Houthi Shiite rebels inspect the rubble of the Republican Palace that was destroyed by Saudi-led airstrikes, in Sanaa, Yemen Image Credit: AP

Aden - At least 149 people including civilians were killed in 24 hours of clashes between government loyalists and rebels in Yemen's flashpoint city of Hodeida, medics and military sources said Monday.

A military source in Hodeida confirmed seven civilians had died in the key port city, without giving further details.

Medics in hospitals across Hodeida reported 110 Houthi rebels and 32 loyalist fighters killed overnight. Military sources confirmed that a Saudi-led pro-government alliance had targeted the rebels with multiple air strikes.

Street battles raged on Sunday in residential areas of Yemen's main port city of Hodeida, forcing medical staff to flee the largest hospital, as Houthi insurgents tried to repel forces backed by the Saudi-led coalition.

Medical sources at Al Thawra hospital told Reuters that several staff members and patients able to move had fled the complex. It was not immediately clear how many patients remained inside.

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"The Houthis are reinforcing their positions near the hospital and that is what scared people," said one staff member.

Hospital spokesman Khaled Attiyah told Reuters that doctors and nurses continued their work in departments such as intensive care, the burns ward and the emergency room "despite the panic".

Last week, rights groups said the Al Houthis had raided the May 22 hospital in the city's eastern suburbs and posted gunmen on the roof, endangering doctors and patients.

The government and Arab coalition accuse Al Houthis of taking advantage of their control of the Hodeida port to obtain weapons from their Iranian patrons as well as confiscate aid intended for Yemenis in order to sustain their war efforts.

On Thursday, the Yemeni army, backed by the Saudi-led alliance’s air power, started a key operation aimed at expelling Al Houthis from the Red Sea city of Hodeida, which has been under the militants’ control since late 2014.

"We hear loud shelling and they are using all kinds of weapons, it is terrifying," said resident Abdullah Mohammed. "In the eastern suburbs, Apache helicopters are bombing Houthi positions all day long."

The coalition has said that wresting control of Hodeida would break the Houthis by cutting off their main supply line and force the group to the negotiating table to end the conflict.

The government forces said they are encircling Hodeida from the southern, western and eastern directions, leaving the northern exit for Al Houthis to flee.

Grain mill seized

Pro-coalition forces took control on Saturday of Red Sea Mills, a main grains facility south of the port which holds about 51,000 tonnes of wheat, a U.N. aid group said.

"Around 60 shells fell inside the compound since the clashes reached that area few days ago but the silos and the grains were not touched," said Ali Reza Qureshi, Yemen's deputy director for the World Food Programme (WFP).

A shipment of grain is unloaded at the Red Sea port of Hodeidah Image Credit: Reuters

"We hope the production will resume in the coming next two weeks as we get 21,000 tonnes monthly from those mills, otherwise we will have to import wheat flour," he told Reuters.

The WFP said last week it plans to double its food assistance programme for Yemen, aiming to reach up to 14 million people "to avert mass starvation".

Arab coalition intervened in Yemen's war in 2015 to restore the internationally recognized government ousted by the Iranian-aligned Al Houthi movement.

Four years of fighting and Al Houthis have not been able to achieve their ambition to take control of the country. In fact, of late, the rebels have been suffering heavy losses at the hands of government forces and resistance groups, and this should prompt them to seek a political solution

U.N. special envoy Martin Griffiths has said he hopes to convene renewed peace talks by the end of the year after the last round of consultations collapsed in September.

The United Nations has no up-to-date estimate of the death toll in Yemen. It said in August 2016 that according to medical centers at least 10,000 people had been killed.