The World Health Organization's representative for Syria said Tuesday she is hopeful the government will grant the agency's request to send teams to the besieged town of Madaya to assess the level of malnutrition and set up medical aid.
In an interview with CBC News, Elizabeth Hoff described her conversations with people in Madaya when she arrived as part of an aid convoy Monday.
"They didn't talk about politics, they didn't talk about the Syrian crisis," she said. "They all talked about the lack of food and that they were hungry."
"A little boy of six years said that he had a brother at home who was so hungry he couldn't come to wait for the food [being delivered by the convoy] but he hoped to bring [him] home some food."
Monday's aid convoy, which included United Nations and other agencies, brought the first food and medical supplies in months to Madaya, where thousands are trapped and local doctors say some have starved to death.
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She said people normally express "much joy and happiness" when convoys arrive with aid, but she was struck by the reaction in Madaya.
"The children were not smiling ... they seemed to be weak and fatigued," she said. "They said, 'We are too weak to play.'"
In an interview with Reuters, Hoff said many malnourished people were too weak to leave their homes and WHO needs to do a door-to-door assessment to verify the situation is as dire as doctors in the town of 42,000 people are reporting. She said a Syrian doctor told her 300-400 needed "special medical care".
"We need unhindered, sustained access, the only thing that will help in the long term is lifting the siege," Hoff added.
The WHO brought 7.8 tonnes of medical supplies to Madaya on Monday, including trauma kits, medicine for treating both chronic and communicable diseases, and antibiotics and nutritional therapeutic supplies for children, according to Hoff.
The agency simultaneously delivered 3.9 tonnes each to Foua and Kafraya, two villages in Idlib province encircled by rebels fighting the Syrian government.
The World Health Organization intends to return to Madaya on Thursday as part of a UN convoy with more medical and food supplies, she said.
The Syrian Observatory for Human Rights, a group that monitors the war, said at least 300 people left the town and were taken by government forces to the Damascus region. The UN said its vehicles were not used to take anyone out of Madaya.
Mothers have 'no milk for breastfeeding'
Hoff told Reuters a Syrian doctor had said that "mothers had absolutely no milk for breastfeeding, the milk had dried up and the babies are not satisfied".
She visited two medical sites in Madaya, one a private practice based in a home run by two doctors, and the other a makeshift field hospital in a basement. Neither had supplies, she said.
"The doctors at the private practice said they had run out of medicines they received in October and patients preferred to spend what little money they had on food and not health care," Hoff said.
The two doctors lacked equipment for measuring wasting in a child, or even a scale to weigh patients, she said. The makeshift field hospital, down a dark flight of stairs, lacked hygienic conditions, she said. "The room is often so crowded that they had to give a drip to a patient outdoors because there was no room in the clinic."
The doctors told her that they see patients with "acute respiratory infections, urinary tract infections and anaemia" she said. Others had low blood sugar. "An elderly lady had not eaten for 20 days, she was picked up unconscious on the street and brought in. She had bruises from the fall. She was severely undernourished."
"I spoke with a man who said he was 45 and severely malnourished, he could hardly talk. He said he had four children at home who are in a bad situation. He was totally dehydrated and had a yellow colour and was distressed," Hoff said. "A pregnant woman was there who came in regularly unconscious ... she was lying in front of me, with very low blood sugar and lacking food. The nurse had nothing to give [her]."