The Syrian government has allowed humanitarian workers access to an opposition-held town near the border with Lebanon where people are reported to be starving to death in the freezing cold weather.
The United Nations said in a statement on Thursday that it was preparing to deliver humanitarian assistance in the coming days to the besieged town of Madaya. Two Shia towns that have been cut off by rebels in the province of Idlib will also receive UN aid.
Describing the situation as tragic is merely airbrushing reality on the ground
Residents of Madaya, about 25km northwest of Damascus, are suffering from severe malnutrition and have little access to fuel and medical supplies because of the siege by government regime forces since July.
Abu Abdul Rahman, a resident in Madaya, told Al Jazeera he had not eaten for four days.
Hungry and weakened, Rahman and his family have been trying to limit their movements inside their house in the Syrian town of Madaya, fearing any activity would drain the little energy left in their bodies.
"There are no more cats or dogs alive in the town. Even tree leaves that we have been eating have become scarce," he told Al Jazeera over the phone.
The Red Cross said people in the town are burning plastic to keep themselves warm.
As days pass by, Rahman said that he had little hope he and his family can stay alive.
"Describing the situation as tragic is merely airbrushing reality on the ground," he said in a subdued voice.
The Syrian Observatory for Human Rights on Wednesday said at least 23 people, including children, had died in rebel-held Madaya because of the siege.
At least 300 children in Madaya are suffering from malnutrition, the UK-based monitoring group said.
Local activists said an estimated 40,000 people in Madaya have little access to food and medicines.
| Starvation as a tool of war in Syria
Melissa Fleming, chief spokeswoman for the UN refugee agency, told Al Jazeera that hundreds of thousands of people were in similar situations across Syria.
"We believe there are 400,000 people in 15 towns and cities who are in a situation where they are besieged by different parties to the conflict," Fleming said.
"Besieged translates into civilians completely cut off from any humanitarian aid: no food, no medicine, shelters without heat and water. These are situations under which people cannot survive any more."
Pawel Krzysiek, a spokesman for the Red Cross in Damascus, also outlined the scale of suffering in the area.
"We have seen credible reports that people are starving ... People are hungry and it is very cold out there with no electricity or fuel," Krzysiek told the DPA news agency.
Medical professionals in Madaya said people "were eating grass to stay alive".
"We cannot provide milk for infants," Dr Khaled Mohammed told the German news agency DPA. "Today a 10-year-old child died of malnutrition."
The opposition Syrian National Coalition warned of a "humanitarian catastrophe" in Madaya.
The nearby town of Zabadani is also under siege, despite a deal last month that saw Sunni rebel fighters given free passage out of the town in exchange for the evacuation of Shia families from the northern towns of Kefraya and Fua.
The UN's Syria mediator aims to convene peace talks in Geneva on January 25 in the latest effort to end nearly five years of conflict - in which more than 250,000 people have died.
Source: Al Jazeera and agencies