Starving to Death in Madaya

In late spring 2016, 12-year-old Ola died in Syria. In a place where her death could easily have been caused by barrel bombs, missiles, or mortar fire, she instead suffered a slow and painful death from starvation. This happened because she lived in Madaya, a small town controlled by opposition forces an hour’s drive from Damascus that the Syrian government has besieged since July 2015. A new report released by Physicians for Human Rights (PHR) and the Syrian American Medical Society (SAMS) highlights the harsh conditions faced by Madaya’s 40,000 besieged residents. For a year, the population has been forced to survive on the meager supplies and services available inside the town’s narrow boundaries. With inadequate food stores and medical care, they have suffered from starvation and malnutrition, and succumbed to disease, traumatic injury, and other life-threatening conditions. The population, roughly four times its original size due to internal displacement in the country prior to the siege, is surrounded by 12,000 landmines and 65 checkpoints manned by snipers.

In December 2015, after nearly six months of siege and only one humanitarian aid delivery that included expired food, reports from Madaya appeared in international news outlets, including graphic images of starving children and adults. This prompted a large-scale effort by the United Nations and humanitarian groups to deliver aid and ease the impact of the siege in Madaya. However, of the four humanitarian aid deliveries to Madaya between January and April 2016, none included adequate food and medical supplies to stave off advanced malnutrition and starvation for all of the town’s residents. Syrian government officials only permitted limited quantities and types of food and medicine and stripped out essential aid from convoys, such as kits to treat severe acute childhood malnutrition. UN agencies also failed to deliver some of the aid they promised, including cans of tuna for hundreds of malnourished children suffering from a protein deficiency. These half-measures, lauded by the media and UN officials as progress toward ending the siege, have been far from sufficient to alleviate the immense suffering in Madaya. Now, more than two months since the town last received an aid delivery in late April and more than a month since the International Syria Support Group (ISSG) promised airdrops if government authorities did not grant access to ground convoys, its residents are again on the brink of starvation.

As a result of the tragically inadequate response to Madaya’s needs, Ola and other residents suffering from the effects of starvation found little relief in the aid. When she died in May 2016, Ola became one of at least 86 people who have perished from siege-related causes since the siege on Madaya began – 65 died from malnutrition and starvation, 14 from landmines, six from snipers, and one from a chronic health condition. Almost all 86 could have been saved if they had had access to food, medication, medical equipment, and medical treatment by specialized health workers. But all of those things exist in grossly insufficient numbers in Madaya, and two dentistry students and a veterinarian are left to care for the town’s 40,000 residents. With the siege still firmly in place, the lives of Madaya’s remaining residents hang in the balance, with hundreds suffering the effects of malnutrition, untreated chronic health conditions, infectious diseases, and traumatic injuries.

Dr. Muhammad Darwish was a dentistry student when the conflict broke out. Now he is one of Madaya’s few remaining health care providers. He explains: “What we need in Madaya, and in all besieged areas in Syria, is to lift the siege once and for all. No more beating around the bush and allowing a few convoys in here and there that don’t include medication and with aid that doesn’t even meet the needs of a quarter of the population.”

Madaya is not the only place where siege warfare is being brutally used. Syrian government forces and, to a lesser extent, non-state armed groups are besieging nearly one million people across the country. They have denied deliveries of food, medicine, and other supplies that are indispensable to survival, subjecting entire populations to slow deaths by starvation and lack of health care – actions that constitute war crimes. Yet the only action the UN Security Council and other world leaders have taken is to issue toothless statements decrying the violations.

The death toll will only increase the longer the sieges are in place. The UN Security Council, the ISSG, and UN aid agencies have all failed Syrians again and again by refusing to enforce their resolutions, follow through on their promises, and act according to their humanitarian principles to serve those most in need. It is past time that these agencies and world leaders take concrete action to ensure that civilians starving at the hands of the Syrian government are given a chance to live and are not condemned to die because of politics. The first step they can take is to implement air drops as promised to provide short-term relief to those at risk of starvation.

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