Dr Shamael Ishawi is from the health clinic in this area. He told me that the unclean river water is leading to the spread of typhoid.

Inside the city the hospital which I had spent some time in earlier this year is in ruins. Refugees have returned to the city, but they are living in appalling conditions.

There is no evidence whatsoever of the reconstruction effort that the Iraqi government and the US claim is underway.

Residents have to pass through five checkpoints to get into the city. The Iraqi troops on the checkpoints humiliate the people, calling them “sons of bitches, sons of dogs”. They and their cars are searched. There can be no question of “foreign fighters” operating inside Fallujah.

But still you can hear occasional gunfire. There are acts of resistance by ordinary residents who remain deeply opposed to the occupation.

It’s not surprising when you consider that the water in the city itself is not clean. A doctor told me there was severe dysentery because there was no clean water.

I have a list from doctors in the city saying what they need. They have no anaesthetics or antibiotics. It is hell.

We went to the cemetery and there was a freshly dug trench. I asked one of my friends why it was there. He said it was because they expected another assault on the city and “we have to be ready” to bury bodies.

It’s also clear that the US army and their Iraqi puppets are repeating the kind of assault they launched on Fallujah on other cities.

I was part of a team trying to bring medical aid to people in western Iraq. We tried to get to a place called Ramana on the border of the city of al?Qaim on 6 June.

But the Americans blockaded the road and refused to let people enter. When we told them we were doctors, they still refused—and they took the tapes from the cameras we were using to film.

So we decided at least to stay in the clinic near Ramana. We stayed to help the clinic. We saw the families leaving the city as refugees. We saw about 300 families leaving to try and find a place to stay. They ended up having to stay in the desert.

By coincidence I saw one of my friends who had been working in the hospital. He went out through the desert to try and get some help for the clinic. We had a chat with him.

What he described was like what happened in Fallujah — it was a disaster. People were being prevented from going into the hospital.

All the time the US and Iraqi forces were sending troops into the hospital, saying they were looking for insurgents. Anyone who was young and had been shot was taken directly from inside the hospital.

After that they started bombing by aircraft all the houses on the border of al-Qaim.

They continued to prevent anyone going inside the city to help injured people. Because of that there were many people left trapped under collapsed buildings — mainly women and children. I have just received a phone call saying there are still bodies trapped under the rubble.

After that we entered Ramana and saw a grave of 13 members of one family who had been killed in one air attack. They were all in one grave. On the sign next to it it said the youngest of them was two years old.

They are attacking and seizing any young person. The west of Iraq is in medical and humanitarian crisis. I am passing on the desperate appeal from doctors in the area for immediate medical assistance.