The voice of Abdulkareem, 43, a former construction worker trapped inside the fast-shrinking Isis enclave in Mosul, trembles with fear as he describes the battle raging around him. He knows that it would be dangerous to try to escape, but it may be even more risky to stay where he is. He told The Independent in a phone interview: “I cannot speak more loudly because they [Isis] will shoot me if they catch me talking on the phone.”

Abdulkareem lives in the Dachat Barga neighbourhood near the al-Maydan district which is being heavily fought over as the Iraqi security forces pin Isis fighters, who may number only 300 combatants, in a small part of the Old City of Mosul with their backs to the Tigris River. “It is a small area, but it is like Stalingrad in that the buildings wrecked by bombs and shells provide good defensive positions,” says one observer, who wished to remain anonymous.

Abdulkareem can hear the sounds of fighting all around him in Dachat Barga, but he dare not go out and see exactly what is happening. “We can hear the roar of the bombing and the mortar fire,” he says. “But we don’t know whether it is the Iraqi army, the coalition airstrikes or Daesh [Isis].” A week ago, his sister and her husband were injured. A mortar shell hit their house, though nobody knew who fired it. He heard later that they were safe in the al-Farouq neighbourhood which had been overrun by Iraqi forces.

The children of Mosul: Iraqi youngsters left psychologically damaged by ISIS war

The assault on Mosul by the Iraqi government started on 17 October last year and has now been going on for 262 days. The investment of the Old City, with its close packed houses and narrow alleyways, has been going on for a much shorter time, but many of its inhabitants have run out of food. “We have only wheat grain to cook and eat,” says Abdulkareem. “We buy 10 litres of water for 15,000 Iraqi dinars (about £10).” The water comes from deep wells dug since Isis captured Mosul three years ago, but petrol is needed to work the pump bringing up the water and this is often unavailable.

Nobody knows how many people are dying in the last stages of the siege as the last resistance of Isis is extinguished. Iraqi military commanders prematurely announce the capture of a neighbourhood long before it is secured. Hasan, who is working with a medical team searching the rubble for bodies, says that people are flooding out of the ruins when they think it safe to do so. “We are receiving hundreds of civilians from Al-Farouq and Al-Maydan and the other surrounding areas of the Old City,” he says. “Most of the victims are women and children. Yesterday three women dressed in black were wearing explosive belts. They blew themselves up and killed dozens of civilians and wounded many others.”

Some people have kept the dead bodies of their children and family members in their houses, because they will be shot if they try to go outside to bury them. “A woman was trying to flee with her three children,” says Hasan. “The children were shot and the Isis militants let the woman go. This happened two days ago in a small neighbourhood in the old city called Dachat Barga.”

The level of destruction in Mosul is worse than in any previous battle in Iraq, say senior UN officials. Some 900,000 people have fled the city and over a third of them are in camps. Lise Grande, the UN coordinator for humanitarian affairs in Iraq, is quoted as saying that “the level of damage is far higher than we expected”. Six districts, including most of the ancient Old City, have been totally destroyed while all the others have been damaged to a greater or lesser degree. Basic repairs to water, electricity and health care facilities will be costly, far greater than the UN had predicted. There are no precise figures for civilian casualties since the start of the siege, but the UN says there have been 15,000 trauma injuries sent for treatment.

People from Mosul who flee say they were confined to their houses by Isis who said they would be shot if they opened their door and set foot in the street. This makes the decision to escape particularly fraught, worsened by a fear that government forces suspect that groups escaping include Isis fighters and suicide bombers in disguise. Displaced people try to establish their credentials as opponents of Isis by denouncing each other as Isis “sleepers”.

In pictures: Mosul offensive Show all 40 1 /40 In pictures: Mosul offensive In pictures: Mosul offensive A doctor carries an Iraqi newborn baby at a hospital in Mosul, Iraq July 18, 2017. Reuters In pictures: Mosul offensive Iraqi girls play at a yard of a school in Mosul, Iraq July 18, 2017alal Reuters In pictures: Mosul offensive A woman on crutches who is a relative of men accused of being Islamic State militants is seen at a camp in Bartella, east of Mosul, Iraq July 15, 2017. Picture taken July 15, 2017. Reuters In pictures: Mosul offensive A displaced girl, who fled from home carries a doll at Hamam al-Alil camp south of Mosul, Iraq July 13, 2017. Reuters In pictures: Mosul offensive Iraqi federal police members and civilians celebrate in the Old City of Mosul on 9 July 2017 after the government's announcement of the "liberation" of the embattled city. Iraqi Prime Minister Haider al-Abadi's office said he was in "liberated" Mosul to congratulate "the heroic fighters and the Iraqi people on the achievement of the major victory" AFP/Getty Images In pictures: Mosul offensive A picture taken on 9 July 2017, shows a general view of the destruction in Mosul's Old City. Iraq will announce imminently a final victory in the nearly nine-month offensive to retake Mosul from jihadists, a US general said Saturday, as celebrations broke out among police forces in the city. AFP In pictures: Mosul offensive Members of the Iraqi federal police raise the victory gesture as they ride on a humvee while advancing through the Old City of Mosul on 28 June 2017, as the offensive continues to retake the last district held by Islamic State (IS) group fighters. AFP/Getty Images In pictures: Mosul offensive Smoke billows as Iraqi forces advance through the Old City of Mosul on 26 June 2017, during the ongoing offensive to retake the last district held by the Islamic State (IS) group. AFP/Getty Images In pictures: Mosul offensive An Iraqi man wearing the green scarf of the Shi'ite faith kisses an Iraqi Army soldier on safely reaching the Iraqi forces position as Iraqi civilians flee the Old City of west Mosul where heavy fighting continues on 23 June 2017. Iraqi forces continue to encounter stiff resistance with improvised explosive devices, car bombs, heavy mortar fire and snipers hampering their advance. Getty Images In pictures: Mosul offensive A picture taken from the inside of an Iraqi forces armoured vehicle shows residents walking through a damaged street as troops advance towards Mosul's Old City on 18 June 2017, during the ongoing offensive to retake the last district still held by the Islamic State (IS) group. Military commanders told AFP the assault had begun at dawn after overnight air strikes by the US-led coalition backing Iraqi forces. They said the jihadists were putting up fierce resistance. AFP/Getty Images In pictures: Mosul offensive Iraqi Army soldiers advance in a destroyed street after an Iraqi forces airstrike targeted an Islamic State sniper position 17 June 2017 in al-Shifa, the last district of west Mosul under Islamic State control. IS snipers, as well as car and suicide bomb attacks continue to hinder the Iraqi forces efforts to retake the final district. A series of airstrikes by Iraqi helicopter gunships attempted to hit multiple Islamic State sniper positions in al-Shifa. Getty Images In pictures: Mosul offensive An Iraqi soldier frisks a displaced Iraqi man at a temporary camp in the compound of the closed Nineveh International Hotel in Mosul on 16 June 2017 which was recovered by Iraqi troops from Islamic State group fighters earlier in the year. A screening centre set up in the compound's fairgrounds sees a constant stream of Iraqis fleeing the battle for Mosul, awaiting their turn to be checked by the Iraqi forces who are searching for suspected Islamic State (IS) group members. The small fairground lies at the end of a pontoon bridge across the Tigris recently opened to civilians that is the only physical link between the two banks of the river. AFP/Getty Images In pictures: Mosul offensive Iraqis staying at the al-Khazir camp swim in a river near the camp for internally displaced people, located between Arbil and Mosul on 11 June 2017. AFP/Getty Images In pictures: Mosul offensive Iraqi government forces drive on a road leading to Tal Afar on 9 June 2017, during ongoing battles to retake the city from Islamic State (IS) group fighters. AFP/Getty Images In pictures: Mosul offensive An Iraqi policeman carries a poster bearing an image of Mosul's iconic leaning minaret, known as the "Hadba" (Hunchback), on 22 June 2017. AFP/Getty Images In pictures: Mosul offensive Iraqis stand in line to receive food aid in western Mosul's Zanjili neighbourhood on 7 June 2017, during ongoing battles as Iraqi forces try to retake the city from Islamic State (IS) group fighters. Living conditions in Mosul have again deteriorated since the start of the Iraqi government's offensive on the city in October in which they retook a large part of the west of the city. AFP/Getty Images In pictures: Mosul offensive Displaced Iraqis carry lightbulbs and sacks as they evacuate from western Mosul's Zanjili neighbourhood as government forces advance in the area during their ongoing battle against Islamic State (IS) group fighters on 13 May 2017 AFP/Getty Images In pictures: Mosul offensive A member of the Iraqi Counter-Terrorism Service (CTS) flashes the victory gesture as he patrols in western Mosul's al-Islah al-Zaraye neighbourhood on 13 May 2017 AFP/Getty Images In pictures: Mosul offensive Iraqi army soldiers from the 9th armoured division on a truck flash the sign of victory as they drive back from Mosul to the town of Qaraqosh (also known as Hamdaniya) Getty In pictures: Mosul offensive Members of Iraqi forces flash the sign of victory on their vehicle as they advance towards Hammam al-Alil area south of Mosul Getty In pictures: Mosul offensive A member of Iraqi security forces gestures in Hammam al-Alil, south of Mosul, Iraq Reuters In pictures: Mosul offensive Iraqi children, one flashing the sign of victory, greet Iraqi army's soldiers from the 9th armoured division in the area of Ali Rash, adjacent to the eastern Al-Intissar neighbourhood of Mosul Getty In pictures: Mosul offensive Peshmerga forces look at a tunnel used by Islamic State militants near the town of Bashiqa, east of Mosul, during an operation to attack Islamic State militants in Mosul, Iraq Reuters In pictures: Mosul offensive An Iraqi soldier takes a photograph with his phone as his comrade stands next to a detained man, whom the Iraqi army soldiers accused of being an Islamic State fighter, who was fleeing with his family in the Intisar disrict of eastern Mosul, Iraq Reuters In pictures: Mosul offensive Iranian Kurdish female members of the Freedom Party of Kurdistan (PAK) hold a position in an area near the town of Bashiqa, some 25 kilometres north east of Mosul Getty In pictures: Mosul offensive Iraqi families, who fled their homes in Hamam al-Alil, gather on the outskirts of their town Getty In pictures: Mosul offensive Displaced people walk past a checkpoint near Qayara, south of Mosul, Iraq AP In pictures: Mosul offensive Iraqi families who were displaced by the ongoing operation by Iraqi forces against jihadists of the Islamic State group to retake the city of Mosul, are seen gathering in an area near Qayyarah In pictures: Mosul offensive A boy who just fled Abu Jarbuah village is seen with his family at a Kurdish Peshmerga position between two front lines near Bashiqa, east of Mosul, Iraq Reuters In pictures: Mosul offensive An Iraqi child eats a pomegranate upon the arrival of Iraqi forces in the village of Umm Mahahir, south of Mosul Getty In pictures: Mosul offensive People who just fled Abu Jarbuah village sit as they eat at a Kurdish Peshmerga position between two front lines near Bashiqa, east of Mosul, Iraq Reuters In pictures: Mosul offensive A couple who just fled Abu Jarbuah village are escorted by Kurdish Peshmerga soldiers Reuters In pictures: Mosul offensive Women carry a boy over a wall as civilians flee their houses in the village of Tob Zawa, Iraq AP In pictures: Mosul offensive An Iraqi soldier and a civilian ride a motorbike as smoke rises behind them, on the road between Qayyarah and Mosul Getty In pictures: Mosul offensive A member of Iraqi forces, wearing a skull mask, waits at a checkpoint for people fleeing the main hub city of Mosul Getty In pictures: Mosul offensive An Iraqi soldier sits at a checkpoint in an area near Qayyarah Getty In pictures: Mosul offensive Iraqi men prepare food portions for Iraqi forces deployed in areas south of Mosul Getty In pictures: Mosul offensive Iraqi forces celebrate upon the arrival of vehicles bringing food to them Getty In pictures: Mosul offensive Iraqi childen smoke cigarettes upon the arrival of Iraqi forces in the village of Umm Mahahir, south of Mosul Getty In pictures: Mosul offensive A member of Iraqi forces distributes drinks to children in the village of Umm Mahahir, south of Mosul Getty

The dilemmas facing people within the last Isis strongholds in Mosul are explained by Abu Mohammed, 53, who last week fled the Old City with a group of civilians. Isis had, in fact, retreated from their neighbourhood, but they were not sure of this. The decision that they must all flee was taken by “a man whom the people of our neighbourhood all respect. He was rich and helped people a lot until he had become bankrupt. This man asked us to move out of our houses and rush towards the Iraqi army.”

When they reached Iraqi forces, they told them “about some Daesh men with us. I know a teenager who was with our group. He was later arrested and turned out to be Daesh. He was Iraqi but not from Mosul.” Abu Mohammed says that they suspected the teenager because he was looking healthy and well-fed and “not suffering from starvation like the other civilians”.