Supplies of food and medicine have finally reached starving residents in the Syrian town of Madaya after six months under a punishing siege. The Syrian government gave permission for a convoy of aid from the United Nations and Syrian Arab Red Crescent, following months of refusals, and after an international outcry at images of skeletal corpses and reports of families forced to eat grass, weeds and cats.
The International Committee of the Red Crescent (ICRC) confirmed that the first lorries entered the town as darkness fell, with distribution due to continue through the night.
Convoys also reached two towns besieged by Islamist rebels in the north of Syria as part of an elaborate three-way agreement.
It was too late for some, however. The Médecins Sans Frontières (MSF) aid agency said that five people, including a nine-year-old boy, died in Madaya on Sunday. The charity said that the medics it supported in the town had reported 28 deaths from starvation since the start of December, when supplies started running out. There were also 10 people suffering from severe starvation needing urgent hospital care, and 200 more malnourished patients, it said.
The mountain town, which lies near the Lebanese border just 15 miles from the Syrian capital Damascus, has been under siege by government forces and its allies from the Iranian-backed Lebanese militia Hezbollah.
Its fate has been bound with the pro-government, predominantly Shia villages of Kefraya and Fua in the province of Idlib as part of a UN-sponsored truce. They have been besieged since March by hardline Islamist rebels seeking to topple the Syrian president Bashar al-Assad. They, too, are said to have been suffering shortages of food and medicine, although they have received some aid drops from the government via helicopter.
The UN deal enabled one initial delivery of aid to get through to the three towns in October. Since then, no supplies have reached Madaya. Its estimated 40,000 inhabitants – battling the cold weather and snow – have grown increasingly desperate amid severe shortages of food and medicine. Prices soared to as much as $250 (£170) for a bag of rice, forcing people to scavenge for supplies.
The UN said it hoped that today's delivery of food, medical items and blankets would be the first in a series of convoys to reach the town in the coming week. Marianne Gasser, head of the ICRC delegation in Syria, warned that “it must not be just a one-off distribution”. She said: “To relieve the suffering of these tens of thousands of people, there has to be regular access to these areas.”
In pictures: Syria conflict
In pictures: Syria conflict
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Syrians carry children amid debris following a air strike by government forces in the northern city of Aleppo
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A Syrian man carries a girl on a street covered with dust following a air strike by government forces in the northern city of Aleppo
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Syrians react as they stand amid debris following a air strike by government forces in the northern city of Aleppo
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A Syrian man carries a girl amid debris following a air strike by government forces in the northern city of Aleppo
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An injured Syrian man walks out from the rubble of a destroyed building following a air strike by government forces in the northern city of Aleppo
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A Syrian woman makes her way through debris following a air strike by government forces in the northern city of Aleppo
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People stand on the rubble of collapsed buildings at a site hit by what activists said was a barrel bomb dropped by forces loyal to Syria's President Bashar al-Assad, in the Al-Fardous neighbourhood of Aleppo
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Syrian residents stand amid the rubble of destroyed buildings
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A Syrian resident grasps a mattress amid rubble in the al-Firdous neighborhood of the northern city of Aleppo
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A bullet-riddled parking sign stands amid debris in a deserted street leading into the old city of Homs
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A general view shows abandoned buildings on a deserted square in the old city of Homs after Syrian government forces regained control of rebel-controlled areas
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A mosque is pictured through shattered glass in the old city of Homs, as rebel fighters withdrew from the city centre in line with a negotiated withdrawal deal with the government after having held out under tight siege for nearly two years
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Buses carrying Free Syrian Army fighters leaving Homs. Exhausted and worn out from a year-long siege, hundreds of Syrian rebels left their last remaining bastions in the heart of the central city of Homs under a cease-fire deal with government forces. The exit of some 1,200 fighters and civilians will mark a de facto end of the rebellion in the battered city, which was one of the first places to rise up against President Bashar Assad's rule, earning it the nickname of "capital of the revolution"
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Syrian government forces hold up a portrait of President Bashar al-Assad (L) while others raise the national flag on top of a pole in the old city of Homs
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Forces loyal to Syria's President Bashar al-Assad run through Aleppo's Bustan al-Qasr crossing after their release by rebels. They were freed as part of a larger deal which saw the last remaining Syrian rebels in central Homs city evacuate their positions and free captives in several locations in northern Syria
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A Syrian woman and two children walk past heavily damaged buildings in the northern city of Aleppo
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A man carries a wounded girl following a reported bombardment with explosive-packed "barrel bombs" by Syrian government forces in the al-Mowasalat neighborhood of the northern Syrian city of Aleppo
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A wounded man sits as he is treated at a makeshift hospital following a reported bombardment with explosive-packed "barrel bombs" by Syrian government forces in the al-Sakhour district of the northern city of Aleppo
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Debris rises in what Free Syrian Army fighters and Islamic rebels said was an operation to strike Al-Sahaba checkpoint, which is considered a gateway to Al-Dayf valley, and remove forces loyal to Syria's President Bashar Al-Assad in Maarat Al-Nouman, Idlib province
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Men try to put out fire at a site hit by what activists said was an air strike by forces loyal to Syria's President Bashar al-Assad in the town of Azaz, north of Aleppo, near the border with Turkey
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Civil Defence members try to put out fire
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Survivors react at a site hit by what activists said was an air strike by forces loyal to Syria's President Bashar al-Assad in the town of Azaz, north of Aleppo, near the border with Turkey
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Residents queue as they wait to receive food aid distributed by the UNRWA at the Palestinian refugee camp of Yarmouk, south of Damascus
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Belongings of Syrian rebels inside a chapel at Crac des Chevaliers, the world's best preserved medieval Crusader castle in Syria. The village was destroyed in fighting between the government and rebel forces while the castle, listed as a UNESCO world heritage site, also has been damaged over the past two years
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Hosen Sabah, a 16-year-old student is comforted by his mother at a hospital in Damascus. Nosen was wounded by a mortar outside his school, while 14 other students were killed and over 80 wounded
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A Free Syrian Army fighter works on a locally made launcher before firing it towards forces loyal to Syria's President Bashar Al-Assad in Mork town
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Syrian policemen and citizens inspecting the site of a car bomb at the entrance of Moadhamiyet al-Sham neighborhood in rural Damascus. According to Syria's Arab News Agency (SANA), a car bomb explosion has gone off in the countryside of Damascus and initial information say there are casualties, where a car rigged with explosions was remotely detonated at the entrance of Moadhamiyet al-Sham neighborhood in rural Damascus during engineering units it was trying to dismantled it
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Opposition fighters carrying a rocket launcher during clashes against government forces in the Sheikh Lutfi area, west of the airport in the northern Syrian city of Aleppo
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A Syrian man helps a woman to make her way through debris following reported air strikes by government forces in the Halak neighbourhood in northeastern Aleppo
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A Syrian man reacts as he carries the body of injured boy following reported air strikes by government forces in the Halak neighbourhood in northeastern Aleppo. According to the Syrian Observatory for Human Rights, at least 33 civilians were killed in the attack
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Syrian rescue workers carry the body of a woman following reported air strikes by government forces in the Halak neighbourhood in northeastern Aleppo
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Syrians gather at the site of reported air strikes by government forces in the Halak neighbourhood in northeastern Aleppo
Ahead of the trucks’ arrival, Hezbollah’s television channel Al-Manar showed a group of men, women and children waiting to greet the convoy.
Speaking to the station, they accused fighters of hoarding supplies and selling them to civilians at vast prices. The same charge has been levelled at the Hezbollah forces surrounding the town, who are accused of making huge profits from bags of food.
“Our children are dying of hunger,” one school teacher told the channel, adding that she had walked to the entrance of the town to make sure she received assistance.
Both sides in the Syrian conflict have been accused of using siege and starvation as a weapon of war. The United Nations estimates that almost 400,000 people are being subjected to such tactics, though some estimates put the figure far higher.
The aid to the besieged towns came as it was reported that at least 12 pupils were killed along with their teacher in a suspected Russian airstrike in Aleppo province.
The Syrian Observatory for Human Rights, a pro-opposition monitoring group, said that the strike took place in the town of Anjara, about nine miles to the west of Aleppo, Syria’s largest city.
Images shared by Syrian activists on social media showed a destroyed classroom, with blood-stained textbooks strewn across the floor.