PHOTO: In Madaya near Damascus, a car on sale for 15 kilograms of rice or 5 kilograms of milk

Worries are growing about the lack of food for 40,000 residents of a town southwest of Syria’s capital Damascus, with claims of more than 20 deaths from starvation.

Madaya has been under a tight siege by the Syrian military since July, when Hezbollah and regime forces tried to overrun the nearby town of Zabadani.

Despite a ceasefire agreement in late September, including the evacuation of rebels and their families from Zabadani, the siege has not been lifted. Local activists say that, with basics such as rice no longer affordable, residents have resorted to eating wild plants, insects and even cats.

Madaya-based media activist Nasir Ibrahim said that on New Year’s Eve, he had managed to find 50 grams of rice. On Friday, with snowfall on the town in the mountains, he went hungry:

The humanitarian situation is very dangerous. Many have died starving and many more will follow them if no immediate aid is allowed in.

Ibrahim said that about 20 people have died so far from starvation. Graphic photos have circulated on social media of emaciated victims. One was identified as an elderly farmer, Jamil Alloush, who is said to have died shortly before Christmas.

Another 10 men have perished trying to break the siege, killed by sniper fire or by stepping on the land mines that surround Madaya, he claimed, adding that another 15 men and six children have lost one or both of their legs or a hand because of the mines.

While most of the the dead are adult men, the activist said that 850 infants are in urgent need of milk, with six newborn babies dying because their mothers were unable to feed them.

Last week, the Syrian Network for Human Rights identified a female victim as Layla al-Mawail.

The threat of starvation is the latest in opposition-held areas near Damascus, some of which have been besieged for three years. In late 2013, more than 120 people reportedly died of malnutrition in Moadamiya, also southwest of Damascus, as the Syrian military tried to break the will of residents and rebels.

See Syria Feature: Moadamiya – “If You Back the Revolution You Will Starve To Death”

A ceasefire agreement was reached in January 2014, but the regime has continued to restrict supplies and movement in and out of the town.

“Let Me Eat in Heaven”

In early December, the pro-opposition Orient News featured a letter from a girl in Madaya to the Angel of Death:

This is my will, mom. Please, keep remembering me and my consecutive laughs,
Mom, keep singing to me, when all are asleep,
And you, my sister, tell my friends that I died while I was hungry,
You, my brother, do not be sad of my loss and remember when we were both crying, “Hungry”.

Oh, Angel of Death! Come and take my soul and let me eat in heaven because I’m hungry,
My family, I will eat for you as I can, so do not worry!

The letter ends with a drawing: “This is my coffin.”