Up to 40,000 people in the besieged Syrian settlement of Madaya have been forced to turn to leaves and flower petals to stay alive after eating all of the town's stray dogs and cats.
Photographs and videos taken inside the former holiday resort show the corpses of men, women and children who have died of starvation as the siege enters its sixth month.
As the Syrian winter grips the city, electricity is in short supply and food sources almost non-existent.
Soldiers loyal to Syria’s embattled president Bashar al-Assad and members of the Lebanese militia Hezbollah continue to surround the city, cutting off fresh supplies of food and drink and preventing citizens from escaping by filling the surrounding countryside with landmines.
One image shared on Facebook appears to show a desperate citizen preparing to slit the throat of a cat while other photos show malnourished children eating a broth made of olive tree leaves and water.
“There are no more cats or dogs alive in the town. Even tree leaves that we have been eating have become scarce,” local resident Abu Abdul Rahman told Al Jazeera.
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
“Describing the situation as tragic is merely airbrushing reality on the ground,” he added.
The situation is so desperate that starving residents spend their days trying not to move in an attempt to conserve energy. With temperatures falling, the Red Cross says locals have been forced to burn plastic to keep warm, exposing themselves to fumes.
As the city’s 40,000 inhabitants consume the final few animals living in the city, many have turned to grass and flower petals to provide basic nutrients.
While this may be just about enough to keep some otherwise healthy adults alive, children, the elderly and the sick are dying on a daily basis.
“We cannot provide milk for infants,” Dr Khaled Mohammed told Germany’s Deutsche Presse news agency. “Today, a 10-year-old child died of malnutrition,” he added.
The price of a kilogram of rice, once the staple food of the town, is understood to have risen to a staggering £170 - far beyond the budget of all but the wealthiest residents.
Dr Mohamad Youssef, who acts as the manager of the medical council in Madaya, told SKy News that two or three residents are dying of starvation every day.
“The death toll is striking mostly the elderly, the women and children,” he said. “The medical staff are on high alert 24 hours [a day]. They are receiving people who are severely ill and fainting all hours - day and night,” he added.
Madaya lies just 15 miles from the Syrian capital Damascus, where Assad’s regime is based.
The Red Cross says it hopes to be in a position to bring aid to Madaya in the coming days but food packages are likely to have a limited effect.
In mid-October more than 20 lorries were allowed to deliver medical and humanitarian supplies to Madaya but those items have already run out. The situation has deteriorated significantly since then, meaning larger and more frequent deliveries are desperately required.Reuse content