BlogIraqi Counter Terrorism Service surgeon Lt. Col. Hayder Al Sudani, right, and Sallah Kahdum, treat patients at a processing station for internally displaced people near Mosul, Iraq, on March 3, 2017.

ERBIL, Iraq—The battle to retake western Mosul from the Islamic State (ISIS) has led to an increase in civilian deaths, injuries, and destruction. This has been compounded by ISIS’s use of civilians as human shields, the city’s dense population, narrow streets, and old building structures, making urban fighting even more challenging. In early April Iraqi officials announced that the US and Iraq would be reassessing tactics used in the fight for west Mosul. (See CIVIC’s brief on protection challenges in Mosul with recommendations to the coalition and Iraqi forces). This announcement follows an ongoing US investigation into airstrikes in Mosul in mid-March, in which over 100 civilians were killed.

Some 400,000 people remain in west Mosul. Some, who have lived under ISIS rule for two-and-a-half years and were forced to flee their homes, described to CIVIC what they saw during the battle: 

Hamad Ramadan Hasan of the al-Nahrawan Quarter in west Mosul, which is still under ISIS control, is 24 years old. He was a high-school student when ISIS entered Mosul in 2014, forcing him to leave school. Today, he is married, and he and his wife left the neighborhood on March 28.

“It was time to make a brave decision and escape the tyranny of ISIS when ISF [Iraqi Security Forces] approached,” he said.

Back in his old neighborhood, living conditions are deteriorating day by day.

“It has become unbearable, indeed,” he said. “People are left with no water and food. … Moreover, we couldn’t stay anymore as it was getting more dangerous with the approach of ISF because artillery bombs were falling on houses.”

Hamad said that civilians are harmed by the ISF artillery. “ISIS use mobile mortars, firing at ISF from a location, then immediately moving away to avoid airstrikes. But ISF smart artillery returns fire 10 minutes later and sometimes airstrikes are carried out on that location an hour later, and civilians get hurt.”

He spoke of an airstrike carried out in al-Risala Quarter in west Mosul, around March 23, near a mosque.

“ISIS snipers targeted ISF from the top of the roof of a civilian house that had 20 civilians in it, and ISF carried out an airstrike on the house killing some ISIS fighters and injuring many civilians,” he said. “Luckily no civilian died,” he added.

‘It was all about decapitation,’ he said.

ISIS tactics to provoke the coalition into causing civilian casualties are well known. Jalila Salim Abdulhadi, 35, of Tal al-Ruman Quarter, said she witnessed a strike on a neighbor’s house. ISIS had removed the front doors of the houses around it so they could move freely from one to another.

“Nearly 20 ISIS fighters entered our house and then moved to our neighbor’s house,” she said. “The number of fighters increased to around 50 in our neighbor’s house when it was hit by the airstrike. Many ISIS fighters were killed, but luckily the nine civilians in the house were … only injured. It was like a sign from God.”

While she was spared in that attack and eventually made her way to the Chamakor  camp, her troubles go back to before the occupation of Mosul. Her brother, Salih Salim, had worked as a guard in a nearby prison. For this, ISIS kidnapped him a few months before they took Mosul, and killed him.

When Salih was killed, he left two children and his wife, who was pregnant with another baby. Salih’s son, Fahd, 11, now must try to find normalcy by going to school in the Chamakor camp. He said he likes the camp school—unlike the ISIS schools.

“It was all about decapitation,” he said.

Jalila said Fahd was traumatized. “Sometimes he says that he doesn’t want to sleep because ISIS might be there in the camp,” she said.

Children like Fahd often pay the steepest price in conflict. Then there is the story of Karam, the son of Firas Waad, 32, of Wadi al-Hajar Quarter. Karam is 18 months old and suffers from hypothyroidism, and is in urgent need of treatment, according to doctors from Médecins Sans Frontières who are providing medical care in the IDP camp where Karam and his family now reside. But Firas and his family were forced from their house by ISIS on March 8. “Most probably to use it for fighting,” he said.

Had Firas stayed in Mosul, Karam couldn’t have received treatment. The last time Firas took him to a hospital there, it was under ISIS control, and they told him that they wouldn’t admit his son because there were more urgent cases. When he argued with them to take his son’s case, he said, they threatened to kill Karam if he didn’t leave. But it is little better in the camp, he said.

“This camp is like a prison. I can’t go out and take my son to a doctor. Maybe I will finally decide to go back to Mosul. I am actually confused and don’t know what to do about my son’s condition.” Most IDP camps don’t allow movement outside the camp. Emergency treatment and clinics are being set up in camps, but more complicated cases and surgeries require visits to hospitals in large cities like Erbil, which is a 2-3 hour drive, given numerous checkpoints on the way.

The challenges to fighting ISIS in populated areas should not be understated. But the anti-ISIS coalition and the Iraqi forces must constantly assess and adjust tactics so that civilian suffering is reduced. Slowing operations and reviewing tactics can improve the situation for civilians and alleviates their suffering, but military planners should also ensure that necessary food, water, and aid is going to those trapped in Mosul. Safe routes should be created so civilians can leave, even though they can be risky; ISIS snipers often attack fleeing civilians. Civilians in Mosul who have suffered under ISIS rule are navigating survival in one of the most challenging military operations.

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