Updated

Heavy fighting broke out in western Iraq (search) between pro- and anti-government tribes Tuesday, leaving at least 35 people dead from both sides, hospital officials said.

The outcome could affect the ease with which foreign extremists move in and out of the border area.

The clashes between the pro-government Bumahl tribe and the pro-insurgent Karabila tribe began after 2 a.m. in the western city of Qaim (search) near the Syrian border, said the officials at the Qaim General Hospital. They spoke on condition of anonymity for fear of retaliation from terrorists.

The officials said 20 members of the Bumahl tribe and 15 from Karabila were killed in the clashes. He said dozens were also wounded.

Recent fighting in Qaim, 200 miles west of Baghdad, has left several people killed and wounded.