by Human Rights Watch, which has called for an independent investigation.

Hundreds of refugee tents are located among the residential buildings at the two bombing sites, and the tents are "easily visible from the air, making it difficult to understand how an accident of this nature could have occurred," Human Rights Watch said.

When the bombing began, 40 volunteers from the Nigerian Red Cross Society were just starting to distribute food to thousands of refugees. Nine of the volunteers were in critical condition with injuries from the explosions, the Red Cross said.

The town had been isolated by war and poor roads since last June, and some refugees had already died of malnutrition. The refugees were desperate for food, which finally arrived on the day of the air strike.

MSF said the victims "deserve a transparent account" of the disaster. "People had sought safety in what they thought was a protected site – instead they were bombed by those who were meant to safeguard them," said a statement by Bruno Jochum, MSF's general director.

MSF medical co-ordinator Mohammed Musoke, who helped treat the wounded, described a six-month-old infant who had a piece of shrapnel embedded in his neck. The baby, like dozens of other victims, was evacuated by helicopter to the nearest city, Maiduguri. "In the helicopter, the child was crying uncontrollably," he told MSF.

A day after the bombing, many of the injured had not yet been evacuated and were "still in a very bad shape," he said. There was no hospital in the town, and many of the injured died from lack of medical equipment.

"We saw dozens of patients with multiple traumatic injuries, including open fractures and wounds to the abdomen and chest," Dr. Musoke said.

"There was a 10-year-old boy with a large, deep flesh wound to his thigh. The flesh was hanging loose on one side and you could see through to the bone. This kind of wound is extremely painful, but all the time that I was applying bandages to the wound, he stayed expressionless and numb."

Baba, a 37-year-old refugee who was injured in the bombing, said he had often seen Nigerian warplanes flying past the town. "But on Tuesday, it was different," he said in an MSF interview. "The plane flew back and forth, and we knew something was wrong before the bombing happened."

He said he began running as soon as the first bomb hit. He was hit by shrapnel from the second explosion. "I started feeling pain and when I looked I saw that there was a hole in my leg and my foot, and that I was bleeding."

The disaster at Rann is just the latest in a series of bombings and other attacks by Nigerian military forces that have killed scores of civilians in recent years.

It also illustrates the growing threats to humanitarian agencies in war zones. Russian and Syrian forces have repeatedly bombed and shelled hospitals and clinics in Syria, including MSF clinics, killing dozens of people. In Afghanistan, U.S. warplanes bombed an MSF hospital in Kunduz, killing more than 40 patients and staff.

Last year alone, more than 90 humanitarian workers were killed in attacks of various kinds across the world, and 154 were injured, according to a database maintained by the International NGO Safety Organization.

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