The population of Mosul has endured huge suffering in the war to retake the northern Iraqi city from terror group ISIS and trauma cases among civilians are sharply rising in the last stages of battle, Doctors Without Borders (MSF) said on Wednesday.

The city’s basic infrastructure has also been hard hit, with six western districts almost completely destroyed and initial repairs expected to cost more than $1 billion, the United Nations said.

Tens of thousands of civilians remain trapped among the shattered buildings in ISIS’s final redoubt in Mosul’s Old City by the western bank of the Tigris river, MSF said.

Civilians who have managed to get medical treatment are suffering from burns and shrapnel and blast injuries, while many are in need of critical care and are under-nourished, MSF officials said.

But there is concern that only a small number of the civilians were getting the medical attention they required.

“Really, (there is) a huge level of human suffering,” Jonathan Henry, MSF emergency coordinator in west Mosul, told reporters in Geneva after spending six weeks in Iraq.

“This is a massive population that has been traumatized from a very brutal and horrific conflict,” he said.

Iraqi commanders have predicted final victory in Mosul this week after a grinding eight-month assault that has pushed ISIS into a rectangle no more than 300 by 500 meters in the city whose population used to be 2 million.

International charity Save the Children said in a separate report that fighting and years of living under ISIS have left Mosul’s children with dangerous levels of psychological damage.

Findings from focus group discussions with 65 children in a displacement camp south of Mosul found that children are so deeply scarred by memories of extreme violence they are living in constant fear for their lives, unable to show emotions, and suffering from vivid “waking nightmares”.