By Lisa Barrington and Stephanie Nebehay
Residents of a besieged Syrian town have told UN investigators how the weakest in their midst, deprived of food and medicines in violation of international law, are suffering starvation and death, the top UN war crimes investigator has told the news agency Reuters.
An aid convoy on Monday (local time) brought the first food and medical relief for three months to the western town of Madaya, where 40,000 people are trapped by encircling government forces.
But Paulo Pinheiro, chairman of the UN commission of inquiry documenting war crimes in Syria, on Tuesday said his team remained "gravely concerned" about the humanitarian situation there.
"As part of our investigations, the Commission has been in direct contact with residents currently living inside Madaya," he said in an emailed reply to Reuters questions.
"They have provided detailed information on shortages of food, water, qualified physicians, and medicine. This has led to acute malnutrition and deaths among vulnerable groups in the town," he said in the email sent from his native Brazil.
Rebel forces are also besieging the government-held villages of Foua and Kafraya in Idlib province, where UN supplies were also delivered on Monday, Pinheiro noted.
Aid workers who reached Madaya spoke of "heartbreaking" conditions being endured by emaciated and starving residents, with hundreds in need of specialised medical help.
"It's really heartbreaking to see the situation of the people," said Pawel Krzysiek of the International Committee of the Red Cross. "A while ago I was just approached by a little girl and her first question was did you bring food ... we are really hungry."
The World Health Organization said it had asked the Syrian government to allow it to send mobile clinics and medical teams to Madaya to assess the extent of malnutrition and evacuate the worst cases.
A local doctor said 300 to 400 people needed special medical care, according to Elizabeth Hoff, the WHO representative in Damascus who went into Madaya with the convoy.
"I am really alarmed," Hoff told Reuters by telephone from Damascus, where she is based.
"People gathered in the market place. You could see many were malnourished, starving. They were skinny, tired, severely distressed. There was no smile on anybody's face. It is not what you see when you arrive with a convoy. The children I talked to said they had no strength to play."
Negotiations to get into Madaya and the other two villages near Idlib were lengthy and difficult.
There are presently about 15 siege locations in Syria, where 450,000 people are trapped, the United Nations says.
The WHO intends to return to Madaya on Thursday as part of a UN convoy with more medical and food supplies, Hoff said.
ICRC spokeswoman Dibeh Fakhr also said its next distribution is planned for Thursday. The aid consists of blankets and medicine as well as food.