The UN's humanitarian chief Lise Grande said in an interview on Friday with The Associated Press that the global body expects the final battle for the Old City to start "within days".
She said another innovation, by the U.N. Population Fund, has been to deploy near the front lines specialized mobile teams to support fleeing women and girls who have been sexually abused.
USA -backed Iraqi forces have been battling the extremists in Mosul, the country's second largest city, since October.
She said 860,000 people have already fled Mosul a number "beyond the worst case" the United Nations expected. Most are living in camps, but many prefer to stay with family and friends or live in damaged and abandoned buildings outside Mosul.
The army's 15th Infantry Division advanced in the rugged area in the north of the IS-held town of Mahlabiyah, some 35 km west of Mosul, and recaptured the villages of al-Buweir, al-Zanazil, al-Salam and al-Mansour, along with the nearby abandoned Mansour industry compound and water facility, Abdul-Amir Yarallah from the Joint Operations Command, said in a brief statement.
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The UN refugee agency representative in Iraq, Bruno Geddo was quoted, as saying in Geneva, Switzerland, that the ISIS has been capturing civilians in battles outside of Mosul and forcing them into the Old City, which is under their control. The UNHCR warns conditions in the old city are worsening for the civilians trapped there. "These civilians are basically held as human shields in the Old City". It may be recalled that the Iraqi coalition forces are now trying to retake Mosul from ISIS.
The war there is being waged largely in the densely populated old city, which is a maze of narrow alleyways.
The UN Refugee Agency is working to reunite families separated in flight and is helping displaced people to replace identity documents they have lost.
ISIS snipers are deliberately targeting civilians attempting to flee the city.
"So unless safe passages are available then it will be very hard for civilians to get out. So it is a very dire situation", said El Khalek.