The first trucks of aid entered the besieged Syrian town of Madaya on Monday, where more than two dozen people have reportedly starved to death, as the UN called for hundreds to be evacuated for medical treatment.
The Syrian Arab Red Crescent said 44 trucks loaded with food and other aid entered the rebel-held town late afternoon, while 21 other trucks went to the government-controlled towns of Fuaa and Kafraya.
Tearful women and children, bundled up against the cold, waited in the dark for the trucks bringing vital supplies after six months encircled by President Bashar al-Assad's forces.
"Our children are starving, our bodies are trembling," Ghaitha Assad, a 27-year-old resident, told AFP.
"We have no food -- even bread. There is no water, no electricity, no heating. Our children cry all night, we are unable to find anything to feed them."
The UN World Food Programme said the supplies could feed more than 40,000 people for one month, and the ICRC said it was taking enough medicine for three months.
"I saw a young man killing cats and presenting the meat to members of his family as rabbit," Hiba Abdel Rahman, 17, told AFP.
"Some people went through garbage bins, others ate grass. We sought food from the fighters but they refused to give it to us."
Some 28 people have died of starvation in the city since December 1, including five on Sunday alone, according to Doctors Without Borders, known by its French acronym MSF.
The United Nations said it has asked the Syrian regime and opposition to allow 400 people, many starved and malnourished, to be airlifted out of Madaya for urgent medical attention.
"Around 400 are in need of being evacuated for life-saving medical attention," UN aid chief Stephen O'Brien told reporters after a Security Council meeting.
"They are in grave peril of losing their lives."
- 'Heartbreaking' -
The head of the International Committee of the Red Cross's Syria delegation said the operation would likely last a few days.
Spokesman Pawel Krzysiek, who reached Madaya with the trucks, said the "first impression is really heartbreaking".
"We see a lot of people on the streets. Some are smiling and waving at us but many are just simply too weak, with a very bleak expression, too tired," he said in an audio message.
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Assad gave permission for the deliveries on Thursday after an outpouring of international condemnation, as footage of emaciated children in Madaya emerged on social media.
But Syria's envoy to the UN dismissed reports of civilians dying as fabrications, accusing "terrorists" inside the town of stealing supplies.
Ambassador Bashar Jaafari said the reports were aimed at "demonising" the Assad regime and "torpedoing" peace talks later this month.
"Actually, there was no starvation in Madaya," he told reporters. "The Syrian government is not and will not exert any policy of starvation on its own people."
Fifty trucks bearing the Red Crescent symbol were on their way to Madaya and 21 heading to Fuaa and Kafraya, which are home to 20,000 people, the ICRC said.
The three towns, along with rebel-held Zabadani, were part of a landmark six-month deal reached in September to allow humanitarian assistance.
A first aid delivery went ahead in October and in December some 450 fighters and civilians were evacuated from Zabadani, Fuaa and Kafraya.
- 'Inhuman tactic' -
More than 260,000 people have been killed in Syria since the conflict began in March 2011 with anti-government demonstrations.
The UN is struggling to deliver aid to about 4.5 million Syrians in hard-to-reach areas, including nearly 400,000 people in 15 besieged areas.
The United States and Britain on Monday appealed for an end to all sieges in Syria, while France called for the immediate establishment of "humanitarian measures".
"Starving civilians is an inhuman tactic used by the Assad regime and their allies," said Matthew Rycroft, the British ambassador to the UN.
France's ambassador said lifting the sieges was key ahead of a new round of peace talks between Assad's government and the opposition planned for January 25.
US Secretary of State John Kerry said "full access" to besieged towns is needed, urging all parties to cooperate.
Also on Monday, a Russian air strike on a school in northern Aleppo province killed at least 14 children and five adults, the Syrian Observatory for Human Rights said.
Russia, a staunch ally of Assad, began a campaign of air strikes in support of the regime in late September.