While the North American news media have focused on the military triumph of US Marines in Falluja, little attention has been paid to reports that US armed forces killed scores of patients in an attack on a Falluja health center and have deprived civilians of medical care, food and water.

Although the US military has dismissed accounts of the health center bombing as “unsubstantiated,” in fact they are credible and come from multiple sources. Dr. Sami al-Jumaili described how US warplanes bombed the Central Health Centre in which he was working at 5:30 am on November 9. The clinic had been treating many of the city’s sick and wounded after US forces took over the main hospital at the start of the invasion. According to Dr. al-Jumaili, US warplanes dropped three bombs on the clinic, where approximately sixty patients–many of whom had serious injuries from US aerial bombings and attacks–were being treated.

Dr. al-Jumaili reports that thirty-five patients were killed in the airstrike, including two girls and three boys under the age of 10. In addition, he said, fifteen medics, four nurses and five health support staff were killed, among them health aides Sami Omar and Omar Mahmoud, nurses Ali Amini and Omar Ahmed, and physicians Muhammad Abbas, Hamid Rabia, Saluan al-Kubaissy and Mustafa Sheriff.

Although the deaths of these individual health workers could not be independently confirmed, Dr. al-Jumaili’s account is echoed by Fadhil Badrani, an Iraqi reporter for Reuters and the BBC. Reached by phone in Falluja, Badrani estimated that forty patients and fifteen health workers had been killed in the bombing. Dr. Eiman al-Ani of Falluja General Hospital, who said he reached the site shortly after the attack, said that the entire health center had collapsed on the patients.

It was well-known that the Falluja facility was a health center operating as a small hospital, a protected institution under international law. According to James Ross of Human Rights Watch, “the onus would be on the US government to demonstrate that the hospital was being used for military purposes and that its response was proportionate. Even if there were snipers there, it would never justify destroying a hospital.”

US airstrikes also leveled a warehouse in which medical supplies were stored next to the health center, Dr. al-Jumaili reports. Ambulances from the city had been confiscated by the government, he says, and the only vehicle left was targeted by US fire, killing the driver and wounding a paramedic. Hamid Salaman of the Falluja General Hospital told the Associated Press that five patients in the ambulance were killed.

US and allied Iraqi military forces stormed the Falluja General Hospital, which is on the perimeter of the city, at the beginning of the assault, claiming it was under insurgent control and was a center of propaganda about civilian casualties during last April’s attack on the city. The soldiers encountered no resistance. Dr. Rafe Chiad, the hospital’s director, reached by phone, stated emphatically that it is a neutral institution, providing humanitarian aid. According to Dr. Chiad, the US military has prevented hospital physicians, including a team of surgeons, anesthesiologists, internists and general practitioners, from entering Falluja. US authorities have denied all requests to send doctors, ambulances, medical equipment and supplies from the hospital into the city to tend to the wounded, he said. Now the city’s only health facility is a small Iraqi military clinic, which is inaccessible to most of the city’s remaining population because of its distance from many neighborhoods and the dangers posed by US snipers and crossfire.

“Falluja is dying,” said Dr. al-Ani. “We want to save whoever we can.” Jim Welsh, health and human rights coordinator for Amnesty International in London, notes that under the Geneva Conventions, “medical personnel cannot be forced to refrain from providing healthcare which they believe is their ethical responsibility.” The 173-bed Falluja General Hospital remains empty, according to Dr. Chiad.

The Iraqi Red Crescent Society has called the health conditions in and around Falluja “catastrophic.” One hospital staff member who recently left the city reports that there were severe outbreaks of diarrheal infections among the population, with children and the elderly dying from infectious disease, starvation and dehydration in greater numbers each day. Dr. al-Jumaili, Dr. al-Ani and journalist Badrani each stated that the wounded and children are dying because of lack of medical attention and water. In one case, according to Dr. al-Jumaili, three children died of dehydration when their father was unable to find water for them. The US forces cut off the city’s water supply before launching their assault.

“The people are dying because they are injured, have nothing to eat or drink, almost no healthcare,” said Dr. al-Ani. “The small rations of food and water handed out by the US soldiers cannot provide for the population.” For the thousands living in makeshift camps outside the city, according to Firdus al-Ubadi of the Red Crescent Society, hygiene and health conditions are as precarious as in Falluja. There are no oral rehydration solutions or salts for those who are dehydrated, she says.

These reports demand an immediate international response, an end to assaults on Falluja’s civilian population and the free passage of medical aid, food and water. Louise Arbour, the United Nations High Commissioner for Human Rights, has vowed to investigate “violations of the rules of war designed to protect civilians and combatants” in Falluja and to bring the perpetrators to justice. The San Francisco-based Association of Humanitarian Lawyers has petitioned the Inter-American Commission on Human Rights of the Organization of American States to investigate the deaths. The bombing of hospitalized patients, forced starvation and dehydration, denial of medicines and health services to the sick and wounded must be recognized for what they are: war crimes and crimes against humanity.