Threat realized

Casualties mounted quickly at Fallujah Hospital as al-Qaeda fighters moved in Jan. 3 to take over the key Iraqi city on the Euphrates, just 42 miles from Baghdad. Clad in black masks, the Sunni militants attacked police headquarters and the mayor’s office in a direct, close-range challenge to the Shiite-led government of Prime Minister Nouri al-Maliki.

The hospital reported 13 deaths of civilians and 125 people with multiple injuries. Casualties include women and children, according to Firas Alkubaisy, a physician there. “There is [a] shortage of supplies and staff,” Alkubaisy told me in an email, “and no electricity.”

The physician had traveled to Baghdad just before the attack—and was unable to return due to a government curfew that blocked roads linking Fallujah and the capital. He received reports from medical staff, including the chief doctor and a group of nurses from India, mostly Christians, who live in Fallujah and work at the hospital.

“Let the whole world know that life in Iraq is miserable,” wrote nurse Roshni Sara in a Facebook post. “Every gunshot takes away one life, which leaves many dependents abandoned, helpless, and sufferers for a lifetime.”

Alkubaisy said over 9,000 families (out of a city population of about 300,000) escaped Fallujah as al-Qaeda moved in, but most were caught by surprise and remained caught in a city under siege. It was an unprecedented advance by the Islamic State of Iraq and Syria (ISIS), the reconstituted al-Qaeda affiliate that has also in recent weeks gained the upper hand among rebel factions fighting the government in Syria.

ISIS militants cut power lines as they advanced on Fallujah ahead of Friday prayers Jan. 3. They took over key areas of the city and ordered residents not to use power generators, forcing police to the outskirts of the city to regroup and services on the Muslim day of prayer outdoors into the streets. As residents by the thousands bowed to pray in public spaces, militants seized a public park stage—according to The New York Times—waving an Islamic flag and daring authorities to evict them: “We declare Fallujah as an Islamic state, and we call on you to be on our side!” one fighter shouted to the crowd.

Alkubaisy said most Sunnis in Fallujah don’t identify with the extremists, but have protested the Maliki government for holding for years without charges—and abusing—Sunni political prisoners.

Anbar Province surrounding Fallujah has long been a breeding ground for terrorist activity in Iraq. At the start of insurgency against the United States in 2004, armed militants attacked four American contractors, beat and burned them, then hung their charred bodies from a bridge crossing the Euphrates River. Multiple U.S. operations and the U.S. surge culminated in the Anbar-based “Sunni Awakening” in 2008 that turned the tide of war in Iraq for the United States. But nearly one-third of all U.S. troops killed in Iraq died fighting in Anbar.

Republicans lashed out at the Obama administration for not doing more to honor those sacrifices and shore up U.S. gains in Iraq. Recent events are “as tragic as they were predictable,” said Sen. John McCain, R-Ariz., and Sen. Lindsey Graham, R-S.C., in a joint statement. Many Iraqis are responsible for this “strategic disaster,” they said, but the administration cannot escape its share of the blame: “When President Obama withdrew all U.S. forces … over the objections of our military leaders and commanders on the ground, many of us predicted that the vacuum would be filled by America’s enemies and would emerge as a threat to U.S. national security interests.”