Militants from the Islamic State have launched a counter-offensive in an attempt to repel the Iraqi military from Falluja, while upwards of 50,000 civilians remain trapped in the city.

Iraqi officials say the IS attack was repelled, but the military suffered a number of casualties.

Unconfirmed reports say IS used six explosive-laden cars in an attempt to slow the progress of the Iraqi military, but none reached their targets.

The move to recapture Falluja from IS is seen as a stepping stone towards retaking the strategic city of Mosul, the largest city held by IS and the presumed location of various high ranking members of the IS elite, including the cleric and leader of the group Abu Bakr al-Baghdadi.

Aid workers have raised concerns about the 50,000 civilians believed to be trapped in Falluja, with local reports of people starving to death or being executed by IS militants if they refused to fight for the Islamist group.

The Norwegian Refugee Council (NRC), that has been integral in rescuing a number of families from the besieged city, reports that medical supplies have run out and food is scarce.

Reporting from inside Falluja, 40-year-old Um Ahmed told the NRC:

“Families are calling for help. We just want to leave the city, we just want to leave it.

“The stocks in the hospitals are running low. There is no medicine for ordinary people. Instead of providing adequate treatment, doctors often simply amputate a patient’s arms or legs if they are in pain. There is no anesthetic left in the hospitals.

“Food is scarce and we have mostly been relying on dates for our meals. Sometimes we burn wood to grill some aubergines over the fire for lunch. The price of vegetables has gone up in the city as a result of the food shortages. It has been seven months since we had sugar or rice.”