NOTE: Doctors from four hospitals in Baghdad were interviewed in compiling this report; all asked that their names be left out.

When the United States began the siege of Fallujah, it targeted civilians in several ways. The power station was bombed; perhaps even more important, the bridge across the Euphrates was closed. Fallujah's main hospital stands on the western bank of the river; almost the entirety of the town is on the east side. Although the hospital was not technically closed, no doctor who actually believes in the Hippocratic oath is going to sit in an empty hospital while people are dying in droves on the other bank of the river.

So the doctors shut down the hospital, took the limited supplies and equipment they could carry, and started working at a small three-room outpatient clinic, doing operations on the ground and losing patients because of the inadequacy of the setup. This event was not reported in English until April 14, when the bridge was reopened.

In Najaf, the Spanish-language "Plus Ultra" garrison closed the al-Sadr Teaching Hospital roughly a week ago (as of yesterday, it remained closed).

With 200 doctors, the hospital (formerly the Saddam Hussein Teaching Hospital) is one of the most important in Iraq. Troops entered and gave the doctors two hours to leave, allowing them to take only personal items -- no medical equipment. The reason given was that the hospital overlooks the Plus Ultra's base, and that the roof could be used by resistance snipers.

Al-Arabiya has also reported that in Qaim, a small town near the Syrian border where fighting recently broke out, that the hospital had been closed, with American snipers positioned atop nearby buildings.

The United States has also impeded the operation of hospitals in other ways. Although the first Western reports of U.S. snipers shooting at ambulances (see http://www.empirenotes.org/fallujah.html) caused something of a furor, two days ago at a press conference the Iraqi Minister of Health, Khudair Abbas, confirmed that U.S. forces had shot at ambulances not just in Fallujah but also in Sadr City, the sprawling slum in East Baghdad. He condemned the acts and said he had asked for an explanation from his superiors, the Governing Council and Paul Bremer.

There are also persistent claims that after an outbreak of hostilities American soldiers visit hospitals asking for information about the wounded, with the intent of removing potential resistance members and interrogating them. Nomaan Hospital in Aadhamiyah and Yarmouk Hospital in Yarmouk (both areas of Baghdad) got visits from U.S. forces in the first days after the fighting in Fallujah started -- the lion's share of evacuated wounded from Fallujah were taken to those two hospitals. Doctors generally resist being turned into informants for the occupation; one doctor actually told me that he has many times discharged people straight from the emergency room, with inadequate time to recuperate, just to keep them out of military custody. As he said, "They are my countrymen. How can I hold them for the Americans?"

While the American media talks of the great restraint and "pinpoint precision" of the American attack, over 700 people, at least half of them civilians, have been killed in Fallujah. And, according to the Ministry of Health, in the last two weeks, at least 290 were killed in other cities, over 30 of them children. Many of those who died because of the hospital closures will never be added in to the final tally of the "liberation."

By any reasonable standard, these hospital closings (and, of course, the shooting at ambulances) are war crimes. However afraid the Plus Ultra garrison may have been of attack from the rooftops, they didn't have to close the hospital; they could simply have screened entrants. In the case of Fallujah, it's clear that one of the reasons the mujahideen were willing to talk about ceasefire was to get the hospital open again; in effect, the United States was holding civilians (indirectly) hostage for military ends.

After an earlier article about attacks on ambulances, many people wrote to ask why U.S. forces would do this -- it conflicted with the image they wanted to have of the U.S. military. Were they just trying to massacre civilians? And, if so, why?

In fact, it's fairly simple: the United States has its military goals and simply does not care how many Iraqi civilians have to be killed in order to maximize the military efficiency of their operations. A senior British army commander recently criticized the Americans for viewing the Iraqis as Untermenschen -- a lower order of human being. He also said the average soldier views all Iraqis as enemies or potential enemies. That is precisely the case. I have heard the same thing from dozens of people here -- "They don't care what happens to Iraqis."

Although this relatively indiscriminate killing of civilians may serve American military ends -- keeping the ratio of enemy dead to American soldiers dead as high as possible -- in terms of political ends, it is a disaster. It is very difficult to explain to an Iraqi that a man fighting from his own town with a Kalashnikov or RPG launcher is a "coward" and a "war criminal" (because, apparently, he should go out into the desert and wait to be annihilated from the sky) but that someone dropping 2000-pound bombs on residential areas or shooting at ambulances because they may have guns in them (even though they usually don't) is a hero and is following the laws of war.

When I was here in January, there was a pervasive atmosphere of discontent, frustration, and anger with the occupation. But most people were still just trying to ride it out, stay patient, and hope that things improved. The wanton brutality of the occupation has at long last put an end to that patience.

Before, the occupation might have succeeded -- not in building real democracy, which was never the goal, but in cementing U.S. control of Iraq.

It cannot succeed now. The resistance in Fallujah will be beaten down, with the commission of more war crimes; if the United States invades Najaf, it will be able to win militarily there as well. But from now on, no military victory will make Iraqis stop resisting.

Rahul Mahajan is publisher of Empire Notes. and author of Full Spectrum Dominance: U.S. Power in Iraq and Beyond. He can be reached at rahul@empirenotes.org.