Madaya residents under seige
Residents in Madaya, Syria, are under siege by a government-led coalition and opposition groups Reuters

Another 16 people have died in the besieged Syrian town of Madaya since the delivery of aid in three convoys earlier this month according to the aid group Médecins Sans Frontières (MSF). The group estimates that between 1.5-2 million people are trapped by action from Syrian government-led coalition and opposition groups.

After the heavy shelling of the town last summer and the escalation of the siege during the winter huge restrictions have been placed on humanitarian assistance with the absence of medical supplies and enough food to treat cases of malnutrition with many people dying of starvation. Brice de le Vingne, MSF's director of operations, said: "It is totally unacceptable that people continue to die from starvation, and that critical medical cases remain in the town when they should have been evacuated weeks ago."

Medical teams are struggling to cope with demand from the sick, according to MSF, and the situation in Madaya is worsening as there are no doctors in the town. There are an estimated 320 cases of malnutrition in the town of 20,000 people, of which 33 are severe and in "danger of death" according to the charity.

"There needs to be a permanent and independent medical presence in Madaya immediately, as we expect the medical situation to worsen as access to healthcare for people inside remains extremely limited," de le Vingne said. MSF medics have also reported malnutrition in other towns in Syria, including in Moadamiyah, southwest of Damascus.

De le Vingne added: "The warring parties responsible for these besiegement strategies need to allow unhindered medical and humanitarian access immediately, in accordance with international humanitarian law. This includes lifting any restrictions on medical evacuations from these zones."

A convoy of international aid trucks delivered desperately needed food and medicine to Madaya on 11 January. Reports suggest that besieged residents had been forced to eat stray cats and dogs to stay alive.