BAGHDAD (Reuters) - Human Rights Watch (HRW) on Thursday called on Iraqi forces to allow aid to enter the Islamic State-held city of Falluja where it said tens of thousands of residents face acute shortages of food and medicine.
The Iraqi army, police and Iranian-backed Shi'ite militias - backed by air strikes from a U.S.-led coalition - have maintained a near total siege on Falluja, located 50 km (30 miles) west of Baghdad, since late last year.
Residents were making soup from grass and using flour from ground date seeds to make bread, HRW said in a report. Food, when available, costs up to 50 times the normal price.
"The people of Falluja are besieged by the government, trapped by (Islamic State), and are starving," said Joe Stork, HRW's deputy Middle East director. "The warring parties should make sure that aid reaches the civilian population."
Falluja - a long-time bastion of Sunni Muslim jihadists - was the first Iraqi city to fall to Islamic State, in January 2014, six months before the group swept through large parts of northern and western Iraq and neighbouring Syria.
New York-based HRW also called on the militants to allow food and medicine into the city and to permit residents to leave. Iraqi and U.S. officials have said they are worried the insurgents would confiscate any aid sent to Falluja.
Defence ministry spokesman Naseer Nouri accused Islamic State of using civilians to obstruct the advance of Iraqi forces.
"The real siege is not by Iraqi forces," Nuri said.
"The Iraqi forces are liberating, they want to liberate the city's residents who have been held hostage by Daesh (Islamic State) for more than three years. Daesh is the one really besieging Falluja."
Nuri said Iraqi forces had opened three corridors for civilians to flee but alleged the militants had barred them from leaving.
Since recapturing Ramadi - a further 50 km to the west - from Islamic State more than three months ago, Iraqi authorities have not made clear whether they will attempt to take Falluja soon or leave it contained while the bulk of their forces head north towards Mosul, the largest city under the militants' control.
The humanitarian crisis has made recapturing Falluja from Islamic State a priority, Nouri said, but added it is up to military leaders to decide when.
In the past two weeks, Iraqi forces backed by coalition air strikes have retaken significant parts of Hit, a strategic town 50 km northwest of Ramadi, and three villages in the Makhmour area, which is set to be a key staging ground for a future assault on Mosul.
HRW, which has not had access to Falluja, said it relied largely on activists in Baghdad to communicate with residents directly or through people in contact with them.
"The humanitarian picture in Falluja is bleak and getting bleaker," said Stork. "Greater international attention to the besieged towns and cities of the region is needed or the results for civilians could be calamitous."
(Reporting By Stephen Kalin; Editing by Raissa Kasolowsky)