After they'd emptied their cupboards and eaten the last of the donkeys and cats, the people of the besieged Syrian town of Madaya began cooking grass.
For nearly three weeks, that was nearly all Um Ali, a grandmother in her 60s, ate.
When she begged pro-government troops to leave in search of food, they threatened to shoot her, Um Ali told NBC News. She ran anyway, slipping past snipers down a fog-shrouded road with her daughter-in-law and crossing the border into Lebanon, leaving behind five children aged 15 to 30. She later heard that a family of six had been killed on the same route the day after her escape.
This is how desperate things have gotten in Madaya, one of many communities isolated by a grinding civil war in which both sides have been accused of deliberately starving civilians.
"Let me be clear: the use of food as a weapon of war is a war crime," United Nations Secretary General Ban Ki-moon said.
Images of emaciated Madaya residents prompted an international outcry, forcing the Syrian government to allow UNICEF to bring supplies into the town of 40,000 and two other municipalities, Kefraya and Foua, this week.
That has brought hope to thousands of trapped residents.
But relief arrived too late for many, including a 16-year-old boy who died as aid workers watched. Aid workers reported seeing many other severely malnourished children.
“As one of the children I met told me, ‘You can forget, you can run away from mortars and rockets and bombs, but you can never forget that you are hungry,'” said Abeer Pamuk, a spokesperson for the relief group SOS Children's Villages.
Pamuk also recalled parents pleading with relief workers to take their children with them.
"Once they see somebody wearing a vest," Pamuk said, "they run after us and they're like, 'Don't take me, I don't want to go. Just take my children out. I don't want them to live here anymore. They're going to die before my eyes if you don't take them out.'"
Six people died in Madaya on Thursday, a local food-distribution volunteer told NBC News. Dozens have been reported dead in the weeks prior.
And the crisis is far from over. The newly delivered supplies aren't expected to last longer than 10 days.
Um Ali is one of the lucky ones. She is safe with relatives in Saadnayel, a town in Lebanon's Bekaa Valley. By the time she fled, six weeks ago, the price of a kilo of rice had hit $200. People had started eating grass and mulberry leaves, which sickened many. A friend who went searching for something more substantial got blown up by one of the land mines buried across the outskirts of town.
From Lebanon, Um Ali sent her children $500. By then,the price of rice had risen again. The money bought them only two kilos, she said.
After the relief supplies arrived, Um Ali communicated with her family using WhatsApp and learned that her children had received rice, dried beans, lentils and cooking oil. They were overjoyed.
But if more doesn't arrive soon, they'll be starving again.