AP, Mosul :
As Iraqi forces pushed into southwestern Mosul, four Islamic State fighters moved into Omar Khudair's home and took up positions on the roof.
The 17-year-old, his parents and siblings took cover in his aunt's house next door, and for the next half hour they huddled in a back room as the battle raged overhead. Then the airstrikes came, blowing up a cluster of houses, killing not only the fighters, but 18 members of Khudair's extended family. The teen was one of the few to survive, left covered in burns and shrapnel wounds.
The fight for the western half of Mosul could the deadliest yet for civilians. Iraqi forces have increasingly turned to airstrikes and artillery to clear heavily populated, dense urban terrain, and residents running out of food and supplies are fleeing their homes at higher rates than previously seen in the Mosul operation.
More than 750 civilians have been killed or wounded since the fight for western Mosul began a month ago, front-line medics say, a number they expect to spike as Iraqi forces push into the old city. They spoke on condition of anonymity in line with regulations.
By comparison, some 1,600 civilians were killed or wounded during the 100 days of fighting to recapture Mosul's less densely populated east, according to reports from nearby hospitals. Mosul's east was declared fully liberated in January.
Airwars, a London-based group that tracks civilian deaths from airstrikes targeting IS in Iraq and Syria, estimates the number of casualties to be much higher, claiming more than 300 civilians have been killed in western Mosul over the last month.
The Pentagon, which has yet to release casualty figures from the last month, has acknowledged 220 civilian deaths from coalition airstrikes in Iraq and Syria since the U.S. campaign against IS began in 2014.
Of the nearly 300,000 people who have fled Mosul since the operation to retake Iraq's second largest city began in October, more than 100,000 have left in the past month alone, according to the United Nations.
Many are fleeing because they have no more food, said Azher Adnan, a local pharmacist volunteering as a medic at a clinic just south of the city. "Every one of my patients, the first thing they say when they approach my clinic is 'I'm hungry,'" he said.