MOSUL, Iraq — “We have wounded!” the men shouted from the roadside. Two soldiers, bleeding, were being bandaged beside their smoking vehicle on the side of a dusty dirt road.

Iraqi special forces Maj. Saif Ali yelled to his driver to stop and leaped out. “Put one inside and the other on top!” he called to his men. One was put in Ali’s seat, the other laid on the vehicle’s hood. “Go!” he shouted, crouching on the hood next to the wounded man. His driver blared the horn and the gunner shot into the air trying to clear a way through a sea of fleeing civilians and livestock.

As Iraqi forces push deeper into western Mosul, the assault is bringing a surge of casualties — at least 30 Iraqi security forces and more than 200 civilians killed or wounded in the last three days. Iraq’s military does not release official casualty reports, but medics at front-line clinics provided figures on condition of anonymity.

The sudden spike in casualty numbers mirrors what played out in Mosul’s east as the fight moved from rural villages to dense urban areas. Front-line medic stations that stood empty for the first days of the assault on Mosul’s west announced last week, are now overflowing. At one clinic Sunday, the dead had to be moved to the ground to free up beds as more injured arrived.

The soldiers that Maj. Ali picked up had been wounded when a mortar — fired from districts held by the Islamic State group — hit them along a route used by the thousands of civilians fleeing Mosul on foot in the days after Iraqi forces first punched into Mamun neighborhood on Friday.

Ali had been on his way back to base after a quick visit to the edge of Mamun neighborhood. Now he was gripping the grate of his Humvee, using his own weight to keep the wounded man from sliding off the hood.

In the front passenger seat, the other soldier — with a head wound — sat with his eyes wide open and glassy. Everyone inside the vehicle rode in almost complete silence as Ali and his gunner shouted directions to the driver and yelled for civilians to move out of the way.

Blood slowly soaked through the black shirt of the man sitting in Ali’s seat. The nearest clinic was five kilometers (3 miles) away — down bumpy dirt roads, crowded with people. After a few moments the soldier went completely limp, his body swaying slackly with each bump the Humvee hit. He was dead.

On Sunday afternoon Iraq’s special forces were still struggling to clear the Mamun neighborhood, bringing them back to a phase of grueling urban combat similar to the fight for eastern Mosul in early November when military attrition rates spiked.

Iraqi forces at a base a few kilometers (miles) south of the front called in airstrikes to take out small units of two or three IS fighters who repeatedly managed to halt advancing Iraqi convoys.

The number of car bombs targeting Iraqi forces in western Mosul has been fewer than what forces experienced in the east: approximately four a day in the west compared to more than dozen a day in the east.

But the number of armed IS drones has ballooned. In a singled day drones dropped more than 70 munitions on Iraqi forces. The bombs mostly caused light injuries but they disrupted operations and monopolized the finite surveillance capabilities available from Iraq’s military and the U.S.-led coalition backing the Mosul fight.

The whizz of mortars on the edge of Mamun neighborhood repeatedly sent families scattering for cover as they tried to flee Mosul’s city limits. The route civilians are using to flee Mosul’s west on foot is still within mortar range of IS fighters inside the city and largely out in the open, leaving people more vulnerable than those who fled the city’s eastern side.

“You can see this road is continually being hit by mortars from (the Islamic State group),” said Lt. Gen. Abdel Ghani al-Asadi a few kilometers back from the front, pointing to the clouds of dust kicked up by the munitions on Mosul’s edge.

At the clinic south of Mosul casualties came in waves: Humvees and pickup trucks swerved in front of the row of simple cots manned by a team of about a dozen doctors and medics.

Rahma Ghanim anxiously looked up as doctors checked her for serious wounds. The 19-year-old had been separated from the rest of her family when Iraqi security forces evacuated them from the edge of Mosul.

Her uncle had stepped on a roadside bomb. The blast killed him instantly, struck her in the back with mild shrapnel wounds and took a finger off her oldest brother’s hand.

A Humvee arrived with the rest of her family and she screamed with joy, pulling away from the doctors treating her when she saw her father and aunt on the hood. The three embraced in tears.

“Where are the rest?” she asked.

Soldiers began opening the doors and six children climbed out, but in one seat was a small body wrapped in a colorful blanket.

“He’s dead! Oh God! Oh God!” Rahma collapsed to the ground with her aunt. She screamed cursing IS, “may God destroy their houses! May God burn their hearts!”

Her father Ghanim Hussein staggered to a sofa in shock, his face caked with dust and blood. “His name was Shukran,” he said, “he was my youngest, four years old.”

Soldiers moved the small body to the side of the road and sped off back to the front as quickly as they arrived.

“Inside Mamun the streets are full of bodies,” Rawa Salem, Rahma’s cousin said. “I saw twenty dead with my own eyes, many of them children.”

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