A five-minute delay on the walk over was just enough time for Um Abed, a 38-year-old widow, to lose her usual spot in her town's long milk line. Everyone here is desperate for milk from the town's only living cow. They try to arrive early, hoping she does not run dry before they get their share. On this day, Um Abed went home empty-handed.
Her youngest are twins, and now she must concoct something to ward off malnutrition, from which they already suffer. Ahmad and Mohammad were born in September 2012, at the outset of the regime siege on Ehsim, located in the mountainous area of Jabal al-Zawiyeh in this northwest province.
She has seven children to feed at home. An eighth, her 17-year-old son, was detained a year ago by the regime. Rahaf, her 15-year-old, suffers from seizures that doctors have been unable to treat.
To make ends meet, Um Abed, whose husband was executed publicly by the regime last year, works as a cleaning lady.
"We get by with the vegetables we grow. I watch people gather every morning to buy milk, and those who get it feel like they've hit the jackpot," she said. Some days, the family has only one meal. Constant shelling often contaminates their food.
Dr. Abu Hassan works in the free field hospital located in Jabal al-Zawiya and is Mohammad and Ahmad's physician.
"Until now, we haven't had a death related to malnutrition, but many children suffer from reduced immunity, especially newborns," he said. "We try to treat them with medication, vitamins and serums. Every week, we have over 10 cases of children suffering from malnutrition, and at least one is in a critical condition."
In the town of Maliha, in rural Damascus province, death has become commonplace since the siege on eastern Ghouta by regime forces began in September.
The first recorded case of child mortality due to malnutrition here was earlier this month: a girl named Farah, who was less than a year old. Her impoverished family of five had fled the town of Deir Selman to Maliha due to daily shelling.
Farah's doctor, Abu Hussam, works at a field hospital in Maliha. "Her condition kept worsening day after day despite our attempts to treat her with serums. Most families residing in eastern Ghouta suffer from acute malnutrition," he said. "The same goes for mothers. Their malnutrition affects their newborns, who are born weak and small. We had a newborn who only weighed one kilogram. This is common among eastern Ghouta newborns."
Farah's mother cries quietly when asked about her daughter. Death by starvation still threatens the rest of this family and their neighbors.
Abu Hussam said a woman in her 50s had recently died of malnutrition, and that there are over 20 cases each week in eastern Ghouta.
Dr. Abu Nawwaf, director of the NGO the Syria Child Bureau, works in both liberated areas and those under siege. "We are currently working to establish a factory to make baby formula inside Syria. We have activists working to get food aid and needed hygiene kits to the areas that are most in need," he said.
"However, we can't enter the besieged areas. For now, we try to send educational brochures on alternative foods to sustain proper nutrition. We always try to get aid into these areas usually via the Red Cross and Red Crescent, and we always try to negotiate."
Until now, there are no substantiated figures on famine-stricken children due to sieges throughout Syria. The Syrian Observatory for Human Rights, a Britain-based watchdog, has documented over 12,000 children killed, with 10 due to famine, over the course of the conflict.
Celine Ahmad is the pseudonym of a Damascus-based Syrian contributor. She reported from Idlib and Damascus provinces.
This article was translated from Arabic by Naziha Baassiri.