Islamic State militants forced a 12-year-old girl to execute five women, including a female doctor who refused to treat ISIS fighters.

The killings took place by firing squad in Nineveh, an Iraqi city notorious for ISIS executions, according to Iraq’s Alsumaria News.

This is reportedly ISIS’ first time employing a female child as an executioner. Young boys have appeared as propaganda in ISIS execution videos.

Last month ISIS released a propaganda video showing Isa Dare, a four-year-old British boy, holding and triggering a detonator to a bomb in a car with three alleged British spies.