For two years, Syrian regime and Hizbullah forces have besieged the town of Madaya, leaving residents to suffer from acute shortages of food, medicine and the critical medical attention many of them desperately need.
More than 60 people, most of them children, have died of hunger and malnutrition in the past two years, medical professionals in Madaya told Al-Mashareq.
"For two years we have been living under total siege, and [we are still alive] due to lack of dying," Madaya native Amina Yusuf al-Shammaa told Al-Mashareq.
"Food is not allowed to enter Madaya; we eat only rice and bulgur because the prices of vegetables, fruit and meat are insanely high," she said.
One day, about a month ago, Amina's 22-year-old daughter Nisreen felt severe abdominal pain while eating lunch. After her pain got worse, the family took her to a field hospital where the lab analysis revealed that she was suffering from malnutrition and calcium deficiency.
The scarce medicine and medical services available in the besieged town failed to alleviate her condition, and it quickly grew worse. She developed paraplegia and lost her ability to see, speak and hear.
Nisreen was one of 18 urgent cases evacuated from Madaya by the Red Crescent under the supervision of the United Nations August 19th.
"My daughter now lies alone in bed in a Damascus hospital," Amina said, adding that the doctors informed her by phone that it will be difficult for Nisreen to recover.
"If it were not for the siege, all treatment and medicine would be available and Nisreen would be taking care of her 6-year-old daughter Rimas," Amina said. "But now she is hanging between life and death."
Mohammed Darwish, a dentistry student and acting medical director of the field hospital in Madaya, described the situation as very dire.
The 40,000 people living under siege in the town lack the basic necessities of life, he said, while prices of nutritious food are prohibitively high, leading to the spread of epidemics and diseases and the deaths of dozens every month.
"The people of Madaya have been reduced to skeletons walking aimlessly in the streets due to severe deficiency of vitamins, minerals and protein in their bodies," he told Al-Mashareq.
"We have more than 500 patients who suffer from calcium deficiency, including 75 children at the teething and walking stages," he said. "We give them pharmaceutical alternatives, but they are not sufficient."
Darwish, who was not able to complete his last year of studies due to the siege, runs the field hospital with two other medical students who also have not completed their degrees in dentistry and veterinary medicine.
"We found ourselves having to provide the minimum level of medical care," he said, adding that the patients in Madaya require actual medical doctors and specialists. "Because they are not available, we communicate via social media with specialists to treat cases that are difficult for us to treat."
"The siege we are under is inhumane and unacceptable to any conscience," Darwish said. "The [town’s] citizens are deprived of everything."
"Why are our children doomed to die of hunger and lack of treatment?" he said.
"I cannot handle children dying anymore," he said, recalling the most recent case of a baby who died six hours after birth due to the lack of an incubator and medicine for her.
Medic Ahmed Abdel Wahab, 24, said the situation in Madaya remains "very tragic" due to the intransigence of Hizbullah.
"We as medics are facing tremendous hardship aiding the injured, the disadvantaged and those with health problems because of the acute shortage of equipment," he told Al-Mashareq.
Abdel Wahab, founder of the Syria Relief Network and Alseeraj for Development and Healthcare, said he tried to treat Nisreen al-Shammaa, but he felt "helpless" with the available medicines.
"All we could do is administer a dose of cortisone to Nisreen four times a day, bearing in mind the dosage is [normally administered] once every six months," he said.
After being part of the recent successful transfer of the 18 urgent medical cases out of Madaya, he said, "We are working to shed light on other cases that need to be transferred to hospitals where treatments are available."
"Our rescue work is not up to the magnitude of the tragedy we are experiencing," he said. "There are people at risk of dying every moment."
Nonetheless, the people of Madaya will persist, he said. "It is true that we are starving and nutritious food prices are insanely high, but we will always hold our heads high," he said.