BEIRUT -- By the time the convoy carrying food arrived, Sereen didn't know how much more she and the other residents of the besieged Syrian town of Madaya could endure.
For months, she recalled, she went days without meals so that her young nieces and nephews could eat the family's diminishing supplies of rice and bulgur. She watched as friends turned into walking skeletons.
Then, in recent weeks, people began dying.
First a neighbor starved to death, followed by his 9-year-old son, she said. On Monday -- the day that a U.N.-backed agreement temporarily lifted the Syrian government's brutal blockade of the mountain hamlet -- Sereen learned that a 60-year-old friend had died.
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The woman's family "said she stopped eating altogether so that her grandchildren could eat," Sereen said Tuesday, speaking from Madaya over Skype. "Her grandchildren survived, thanks be to God."
A deal brokered between President Bashar Assad's government and the United Nations permitted aid groups to send dozens of trucks to this town, near the Lebanese border and about 15 miles west of Syria's capital, Damascus. The operation is expected to last several days -- nearly 50 trucks have already arrived in the town -- and also includes the temporary lifting of a rebel siege against two pro-government villages, Fua and Kefraya, in the northwestern Idlib province.
Images purporting to show people from the town, including emaciated and listless children, have circulated on Twitter and Facebook in recent days and drawn attention to the crisis.
As they began filling empty stomachs with rations of beans and rice Tuesday morning, some of the more than 20,000 people in the town revealed more details of their ordeal. What they described surprised even the aid workers expecting to hear harrowing stories.
Stephen O'Brien, the U.N. humanitarian chief, warned late Monday after aid workers entered the town that 400 severely malnourished people urgently needed medical treatment, or else they were "in grave peril of losing their lives."
Elizabeth Hoff, the World Health Organization representative in Damascus who went on the convoy, told the Reuters news agency that she was "really alarmed" by the situation.
Syria's ambassador to the United Nations, Bashar Jaafari, on Monday denied that the government was using a policy of starvation. Government forces along with allied troops from Lebanon's Hezbollah militia have besieged the pro-rebel village since summer, but he accused Arabic-language media of "fabricating" lies.
Sereen, 40, recalled seeing almost nothing but the effects of starvation all around her during that time. She spoke on the condition that her last name not be used, because of concern for her safety.
She recalled an argument a few weeks ago involving a butcher who refused a customer's request to have his cat prepared as dinner meat.
She also recalled how her 10-year-old niece would forgo meals to give food to her younger sister. "Even the children had to become adults in this situation," said Sereen, who shares an apartment with her grandparents, her mother and her brother's family.
This summer, Sereen fled her home in the neighboring town of Zabadani with her mother during an attack by Syrian troops and Hezbollah fighters.
The assaults on Madaya and Zabadani are part of a military campaign by the Assad government to clear out rebels from key territory stretching from Damascus to Lebanon and the western coastline. The pro-government forces have encircled Madaya but have been careful not to storm it, because of threatened retaliation by rebels against the villages of Fua and Kefraya.
Another U.N.-backed agreement in September was supposed to end the sieges involving all those areas, including a mechanism for bringing in food, but it has faltered.
Before the Syrian uprising began in 2011, Sereen's husband, Mohammed, owned a grocery store and she was a stay-at-home wife. Like many from the area, they joined peaceful demonstrations against the Assad government and then backed an armed rebellion that eventually turned into a civil war that has killed more than 250,000 people.
Their three grown children have since fled the country, she said, but Mohammed was killed fighting for the Islamist Ahrar al-Sham rebel group in Zabadani last summer. She has had little time to mourn, she said.
She has mainly focused on how to survive.
"First, you'd see yourself losing weight. Then the hallucinations started happening. You'd have conversations with people and then completely forget what you said or what you talked about that day," she said, adding that she had lost about 15 pounds since the summer.
She described how the family would pool together jewelry and other precious belongings to pay the war profiteers who would find ways to smuggle basic foods through the checkpoints that Syrian troops and Hezbollah fighters erected around Madaya. Two pounds of smuggled rice could cost $100 or more, she said.
Now she hopes the aid delivery will translate into an end to the siege and a return to the relative normalcy of seeing doctors and eating every day.
"We can't go back to another blockade," she said.