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Iraqis are fleeing fighting in the cities of Fallujah and Ramadi at rates not seen since that country’s civil war six years ago.

In the past week alone, some 65,000 people have left the two cities in Anbar province, the site of fierce fighting between the Shiite-led government and al Qaeda-linked groups, U.N. refugee agency UNHCR said in a statement.

“Many of the displaced… are still in desperate need of food, medical care and other aid,” the U.N. said. “As the insecurity has spread, many families who fled several weeks ago have been displaced again.”

More than 140,000 have been made homeless since the violence broke out at the end of last year, which is on top of the 1.1 million already displaced within Iraq, it added.

The situation for those caught in the fighting is also dire, UNHCR’s senior spokesman Peter Kessler said.

“People are still fighting and mortars are still landing. People don’t have access to food,” he said.

Iraq has just been through its worst 12 months of violence in years, reaching levels not seen since it was emerging from its most turbulent post-invasion period between 2006 and 2008.

In recent weeks, fighters opposed to the government have taken control of parts of the cities of Ramadi and Fallujah. On Sunday, the government forces launched an all-out offensive to push back the fighters in Ramadi, officials said.

On Monday, seven bombs hit the capital Baghdad, killing at least 26 people and wounding 67, officials told Reuters.