When Rabiah Hassan took her daughter to hospital in Fallujah just before the start of the battle there in May, the Islamic State (IS) doctor from Mosul said he would operate only if she gave him the young woman to marry.

“He had already married three girls from Fallujah,” she says at a camp for families who fled Fallujah when IS was driven out in June. “I took my daughter and left the hospital.”

Residents of the longest-held IS city say the organization seized Fallujah in early 2014 promising a revolution that would restore Sunnis to power and provide services the Iraqi government failed to deliver. The pledge resonated in this conservative tribal city, seething after years of government neglect and abuse by Shiite-dominated security forces.

But as Iraqi security forces closed in and money ran out, IS became increasingly brutal. While an estimated 100,000 Fallujah residents left over two years, some 80,000 remained. Why they stayed – and what they endured and how some resisted – is just now coming to light.

IS had tried to prove it could not only seize territory but run its own Islamic state. In Fallujah, the public services it offered for the general population in the end dwindled to nothing as the Iraqi government cut electricity to the city and prices of food and fuel skyrocketed.

Analysts say IS’s failure to maintain local support could play a part in the group’s downfall in Iraq if the government is able and willing to step into the breach.

“It could be a turning point, if – and this is a big ‘if’ – the Iraqi government and other forces play a positive role,” says Kawa Hassan, the Brussels-based director of the Middle East and North Africa program at the EastWest Institute. “The government needs to start with non-sectarian policies addressing local grievances.”

In Fallujah, near a bridge where IS executed and hung a captured Iraqi soldier, the group turned a mosque into a courthouse imposing its harsh interpretation of Islamic Sharia law. As time went on, penalties began to include severe punishment for even minor offenses.

“My husband was sitting in a shop with some friends – old men,” says Hamdiya Mukhlif from Garma, part of the Fallujah area. “They were talking about the lack of services and food. [IS] came later and said ‘Why are you saying bad things about us?’ and they took him for 10 days and beat him.”

“We were like prisoners, we weren’t allowed to talk,” says another Fallujah resident.

With the rising cost of fuel for private generators, few families could afford electricity or access to the Internet. Most were afraid to talk on the phone for fear their calls were being monitored.

IS defied

Despite IS efforts to impose an iron grip, there were flashes of defiance among Fallujah residents.

Karam Ahmed Majid continued to work as a cleaner at the Fallujah hospital after IS took control but says she quickly became disgusted at the way they treated people.

“I told them the Iraqi police are better than you,” she says she told them, an insult in Anbar Province where the federal police were seen as an instrument of Iraqi government oppression.

She says IS fighters put her in a car and took her to a bridge near the city’s Mechanic neighborhood as a warning. “They said, ‘If you keep saying this we will behead you.’ ”

Ms. Majid, a young woman who says she learned to fend for herself growing up an orphan, wasn’t afraid. “There are women who cooperated with IS, but I tried to oppose them,” she says.

Men in Fallujah were required to shorten their trousers to above the ankle and maintain at least a short beard – tradition during prophet Muhammad’s time.

Women were ordered to wear a shapeless, all-enveloping cloak.

“They came and asked me why I wasn’t wearing a khimar,” says Fawzia Abed, her hair covered in a black headscarf with festive gold designs. “I told them I’m an old woman, I’m not going to wear it,” she says.

When they threatened to whip her with cables, she says she told them to go ahead.

She says they left her alone after she finally told them she would wear one only if they gave her the money – about $25 – to buy it.

Why some joined IS

Some joined IS either willingly or under coercion, but most were too poor to have anywhere else to go. When IS began allowing families to leave if they paid the going rate of more than $100 per person, few could raise the money.

IS threw out the school books and implemented its own curriculum. Some families who did not want to send their children to IS schools say they made up excuses when IS officials came to ask why their children were not registered.

“We told them we were worried about the air strikes,” says Suad Khalil, adding that her three youngest children have now been out of school for three years. Other schools were closed when they became bases for IS fighters.

“It was all religion,” says another mother of school-age children. “There was no history, no geography, no language, nothing.”

At the desolate camp 20 miles from Fallujah, Ahoud Alwan and her sister Hind explain they dropped out of school when IS took over while they were in 9th grade. Ahoud still has ambitions of being a doctor and her sister, a teacher.

“They brought in their own textbooks and they only taught about guns – different kinds of rifles – and about religion,” says Ahoud. “We couldn’t study science or English.”

Fallujah’s main hospital, believed to have been featured in an IS video for recruiting international medical staff, was a centerpiece of the self-declared Islamic state.

After the Iraqi health ministry withdrew its own doctors and nurses following the IS takeover of the city, residents said Syrian, Palestinian, Egyptian, and Chechen doctors arrived to take over along with Iraqi IS medical staff. One of the female doctors was a prominent physician from Fallujah.

“They were brainwashed,” says a Fallujah resident, when asked why the physician would have joined IS. “They told them, ‘You will go to paradise.’ ”

The lure of marriage

Another incentive for young men joining IS in conservative Arab society has been access to women. While IS captured women from Iraq’s Yazidi religious minority as sex slaves, Muslim women were married off to fighters. More senior IS officials, under traditional Muslim rules, married up to four women.

“They would demand from families that they either provide sons to join IS or that they give them a daughter,” says a police official in Fallujah. He says the sons were generally sent to the front lines against Iraqi forces or used for manual labor such as digging defensive trenches.

The better public services promised by IS as it tried to prove it could not only seize territory but run its own Islamic state in the end dwindled to nothing as the Iraqi government cut electricity to the city and prices of food and fuel skyrocketed.

As IS revenues, based mostly on taxes and smuggled oil, started to dry up, the group began confiscating the salaries of government workers rather than just taking a cut. As food prices soared, they began hoarding government rations for their fighters, leaving poorer residents to survive on dried dates meant as animal feed.

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Items including sugar were suddenly declared haram – religiously forbidden.

“They made everything in the world haram for people, but allowed everything for them,” says special forces commander Gen. Abdul Wahab al-Saadi.