Covered in dust, their hands raw from digging, Ali Assad and his cousin made a desperate choice – to leave their family under the rubble of their west Mosul home and flee while they still could.
The two men were among hundreds to be evacuated yesterday, during a lull in the fighting prompted by outrage over the high civilian toll from many US airstrikes that have battered the Iraqi city and its trapped population over the past eight days.
With the ground war suspended as a result, families that have sheltered in ruins or taken their chances in what is left of their homes have been leaving Mosul in droves.
Many are arriving shell-shocked and starving at refugee centres on its southern outskirts, where they spoke of more than a week of terror.
“There are six of my family still under our house,” said Assad, 32, cupping his raw hands. “My father, I saw him die in front of me, my brother, two sisters and two cousins.
“My mother survived, but then she was hit by some other explosion and a concrete slab fell on her. She’s badly hurt.”
Both men said 15 people remained buried under three homes after a series of airstrikes on 22 March. The attacks took place in support of a ground push by Iraqi forces that started around 17 March.
On that afternoon, the Mosul Jadida neighbourhood was repeatedly hit, leading to what could be the highest civilian toll of any airstrike in the region since the invasion of Iraq 14 years ago. At least 150 people are thought to have been killed, many of whom died during the five days it took for help to arrive.
At least 80 people are believed to have died while taking shelter in the basement of one of the houses in which families had sought refuge.
Assad said dozens of people remained buried under rubble. “There is no civilian defence, no rescue teams. It is only us and our hands. Everyone has to fend for themselves.”
The lack of a coordinated rescue effort is being blamed by local authorities on the fighting, which has ground to a stalemate as Isis attempts to consolidate its losses and dig in around the centre of west Aleppo, a densely packed area of homes and narrow roads.
Numerous survivors have spoken of people, among them children, shouting for help from the ruins, but having no help from local authorities, or access to digging equipment to use for themselves.
Residents of west Mosul had been seen as the most vulnerable population in the fight against the terror group.
Up to 350,000 people are thought to remain in the city, some being used by Isis as human shields and others unable to flee until the fighting opens up a front for them.
Even then, the escape is typically a dangerous walk through a battlefield, before a long fraught journey to a refugee camp. Jonathan Whittall, project co-ordinator for a Medecins Sans Frontieres (Doctors Without Borders) medical centre south of Mosul, said: “We have witnessed a disturbing trend of some patients reaching our hospital after a significant delay of up to four days.
“One father and son that I met recently had been trapped under rubble for four days after an airstrike and they reached us exhausted, hungry and bewildered. Others who are wounded further away from the front lines into west Mosul can only reach us after the frontline has moved and they are able to escape. We are very concerned about the patients who are unable to reach us and whose treatment is delayed.”
The medical centre, the largest in the area, was nearly empty yesterday for the first time since it opened several months ago. Since then, the organisation has treated 1500 people for conflict-related trauma, many of the cases severe or life-threatening.
Medics supporting the Mosul operation said it is difficult to be specific about the proportion of casualties they are treating who were wounded by airstrikes as opposed to other weapons of war. However, the high number of people buried under rubble indicates that attacks from jets make up a significant component.
US military officials have acknowledged that the strike on Mosul Jadida was carried out by coalition jets and said it was requested by Iraqi officers. US Central Command has launched a formal investigation.
While ground fighting stopped yesterday, fighter jets were still present in the skies above Mosul. US officials said five airstrikes targeting Isis near Mosul were carried out during the day.