It’s just one of the countless cities ripped apart by the Syrian civil war.
But civilians in Madaya have been hit especially hard by extreme hunger. In a video posted by Syrian activists, one skeletal boy — his ribs protruding — says he hasn’t eaten a full meal in seven days.
The situation is so dire that one doctor told CNN’s Raja Razek that he has nothing to give his patients except sugar or salt water.
Madaya is a rebel-held city that has been under siege by regime forces and their allies since July. It has not received an international aid shipment since October.
But on Monday, civilians in the city choked off by military blockades and landmines are expected to get a brief reprieve.
A convoy from the U.N. World Food Programme, International Red Cross and Syrian Arab Red Crescent was set to deliver enough aid to sustain 40,000 people for a month, WFP spokeswoman Abeer Etefa said.
A United Nations source on the ground said the 44-truck convoy had reached the outskirts of Madaya on Monday.
The source said a second convoy has reached the northern province of Idlib to deliver aid to the besieged towns of Foua and Kefraya.
Unlike Madaya, Foua and Kefraya are loyal to the Syrian regime.
But International Red Cross spokeswoman Dibeh Fakhr said the aid will go only so far.
“One short delivery will not be the solution,” she said. “What is needed is regular access.”
Graphic images of death and starvation coming out of Madaya have not been independently confirmed by aid groups or CNN.
But the United Nations said last week that it had received credible reports of people dying of starvation and that the Syrian government had agreed to allow aid convoys into Madaya, Foua and Kefraya.
Unbearable costs and landmines
Even though Madaya is less than 50 kilometers (31 miles) from the capital city of Damascus, the cost of food has crippled the city.
For example, in Damascus, flour costs 79 cents a kilogram. But in Madaya, a kilo of flour costs $120, and a kilo of rice costs $150.
In the capital, milk costs $1.06 a liter. But in Madaya, the price soars to $300 a liter.
Then there’s the problem of landmines, which have made smuggling food into the city extremely dangerous, Dr. Khaled Mohammed said.
Mohammed, who works at a field hospital in Madaya, said he gets about 250 cases of starvation a day. He said the hospital has seen at least 55 deaths from starvation.
On Sunday, he said five people died in the past 48 hours, including a 9-year-old child.
And when a child dies, the doctor said, it’s likely his or her siblings will die soon, too. So families go door to door, urgently trying to gather what they can to feed the siblings.
‘The tip of an iceberg’
“These harrowing accounts of hunger represent the tip of an iceberg,” said Philip Luther, the Middle East director for Amnesty International.
“Syrians are suffering and dying across the country because starvation is being used as a weapon of war by both the Syrian government and armed groups.”
Luther accused both sides of “toying with the lives of hundreds of thousands of people” and said that starving civilians as a tactic in warfare is a war crime.
Eating grass
More than 250,000 Syrians have been killed in the civil war, according to the United Nations. While the vast majority were killed violently, the risk of starving to death continues to grow.
“The last time I had a full meal was at least a month and a half ago,” a Madaya resident named Louay said, according to Amnesty International. “Now, I mainly have water with leaves. Winter is here and the trees no longer have leaves, so I am not sure how we will survive.”
Louay was interviewed on January 7, along with other Madaya residents.
Um Sultan said she hears every day of someone too sick to leave the bed.
“My husband is now one of them,” she told Amnesty. “He can’t leave the bed, and when he does, he faints. I don’t recognize him anymore; he is skin and bones.”
One video shows an old woman stirring a pot of green boiling water. The man filming her asks in Arabic: “Hajji, what are you cooking?”
“Grass for the old man,” she replies.
