A boy being pushed in a buggy in Madaya. Activists say many people in town are too weak to walk.

Others who can still move around, and should normally be in school,
are risking their lives trying to collect plants in minefields around
the town’s outskirts, and several have lost limbs, residents said.
It was not possible to verify their claims because of the siege, but
several independent accounts were consistent in describing life in a
town desperately short of food, medicine and electricity.
“Whether you are a man, woman, child, whether you’re 70 or 20 years
old, you will have lost about 15kg of your weight,” said Ebrahem Abbass,
a defector who had served as a sergeant in the Syrian army. “You don’t
see a child whose eyes aren’t sunken and staring from hunger.”
Up to 30,000 people have been trapped in Madaya since July, under a
tight siege by pro-government forces. They say they are being treated as
pawns in a complicated power play, punished for the suffering of two
villages hundreds of miles away at the hand of anti-government troops.
In the spring of last year, a rebel coalition known as Jaysh al-Fateh captured large swaths of north-western Syria
from the Assad regime, surrounding two Shia enclaves in Idlib province
called Fua and Kefraya, whose citizens are also enduring a debilitating
siege.
Assad’s forces are now starving Madaya and neighbouring Zabadani,
once a stronghold of the opposition, after a punishing six-month
campaign.
Under a ceasefire deal, foreign backers of the government and the
opposition are attempting to orchestrate a population swap, essentially a
peaceful “sectarian cleansing”.
So far they have only managed to agree on an evacuation of wounded
individuals on both sides and safe passage for a single aid delivery in
October.
That allowed convoys to reach Madaya, Zabadani, Fua and Kefraya
simultaneously, but supplies only lasted a few days, residents said.
“I swear by God, and you might not believe me because it sounds
fantastical, I tried to buy some food today, but a kilo of rice is
100,000 [Syrian] pounds,” said Louay. “A kilo of rice, bulgur, lentil,
sugar – 100,000, 100,000, 100,000. That is if you can find it.”

At the black market exchange rate that would be close to £170 for rice.“I’ve personally seen people slaughtering cats to eat them, and even the trees have been stripped of leaves now,” he added.
People are so weak that they often faint, and hunger is made worse by
the biting cold in an area about 1,300 metres above sea level, near the
border with Lebanon.
Though a wooded hill is nearby, snipers have a clear shot, and
residents said more than a dozen people had been killed trying to
retrieve firewood. They also said children had lost limbs trying to
gather grass to eat from nearby fields.
“They blocked all the roads to both towns, and there are a lot of
mines,” said one teacher in Madaya, who did not want to give his name
because of relatives in areas under government control. “There is no way
to explain, the students are always complaining they are hungry, but
they have to study.”
An aid official who visited Madaya and Zabadani in October as part of the convoy said he saw “deep suffering”.
“There was a very dramatic appeal from the children in those two
places, and the same dramatic appeal from Fua and Kefraya,” he said.
“The children should not be suffering.”
The official said he hoped for more agreements to deliver aid. But
for now, the people in all the besieged towns suffer in a tragedy that
is not of their making.
“Here, we no longer call on anyone,” said Louay. “We have called for
help so many times and nobody has heard us. But we want to ask the
officials and decision-makers out there, if you were in this position,
and your children were dying from hunger in front of you, what would be
your reaction to the world outside that let you down? Don’t forget to
ask your readers this question.”