Two days after an international aid convoy reached the besieged Syrian city of Madaya, where thousands of people have been trapped for months, many of them starving, the United Nations said it will launch an investigation into war crimes.
For months, forces loyal to Syrian President Bashar al-Assad, including members of Lebanon’s Hezbollah, cut off food and medical supplies after surrounding the city of 42,000 people.
The last aid shipment was in October, and since then some residents have described eating leaves and grass for survival.
As aid arrived on Monday, UN officials provided on-the-ground accounts of a “horrible and terrible” scene of sick and emaciated people including children.
“We saw thousands of people in desperation, thousands of people who are severely malnourished, older people who were in clear dire physical condition because of lack of regular access to food,” said UN Humanitarian Coordinator in Syria Yacoub El Hillo, “We saw people who seemed to have lost hope that the world cared about them.”
Doctors Without Borders said in December that 23 people died from starvation that month in Madaya, including six children. As the convoy arrived Monday, desperate survivors surrounded the convoy looking for food.
“Most of them have not had bread, rice, or vegetables for quite some time,” said Sajjad Malik, of the UN High Commissioner for Refugees.
At least 400 people were found to be in dire medical condition. The price of goods has risen steeply during the military blockade, with one kilo of rice costing about $300.
In recent months, photos and videos of starving people were increasingly transmitted on social media sites by members of the opposition inside Madaya, causing a burst of urgent pleas from the international community to allow aid into the city.
The UN, which demanded humanitarian access in late December, said 44 trucks of food and medical supplies were allowed in on Monday after “tortuously negotiated local ceasefires” could be arranged between pro-government and rebel forces.
“There were a number of terrible examples of emergencies for intervention, to evacuate 400 critically ill people who are going to die if they don’t get fast to a medical facility that has the capacity to deal with their complicated condition,” Hillo said. “These people must get out today before tomorrow if we are going to save their lives.”
The UN is negotiating a second round of aid for Thursday along with mobile medical units, while it is also pushing for evacuations for some of the more severely affected who are in need of immediate medical attention.
Two others towns surrounded by rebel forces also were allowed aid this week along Syria’s northern border with Turkey. About 21 trucks carrying supplies were allowed into the towns of Kafraya and Foah, where 20,000 people were in circumstances similar to residents of Madaya, the UN said.
The UN commission of inquiry, which documents war crimes in Syria, has contacted residents in Madaya.
"They have provided detailed information on shortages of food, water, qualified physicians, and medicine,” commission chair Paulo Pinheiro told Reuters. “This has led to acute malnutrition and deaths among vulnerable groups in the town."
The commission has been compiling a list of those using starvation as a weapon of war, strategies utilized by both sides of the conflict during the five-year civil war.
"Siege tactics, by their nature, target the civilian population by subjecting them to starvation, denial of basic essential services and medicines," Pinheiro said. "Such methods of warfare are prohibited under international humanitarian law and violate core human rights obligations with regard to the rights to adequate food, health and the right to life, not to mention the special duty of care owed to the well-being of children."
About 4.5 million Syrian people are living in areas that are difficult to reach, and 400,000 are located in 15 cities and towns without access to aid, the UN said.