AMMAN: The ongoing starvation of the blockaded town of Madaya highlights the human cost of uneven truces with the regime and a reliance on outside aid to survive. 

Once a summer resort town for vacationing Damascenes in the Qalamoun mountains near Syria’s western border with Lebanon, Madaya caught the world’s attention last December amidst reports of residents starving to death, despite having signed a truce with the regime.

Today, little has changed. The last aid delivery entered one month ago, but was not enough for the 40,000 blockaded residents. The assistance quickly ran out. At least 16 residents have died since, bringing the death toll to nearly 50, Doctors Without Borders stated earlier this month.

The truce between Victory Army rebels and regime forces last September stipulated that aid would get in, but did not specify a number of deliveries. Two members of the town’s local council told Syria Direct that they have no information about when food will next be delivered. Children in Madaya understand the scarcity, and have internalized anxiety around where their next meal will come from, residents told Syria Direct on Monday.

“People are afraid of hunger now, even the children,” said Hussam Madaya, a member of the town council, recounting an anecdote from his own family. “Yesterday, I noticed how a child, a relative of mine, ate his little plate [of food] and then stole his father’s plate,” he said.

“Imagine the amount of fear.”

The marks of starvation are also showing up on children’s bodies.

“Over the past week, many children have gone to the field hospital with swollen abdomens from fluid retention due to the lack of protein,” Hussam al-Yatim, another member of the Madaya Local Council told Syria Direct on Monday. [See pictures here.]

 Children in Madaya play with toys at an education and rehabilitation center on Sunday. Photo courtesy of Amrha.

“The children are constantly afraid of going hungry,” Abd Alwahab Ahmad, an aid activist in Madaya, 20km northwest of Damascus, told Syria Direct on Monday. “All the time, they are thinking about food and drink, asking when they will be given another meal and what they will eat tomorrow.”

Local Council member al-Yatim said he feels powerless to protect his three young children from the effects of the siege. “Things have happened with my children that bring me to tears,” he told Syria Direct. “I stand with my hands tied and I can’t do anything.”

When food became scarce in recent months, “my wife and I tried to make the children eat two meals and we would eat one meal a day,” al-Yatim said, adding, “sometimes only one meal every two days.”

Al-Yatim bought five biscuits from a roadside stand in Madaya for $100 recently, paying the exorbitant price because “I see my children unable to stand up [from hunger] and silent from trauma,” he says.

Madaya remains under a blockade imposed by regime forces and its ally Hezbollah that began last July during a battle for control of neighboring rebel-held Zabadani, a gateway to key smuggling routes into and out of Lebanon across the Qalamoun mountains.

Surrounded, completely blockaded and struggling to cope with thousands of internally displaced from neighboring Zabadani, supplies of food and medicine in Madaya steadily dwindled last fall as prices skyrocketed.

Despite a truce between regime and rebel Victory Army forces in September that promised some form of relief for the trapped civilians, a single delivery of food aid in October did little to improve living conditions for most Madaya residents, who were reduced to eating leaves and grass to stay alive, Syria Direct reported in early December.

The story of Madaya spread in the global media, accompanied by images of mass starvation and reports of deaths from preventable illnesses and cold. Madaya is only one example of the Assad government’s “kneel or starve” strategy in rebel-held towns; even ones that have signed truces (for Syria Direct’s coverage see here, here and here).

‘Siege and starvation atmosphere’

Aid activists with Amrha, a local aid organization in Madaya, delivered gifts and toys to a children’s center in the town on Sunday, seen in pictures Amrha posted to Facebook the same day. The goal, said the NGO in a statement alongside the pictures, was to distract from a “siege and starvation atmosphere.”

 Children at play in Madaya on Sunday. Picture courtesy of Amrha.

The effort was a joint initiative with the Turkey-based Syrian civil society nonprofit Al-Seeraj, which funded the toys and “specializes in supporting projects like these,” says one Amrha employee named Ahmad who was among those to visit the center on Sunday.

Elementary school-aged children, toting bright blue UNICEF backpacks and bundled up in winter hats and coats indoors are seen playing with dolls, trucks and brightly colored blocks in the photos. A row of fading painted flowers runs along one side of a cinderblock wall. In one picture, two young boys play with a toy military helicopter.

The center cares for 300 children under the age of 12 and aims “to entertain them, to bring them out of the siege atmosphere, and to restore their bodies" by providing daily meals, Ahmad told Syria Direct on Monday.

“We address two issues: the fear of hunger and the fear of bombardment. The children are consumed by the fear of being hungry again,” Ahmad says. “We try to distance them from these obsessions and from the atmosphere of bombardment,” he said, adding that “we teach them what to do during bombardment, to help their siblings and get to the shelters.”

Two weeks ago, 15 Madaya schoolchildren were wounded, some critically, when shelling allegedly by pro-regime Hezbollah fighters near the town struck an elementary school, reported Al-Quds Al-Arabi.

“The children need this psychological support," Ahmad said. 

Unfulfilled promises

A deal hammered out in Munich last Thursday between dozens of countries and, notably, the United States and Russia, called for a “cessation of hostilities” within one week and stipulated the “sustained delivery of assistance” to seven blockaded areas and towns in Syria: Madaya, Deir e-Zor, Fuaa and Kafariya, Outer Damascus, Moadimiyet a-Sham, and Kafr Batna.

The Secretary General of the Norwegian Refugee Council and former UN Office for the Coordination of Humanitarian Affairs (OCHA), Jan Egeland, said last Friday that requests to deliver aid to blockaded areas have been submitted to relevant groups inside Syria, adding that “we expect to get such access without delay.”

This past Sunday, regime forces allowed a Syrian Arab Red Crescent convoy carrying medical aid into rebel-held Douma in the blockaded East Ghouta suburbs of the capital, pro-regime Damascus Now reported. The following day, UNRWA distributed 1,200 aid parcels to residents of besieged south Damascus neighborhoods. Aid also reached regime-blockaded Waer, in Homs, and Damascus’s Moadimiyeh this week.

While Madaya is listed among the blockaded areas set to receive assistance under the terms of the Munich agreement, it is not immediately clear if or when the next aid will arrive.

Amrha activist Ahmad is skeptical of international promises of assistance. Among residents, he says, “there is no trust now in these promises,” he told Syria Direct. “It’s just talk for the world.”

Madaya Local Council member al-Yatim says there is only one solution for his family and the children of Madaya.

“The children have forgotten childhood and the dreams of playing and studying,” he said on Monday.

“The only dream is for the road to be opened, to leave this prison.”