In July 2015, forces aligned with Syrian leader Bashar al-Assad began laying siege to the Syrian town of Madaya, cutting it off from the outside world, including its access to food supplies. By early January, residents had been reduced to eating grass and insects. They had already eaten the city's stray cats and dogs. At least 23 people died from starvation.
Late on Monday, that siege appears to have ended — for the moment — as the first humanitarian assistance trucks, permitted entry under an international agreement to help Madaya, rolled into the city.
But it's still too early to celebrate: Aid trucks had been let into Madaya in October, and the siege was reimposed afterward. But more fundamentally, no agreement can really prevent this kind of starvation from happening again, either in Madaya or in another Syrian city, because this is not a phenomenon specific to this one town but applies widely across the war. The only way to make sure this never happens again is for Syria's war to end.
Why Madaya is starving
Medic in starved #Madaya says people eating herbs in water with salt to survive, stray dogs and cats already eaten pic.twitter.com/AA6BSRsRr4— Richard Engel (@RichardEngel) January 8, 2016
Madaya is a town with a prewar population of 40,000 people in western Syria, near the Lebanese border and the Qalamoun mountain range. Before the war began in 2011, Madaya was a well-known resort town. Today it's in the middle of a war zone: Madaya is near the capital, Damascus, and thus is a valuable link between Assad and his Hezbollah allies in Lebanon.
Syrian rebel groups have held Madaya for some time, and the regime has had them under some degree of siege since July 2015. But in September, things got worse: Hezbollah forces moved into Zabadani, a nearby town. They didn't take the town outright, and still haven't. But Zabadani is Madaya's "only real lifeline to the outside world," as Vice's Avi Asher-Schapiro puts it. So the fighting there effectively shut off Madaya from bringing in supplies such as food.
Since then, Madaya has been under siege by Assad and his Hezbollah allies. They were deliberately attempting to starve out the rebel fighters who held the town: Aside from a brief period of truce in the fall, no supplies were allowed to go into Madaya. That includes humanitarian deliveries such as food.
"Since [a] single one-off food distribution on 18 October, this has been tightened to a total stranglehold siege," a January 7 press release from Doctors Without Borders (MSF) explains.
By mid-January, the situation had gotten really bad. According to Syria Deeply, rice was so scarce that a mere pound cost $250 (you can buy 20 pounds at Walmart for $9). A container of baby formula costs $300. People in war-torn Madaya couldn't afford that, and so had to scavenge — or starve. Between December 1 and January 7 and in MSF-operated hospitals alone, 23 people died of starvation.
"There are no more cats or dogs alive in the town," Rahman, a Madaya resident, told Al Jazeera. "Even tree leaves that we have been eating have become scarce."
The current agreement is not enough to stop this from happening again
On January 7, the Assad regime caved to international pressure and agreed to let aid into Madaya. It wasn't clear that it would actually follow through on this pledge until the first aid trucks rolled into Madaya on Monday evening.
But the town's anguish isn't over. According to the World Food Program, the aid trucks only have enough to feed 40,000 people for one month. That means that even if Madaya's population has fallen to half of its prewar total, the town will need another shipment in two months. If the Assad regime decided it didn't want Madaya to get any more food, it could cut off the town again.
"This is a very positive development. But it must not be just a one-off distribution. To relieve the suffering of these tens of thousands of people, there has to be regular access to these areas," Marianne Gasser, the Red Cross spokesperson in Syria, told Al Jazeera.
In order to actually make Madaya's residents safe from hunger, the world would need to negotiate an end to the fighting in Zabadani — which seems tough, considering the city is currently held by five factions (including al-Qaeda's Syrian branch). And even then, you'd need to get Assad and Hezbollah to foreswear sieges.
That points to the real problem here: the civil war. When you've got an ongoing civil war, where multiple factions are willing to employ extreme brutality to achieve their ends, civilians are always at risk at being starved out by the enemies of the side that controls their town.
In a very literal sense, Madaya's problems are national ones. According to the UN, roughly 400,000 Syrians are besieged around the country. Starvation isn't as extreme in most places as it is in Madaya, but that doesn't mean it can't happen elsewhere.
To make matters worse, it's not just the Assad regime that's besieging civilians. As the New York Times explains:
Nearly half of the 400,000 Syrians the United Nations counts as besieged are surrounded by government forces, who have used the tactic systematically around Damascus and Homs. The largest group is encircled by the Islamic State, which is blockading 200,000 people in Deir al-Zour, in the east. Other insurgents, mainly the Islamist group Ahrar al-Sham, have also encircled more than 12,000 people in isolated pro-government towns in northern Syria, like Foua and Kfarya.
That means there's no guarantee that international negotiations can solve the problem if this happens again in another town. The only way to prevent more Madayas, then, is to end the civil war.