A convoy of 40 trucks carrying long-awaited food and medical supplies entered the Syrian town of Madaya yesterday, bringing humanitarian aid to its besieged residents, including hundreds who are said to be on the brink of death.

After waiting for four hours at a government checkpoint, the first trucks of the convoy moved into Madaya, about 25km north-west of Damascus, shortly after 5.30pm local time (11.30pm in Malaysia), said Red Cross spokesperson Pawel Krzysiek, who accompanied the aid.

At the same time, the first aid trucks entered the isolated north-western Shiite villages of Foua and Kefraya, which have been besieged by hardline Islamist rebels, Lebanese Shiite movement Hezbollah said.

The simultaneous aid supplies were arranged under a UN-sponsored deal between government and rebel forces. Deliveries were to continue overnight, Krzysiek said.

After a UN Security Council meeting in New York late yesterday, the UN said more than 400 people in Madaya were on the brink of death and in need of immediate medical evacuation.

The medical aid organisation Doctors without Borders (MSF) earlier said almost 30 people had died of starvation during a siege by government forces.

US Ambassador to the UN Samantha Power said the situation in Madaya was dire. People desperate to escape the terrible conditions there have fled only to be killed or injured by land mines or sniper fire, she said.

"The aid delivered today, while necessary, is nowhere near enough," Power said in a statement.

Under siege since July

A source in the Syrian Red Crescent said some 330 tonnes of food and medical aid were being sent to Madaya, enough to last for about 40 days.

The town has been under siege since July by forces loyal to Syrian President Bashar al-Assad but also aided by Hezbollah fighters. Madaya last received supplies in October.

Some 40,000 people are believed to be trapped inside the town, according to the International Committee of the Red Cross (ICRC).

Local activists say residents have been reduced to eating grass and leaves in order to survive. The situation has worsened with winter snowfalls.

One eight-year-old boy in Madaya told dpa he and his family had been living on "water, salt and pepper" for the last week, but he was fasting completely on Monday to await the arrival of aid.

"I want to have eggs and potatoes for dinner when the aid arrives," Hassan said via Skype.

"We were told the aid contains food we haven't had for almost three months... I hope they will have bread because I've forgotten the taste of it," Rami, a 10-year-old boy said.

The Syrian Observatory for Human Rights said that the food supplies brought into Madaya included 7,800 sacks of flour.

The trucks also carried 7,800 food parcels each containing sugar, oil, rice, chickpeas, beans, peas, pasta, tomato sauce and tinned foods, the Britain-based group said, citing local residents.

One-time aid not enough

Foua and Kafraya, in Idlib province, have been besieged by rebels since April. The ICRC says some 20,000 people are thought to live there.

At least one person has died there due to lack of food and medical supplies, according to the Observatory.

MSF had asked for food supplies, special food for treating malnutrition, and a basic package of essential medicines and medical supplies to enable the makeshift hospital in Madaya to keep running.

The group warned that regular supplies to Madaya are essential and a one-time delivery of aid will not be enough.

Bashar Jaafari, Syrian Ambassador to the UN, said that reports of starvation in Madaya were "fabrications". He said the government had allowed two months' worth of humanitarian aid into the town in October, which had been diverted by armed groups.

Describing images from the stricken areas as "no less than heartbreaking," White House spokesperson Josh Earnest placed the blame squarely on Assad's regime.

"It's ultimately this failed political system, which is the direct result of Bashar al-Assad's failed leadership, that has led to this problem," Earnest said.

- dpa