An emaciated man in Madaya is seen in this undated picture taken from social media.

Warnings of widespread starvation are growing as pro-government forces besiege an opposition-held town in Syria and winter bites, darkening the already bleak outlook for peace talks the UN hopes to convene this month.

The blockade of Madaya, near the border with Lebanon, has become a focal issue for Syrian opposition leaders who told a UN envoy this week they will not take part in talks with the government until it and other sieges are lifted.

At least 10 people have died of starvation in Madaya in the past six weeks, the Syrian Observatory for Human Rights says. Opposition activists say the number of dead is in the dozens although Reuters could not independently confirm the reports.

“We were living on tree leaves, on plants, but now we are struggling in a snow storm and there are no more plants or leaves,” said Majed Ali, 28, an opposition activist who spoke to Reuters by phone from Madaya. “I was 114 kilos before the siege. Now I am 80.”

Madaya residents make do with water flavoured, where available, with spices, lemon, salt and vinegar, said Abu Hassan Mousa, the head of an opposition council in Madaya.

Where rice or powdered milk are available, the prices can reach some $300 a kilo, residents said. With half a meter of snowfall this week, furniture, doors and wooden fixtures and fittings are being burnt to heat homes, said Ali, the opposition activist.

“Negotiations have no meaning all the time we are besieged, all the time we are hoping for a cup of milk for a child. What are we going to negotiate over? Our dead?” he said.

Blockades have been a common feature of the nearly five-year-old war. Government forces have besieged rebel-held areas near Damascus for several years and more recently rebel groups have blockaded loyalist areas including two villages in Idlib province.

The fate of Madaya, where the World Food Programme (WFP) says the lives of 40,000 people are at risk, may be linked to those villages. The areas were all part of a local cease-fire agreement agreed in September but implementation has been halting.

The last aid delivery to Madaya happened in October. A UN official said on Thursday the Syrian government has agreed to allow assistance into three villages.

Ali described the people of Madaya as hostages held as a bargaining chip for Al-Foua and Kefraya. Aid agencies were hoping for easier access to the area following the cease-fire deal concluded under UN supervision.

“WFP is deeply concerned about the reported humanitarian situation in Madaya, which has been besieged for many months, now threatening the lives of nearly 40,000 people,” WFP spokeswoman Bettina Luescher said.

The blockade of Madaya began about six months ago when the Syrian Army and, Hezbollah started a campaign to reestablish the regime’s control over areas at the Syrian-Lebanese border, including Zabadani.

In this undated photo shows a starving boy in Madaya, Syria.

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