For many in Madaya, emergency aid is too late
Two people will lose their lives to starvation and another 50 from diseases over the next 24 hours, according to Syrian activists in Madaya.
The United Nations is expected to deliver aid to the besieged town this weekend, but starvation has reached such a critical level that dozens could die by then.
"According to a doctor in Madaya, 50 people are going to lose their lives in the next 24 hours unless aid reaches Madaya right now," said Muzna al-Naib, spokesperson for Syria Solidarity UK.
"There are cases of diarrhoea, malnutrition, hepatitis, and people are being poisoned because they are eating pets and leaves."
Poisoned and starved
Despite rumours on social media, no aid has yet arrived to the blockaded Damascus suburb.
On Friday, 23 people died from starvation according to Medicins Sans Frontiers.
It is the weakest and most frail in Madaya who are falling victim to starvation - six of the victims were babies aged under one, and five were aged over 60.
The group said that pharmacy shelves are empty and there is a growing queue of dying civilians outside makeshift hospitals waiting to be saved by medics.
"[They] are even resorting to feeding severely malnourished children with medical syrups as they are the only source of sugar and energy, thereby accelerating the consumption of the few remaining medical supplies," said Brice de le Vingne, MSF Director of operations.
"As well as supplying food, an immediate medical evacuation of sick patients, and an urgent resupply of medicines is the only way to stave off a situation that is now catastrophic."
Madaya has been under a crippling siege from the Syrian regime and Hizballah fighters for 200 days and on Thursday - after mounting pressure - Damascus finally agreed to allow in aid.
But every delay costs lives and it is still not certain if the UN will be able to deliver desperately needed food and medical supplies after countless broken truces and promises by the regime.
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- Social media reacts to the starvation of Madaya
"There is no guarantee that the food wil reach Madaya because this is on the terms of the Syrian regime and even the aid which will arrive will only sustain Madaya residents for one month and then the cycle will start again," said Naib.
Pleasure to pain
Once a popular resort town perched high in the mountains, famine and disease now stalk Madaya and neighbouring Zabadani.
Ghiras al-Nahda a group which provides critically needed help to the 40,000 civilians - including 600 infants - in these besieged areas gave released some horrifying statistics about the devastating blockade
There are over 500 cases of malnutrition in the town and the numbers are growing each day.
More than 70 people suffering from severe malnutrition have been hospitalised for life-of-death treatment, while 150 people are seen by medics each day after fainting from hunger.
One case was shared widely on Arabic social media. Mohammed al-Kharyta, aged 56, put a sign on his car window begging residents to buy his vehicle.
The price was 10 kilos of rice or 5 kilos of dried milk. He died from starvation a few days later.
Damascus has explicitly withheld food as a punishment for residents rebelling, and the regime's ultimate intention is to starve Daraya into submission.
The result has been the haunting images coming out of the town of skeletal children on the verge of death.
"We need aid to reach aid right now," she said.
"Starvation has been happening before Madaya and the world ignored it. They know that the Syrian regime has the power to break the siege or not. If you want this to end [the international community] needs to deal with the Syrian regime, now."
'Break the siege'
Syria Solidarity UK's solution is for the British government to drop aid on besieged areas, as they did in Iraq in 2014 to save Yazidis fleeing for their lives from Islamic State group militants.
Now, London knows which places in Syria people are starving, but instead direct their war planes - loaded with bombs - towards IS territories.
At the same time, Russian and regime jets and helicopters are bombing besieged opposition-held areas.
"There are 15 other besieged areas in Syria documented by the UN almost 400,000 people starving, resolutions not been executed because of the lack of will of the US, the world, America," said Naib.
"My message to Prime Minister David Cameron is act now."