Days of deadly tribal clashes have erupted in southern Libya after a pet monkey attacked a high school girl.
Abdel-Rahman Areish, the head of Sabha city hospital, told the Associated Press news agency on Sunday 20 people have been killed and 50 wounded. Reuters said at least 16 people died in four days of fighting.
Bader al-Daheli, a civil activist, said the two main tribes in the southern city of Sabha - Awlad Suleiman and Gaddadfa - are each backed by heavily armed groups.
According to residents and local reports, the latest bout of violence erupted after a monkey that belonged to a shopkeeper from the Gaddadfa tribe attacked a group of schoolgirls passing by.
The monkey pulled off a girl's headscarf and reportedly bit and scratched her, leading men from the Awlad Suleiman tribe to retaliate by killing three Gaddadfa people - as well as the monkey.
"There was an escalation on the second and third days with the use of tanks, mortars, and other heavy weapons," a resident told Reuters on condition of anonymity because of the denigrating security situation.
"There are still sporadic clashes and life is completely shut down in the areas where there has been fighting."
Like other parts of Libya, Sabha - about 660km south of Tripoli - has been periodically plagued by conflict since the uprising that toppled Muammar Gaddafi five years ago splintered the country into warring factions.
In the Sabha region, a hub for refugee and arms smuggling in Libya's often neglected south, militia abuses and the deterioration of living conditions have been especially acute.
The Gaddadfa and the Awlad Suleiman represent the most powerful armed factions in the region.
During the latest clashes, which took place in the city centre, initial attempts by tribal leaders to calm the fighting and arrange a ceasefire so that bodies could be recovered had failed, residents said.
"There are women and children among the wounded and some foreigners from sub-Saharan African countries among those killed due to indiscriminate shelling," said a spokesman for the Sabha Medical Centre.