BEIRUT, Lebanon - Gaunt, ragged figures fill the streets for as far as the eye can see in the besieged Palestinian refugee camp of Yarmuk outside Damascus, where some 40,000 are said to be slowly starving to death.
The United Nations distributed shocking images this week of thousands of people, their faces emaciated, desperately flocking to receive food aid that only a few were lucky enough to collect.
"We live in a big prison," said Rami al-Sayed, a Syrian activist living in Yarmuk, speaking to AFP via the Internet.
"But at least, in a prison, you have food. Here, there's nothing. We are slowly dying."
"Sometimes, crowds of children stop me on the streets, begging me: 'For the love of God, we want to eat, give us food.' But of course, I have no food to give them," Sayed said.
After months of shelling and fierce fighting in and around Yarmuk between rebels and President Bashar al-Assad's troops, the camp's population has shrunk from more than 150,000 to 40,000. Among them are 18,000 Palestinians.
Since last summer, the area has been under choking army siege, creating inhumane conditions for its inhabitants.
"We've been living off herbs, but these herbs are bitter. Even animals won't eat them," said Sayed.
"And if you go to the orchards to pick herbs from there, to use them to cook soup, you'll get sniped."
"The situation is really tragic. On the streets, all you see are emaciated people, their faces drained of any life. Sadness is everywhere," said Sayed.
Even the UN Relief and Works Agency (UNRWA) for Palestinians was overwhelmed by the drama.
Since January, the agency has only been able to carry out limited, intermittent food distribution in the camp.
- 'Let us out, or let us die' -
"Gaunt, ragged figures of all ages fill the streets of the devastated camp for as far as the eye can see," UNRWA said, adding that such scenes were the agency's "daily reality."
"Humanitarian need has reached profound levels of desperation. Hunger and anxiety are etched on the faces of the waiting multitudes."
Since January, UNRWA has distributed only 7,500 food parcels in Yarmuk, describing that as "a drop in the ocean compared with the rising tide of need."
One parcel feeds a family of between five and eight for 10 days.
"Yesterday (Wednesday) only 10 per cent of people here received assistance," said Sayed.
Ali Zoya, a Palestinian living in Yarmuk, said "the aid will only last a few days."
Much of the camp has been reduced to rubble by shelling, fighting and occasional aerial bombardment.
The distribution only began after rebels from outside the camp agreed to withdraw, following a deal reached with Palestinian factions.
The lack of food in Yarmuk is compounded by medical shortages.
"In the hospitals, there are wounded people who cannot be treated because there are no doctors or medicines," said Sayed.
"I saw a young man with a shrapnel wound to his leg. He won't get better until he is able to leave the camp," which is still under siege even though the rebels have withdrawn.
Since October, more than 100 people have died from food and medical shortages, says to the Syrian Observatory for Human Rights.
After a visit on Tuesday, UNRWA chief Filippo Grandi described the "shocking" conditions of life he witnessed in Yarmuk. He compared the people flocking to the distribution point as "the appearance of ghosts."
Their despair echoes that of families who were trapped in rebel-held areas of the central city of Homs for more than 18 months, also under a tight army siege imposed to turn people against Syria's nearly three-year revolt.
"People here are completely exhausted," said Sayed. "They feel tortured. They say: 'Let us out, or let us die.'"