Iraq’s prime minister is urging residents of Fallujah to rise up against al-Qaeda-linked militants after the government lost control of the city. Swaths of Fallujah are now reportedly in the hands of militants with the Islamic State of Iraq and the Levant. Shifting loyalties among tribal militias fighting alongside the government are complicating the picture. Militants are also holding parts of the nearby provincial capital Ramadi. It is the first time militants have so overtly claimed key cities since the peak of fighting after the 2003 U.S. invasion. On Sunday, Secretary of State John Kerry ruled out any possibility of sending in U.S. troops.

John Kerry: “Now, we’re going to do everything that is possible to help them, and I will not go into the details, except to say that we’re in contact with tribal leaders from Anbar province whom we know, who are showing great courage in standing up against this as they reject terrorist groups from their cities. And this is a fight that belongs to the Iraqis. That is exactly what the president and the world decided some time ago when we left Iraq. So, we are not, obviously, contemplating returning. We’re not contemplating putting boots on the ground. This is their fight, but we’re going to help them in their fight.”

A decade ago, Fallujah was the site of the bloodiest chapter for U.S. troops since the Vietnam War. The U.S. push to recapture Fallujah in 2004 involved the extensive use of depleted uranium and white phosphorus, leaving a legacy of birth defects that continues today.