Medical staff and aid workers in the besieged Syrian town of Madaya have pleaded with international authorities to step in to save its 40,000 residents from starving to death as they remain surrounded by the Lebanese Shiite Hezbollah group.
Madaya, which lies north west of Damascus near the border with Lebanon, has been under siege by the Assad regime and its Hezbollah allies since July.
In the past month alone, more than 30 people have died of starvation or been killed trying to escape, according to activists.
Dr Mohamad Youssef, who acts as the manager of the medical council in Madaya, said two or three residents are dying of starvation every day, in addition to about 50 who are either fainting or become severely ill.
Through a translator, he told the Press Association: "People are surviving by consuming water with sugar, salt or spices if they can find any.
"The death toll is striking mostly the elderly, the women and children."
The worsening conditions have given rise to hepatitis, severe diarrhoea, skin diseases and malnutrition-related conditions. With scarce supplies and basic facilities, medical staff are severely limited in what they can do to help the town's weak residents.
Dr Youssef said: "The medical staff are on high alert 24 hours. They are receiving people who are severely ill and fainting all hours - day and night."
One of the only options was to administer saline solution, he said.
In October, the United Nations reported 31 aid trucks with supplies for 30,000 people reached Fouah and Kafraya in Syria's Idlib Governorate, along with Zabadani and Madaya. However, the situation has deteriorated and supplies have dwindled.
Dr Youssef added: "We ask the world and the aid and health organisations, and the UN Security Council, to act now to save the 40,000 people in Madaya who are starving to death in very cold weather."
An aid worker in the town, who didn't want to be named, said some residents had resorted to eating cats and dogs to survive, while others ate leaves.
He said: "Humanity has fallen with the fall of the first man from hunger in Madaya."
Last week, a pregnant woman was among a group of 30 people who attempted to escape the town. She, along with five others, were killed by the army while others were taken hostage, the worker said.
He added: "There is a committee (for) relief, and medical staff are helping as much as possible to avoid a humanitarian disaster, but with the lack of material the inevitable result is either death by starvation or epidemics."
Activist group Syria Solidarity UK said Britain had a particular responsibility, as a member of the International Syria Support Group and as a permanent member of the Security Council, to make sure that humanitarian assistance reached people in need.
The situation in Madaya risked contravening UN Security Council Resolution 2254 - which attracted unanimous approval in mid-December and endorsed a peace process for Syria - and making it "another empty promise", the group said.
On Monday, the Syrian Observatory for Human Rights said hundreds of land mines had been planted by Hezbollah and Assad forces around the city, which had also been cut off by barbed wires and high fences.
The price of food and supplies had also sky-rocketed and some residents who attempted to gather food around the town had been shot by snipers.