BEIRUT — As Iraqi security forces choke off Islamic State fighters in the militant-held city of Fallujah, civilians inside say they are trapped and struggling to survive.
The military siege, which has tightened in the past two months, is preventing food and medical supplies from reaching the city 40 miles west of Baghdad, while the Islamic State won’t let families leave.
The United Nations says it is “deeply worried” about the deteriorating humanitarian situation and unverified reports of deaths from a lack of food and basic medicine.
Between 30,000 and 60,000 people are estimated to remain in the city, which has been under Islamic State control for more than two years. Their worsening plight comes amid an international outcry over starvation in the besieged Syrian town of Madaya — a disaster residents and officials from Fallujah say they fear could also unfold there if civilians aren’t evacuated.
“We are frustrated, desperate and afraid,” said a 32-year-old Fallujah resident who spoke on the condition of anonymity for fear of reprisals by the Islamic State. “There is hunger, lack of food and lack of medicine.”
Fallujah, which once had a population of more than 300,000, was the scene of some of the United States’ bloodiest fighting during the Iraq war, when Marines battled al-Qaeda in the city’s streets. For years a center of Sunni opposition to Iraq’s Shiite-led government, it was the first city in the country to fall to the Islamic State militants at the beginning of 2014.
Since then, residents have dealt with spiraling food costs and a lack of basic services as Iraqi forces have gradually sealed off Fallujah to isolate the militants.
When the western city of Ramadi was recaptured by Iraqi forces in December, the Islamic State’s supply lines for fighters and ammunition between the two cities were also cut, and along with them the last lifelines for the civilians in Fallujah. Now, little makes it in or out of the city.
With no flour or rice available, people have resorted to eating a gray-colored bread made from grain and birdseed, the Fallujah resident said. Yards have been turned into vegetable patches, and residents are growing what they can, he said.
Shop shelves have long been empty, although farms and palm groves on the outskirts of the city have provided limited supplies.
“On a normal day, the thing I eat most is dates,” said the resident, who spoke by an Internet voice call because the phone networks have been cut. “And soup made from water and onions.”
The situation is deadly, he said, adding that an infant died of malnutrition in January. Lise Grande, the U.N. deputy special representative to Iraq, said the United Nations has received two unverified reports of people who died from hunger — a child and a woman. The organization’s sources in the city have also reported two deaths from a lack of insulin to treat diabetes. However, with access to the city so restricted, such reports are difficult to verify.
“The humanitarian situation in Fallujah has deteriorated dramatically in the past few months,” Grande said. “We are deeply worried about unconfirmed reports that the situation is so bad that people are perhaps dying.”
She said the need for securing a humanitarian corridor out of the city was “urgent.” “I don’t think there’s any doubt in our minds that the situation is getting worse,” she said.
Iraqi security forces, including Shiite militia forces and the Iraqi army, ring the city.
“We don’t allow any supplies to enter, in order for them not to reach Daesh,” said Jaffar al-Husseini, a spokesman for Kitaeb Hezbollah, an Iranian-backed militia that has forces southwest of the city, using the Arabic acronym for the Islamic State.
He said that his forces allow civilians out but that very few have made it to their lines.
“We’ve talked to the government many, many times about making a safe passage for the people to come out,” said Eissa al-Issawi, Fallujah’s mayor, who lives in exile outside the city. Discussions have not progressed to action on the ground, he said.
The Iraqi military says that there are two ways for civilians to leave and that the army is ready to receive them. But local officials say people can’t reach those routes.
Meanwhile, the Islamic State has barred residents from leaving.
“They want to use them as human shields,” said Raji Barakat, a member of the provincial council for Anbar, the province where Fallujah is located.
One former Fallujah resident now displaced to the Iraqi region of Kurdistan said his sick father’s request to leave the city several months ago was denied by the Islamic State.
“Now, it’s impossible,” he said.
He said a woman from southern Fallujah visited his family’s house this week to beg for food, telling his mother she hadn’t eaten for two days. “There’s nothing in the market — no rice, no flour, no eggs, no tomatoes,” he said, adding that most shops have closed their doors.
“The situation is really tragic, with the full meaning of the word ‘tragic,’ ” said Issawi, who is in regular contact with residents. Although farmland has provided some vegetables for residents, there is no fuel or electricity in the city, meaning that farmers can’t use water pumps for irrigation or mechanized agricultural equipment. Militants have hoarded their own stockpiles of food, he said.
The main hospital is open but has no medical supplies, residents and local officials said. They said the city is being neglected because there is a perception that those who remain support the Islamic State.
“The central government considers everyone who remains to be Daesh,” Issawi said.
Kitaeb Hezbollah’s Husseini said the group estimates that about 2,000 Islamic State fighters are in the city and that 80 percent of the people left inside “are with them and they will fight against us.”
But many didn’t have the means to leave or were too sick or afraid, residents and officials said.
“The people of Fallujah are dying a slow death, and no one is planning on liberating it soon,” Issawi said.
Since Ramadi was recaptured in December, Iraqi officials have turned talk to a counteroffensive against Mosul, the de facto Islamic State capital in Iraq. Still, artillery and airstrikes continue to fall on Fallujah daily, residents say, causing more deaths among civilians than hunger, for the moment.
“If nothing changes, the people’s fate will be like that of those in Madaya,” said a tribal sheik from Fallujah who spoke on the condition of anonymity to protect his remaining family inside the city. “It’s a tragedy.”
Mustafa Salim in Baghdad contributed to this report.