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IRBIL, Iraq – The mortar attack that left Um Yousef blind in one eye and killed two of her children came on the same day that Iraqi forces retook her neighborhood in eastern Mosul from the Islamic State group.
"We were supposed to be liberated that day," she said from her hospital bed in the nearby city of Irbil. She asked to only be identified by a nickname to protect her family members still living inside Mosul.
Doctors at West Irbil Emergency Hospital say cases like Um Yousef's are on the rise as Iraqi forces continue to make gains against IS in their effort to take control of Mosul.
The blast of the attack that wounded Um Yousef ripped open her daughter's stomach, killing her instantly. Her son Yousef was hit in the head with shrapnel and he slowly bled out as they waited for hours for help. As Um Yousef was evacuated by the Iraqi military, her husband stayed behind in Mosul to bury the two children.
"I called him by phone, but he just cries, saying nothing," she said. Her youngest daughter, just over a year old who lost three of her toes to the blast, played in her lap.
When the operation to retake Mosul was launched in October more than a million people were estimated to still be living inside the city. While Iraqi forces largely evacuated civilians from cities like Ramadi and Fallujah that were retaken from IS this year, in Mosul they told people to stay put.
Since Iraqi forces pushed into Mosul's city limits in November, the fight has seen relatively high numbers of civilian casualties. In the first week of January the United Nations said 683 people were injured in the city, and at least 817 were wounded during the last week of December.
"You would expect in a conflict like this that the number of civilian casualties would be around 15 percent, a high of 20 percent. What we're seeing in Mosul is that nearly 50 percent of all casualties are in fact civilians," Lise Grande, the U.N.'s humanitarian coordinator in Iraq, told reporters at a briefing last week.
"It's clear that this is because of direct targeting by combatants," she said, explaining that IS fighters are targeting civilians as they try to flee militant-held parts of the city.
Aid groups opened two new hospitals closer to Mosul this month in an effort to see more civilians faster, but West Irbil Emergency Hospital still receives dozens of injured civilians from Mosul every day and is still operating above capacity, said the hospital's administrator, Dr. Lawand Meran.
"We are running out of everything, clean gauze, hospital gowns, even simple saline solution," said Hazhen Mama, a surgeon.
Mama says his work is often complicated by the fact that civilians without immediately life-threatening injuries must wait for days for a security clearance to travel out of Mosul and into Irbil to see a doctor. "When they arrive here they almost all already have infections," he said.
The slow pace of the Mosul fight has also contributed to the high number of killed and injured civilians. As Iraqi forces slowly push IS out of the city, neighborhoods remain frontlines for longer and it's more difficult for severely wounded civilians to be evacuated.
Iraqi leaders initially pledged Mosul would be retaken before January, but the conflict now appears poised to last months longer.
After 35-year-old Khalida Ahmed was shot by an IS sniper outside her home in eastern Mosul she had to wait for three days for help to arrive.
"I was standing at my front gate and I didn't feel anything, but I suddenly fell," she said. A man ran over to help her but was also shot and died shortly after, Ahmed said, and began to cry as she told the story. "He was my neighbor's son," she said.
Another neighbor helped her dress her wound to stop the bleeding.
After Iraqi forces retook her neighborhood over the weekend, a Humvee moved her to a field hospital where she was put in an ambulance and brought to Irbil. Now she says she's waiting for surgery to have her hip replaced.
"I don't know why (IS) shot me," she said, "I didn't have a mobile phone to inform on them, I wasn't resisting them, I'm innocent."
Associated Press writer Salar Salim contributed to this report.