During the mission to Madaya, our teams met many distressed and hungry children - some of them severely malnourished, along with adults in a similar condition. The town’s population of 40,000 is being served by only two doctors, with a limited capacity to save the lives of civilians. Health and medical services including immunisation are collapsing. Young children in Madaya have not been vaccinated against polio, measles and other diseases for close to ten months.

Madaya is by no means unique. Across Syria, civilian areas are being held under siege in 15 different locations by various parties to the conflict. Around 400,000 people have been trapped inside these areas, sometimes for years on end, with highly constrained access to food, clean water, health and other basic services. Lives have been lost as a result, among children and the elderly in particular.

Elsewhere in the country, more than four million people live in hard-to-reach areas with only sporadic access to humanitarian supplies.
  Malnutrition is a particular threat to children and people with chronic diseases trapped in these areas, making them more vulnerable to disease and longer-term under-development. Meanwhile, mothers who are malnourished are more likely to have malnourished children.

Unless humanitarian assistance is delivered promptly and on a regular basis to all besieged and hard-to-reach areas of Syria, malnutrition levels will continue to increase and more lives will be lost.

The access granted for limited deliveries of humanitarian supplies is not enough. The immediate lifting of sieges in Syria is required, followed by assessments of health and other needs of the population, the provision of on-site medical and nutritional therapeutic care and the evacuation of the wounded and sick to be treated.

WHO and UNICEF appeal to all parties to the conflict to respect their obligations under International Humanitarian Law to allow and facilitate immediate and uninterrupted humanitarian access to all areas throughout the country.