Syrians wait for the arrival of an aid convoy on Monday in the besieged town of Madaya. (Marwan Ibrahim/AFP/Getty Images)

By the time the convoy carrying food arrived, Sereen didn’t know how much more she and others in the besieged Syrian town of Madaya could endure.

She had skipped meals for months, she said, 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 died of starvation, 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.

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 al-Assad’s government and the United Nations permitted aid groups to send ­dozens of trucks to the town, near the Lebanese border and about 15 miles northwest of Syria’s capital, ­Damascus. The operation is expected to last several days and will also deliver food to two pro-government villages, Fua and ­Kefraya.

Pro-government forces have besieged Madaya, an opposition stronghold, since the summer, cutting off the flow of food and goods into the town. Fua and Kefraya, two villages in the northern province of Idlib, have been surrounded by rebels and face regular bombardment.

Images purporting to show people from Madaya, 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 further details of their harrowing ordeal to aid workers and journalists.

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 and 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 remembered 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 described 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 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 had 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 a considerable amount of weight.

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.

In November, she said, she attempted to brave the checkpoints with snipers that surround the town and flee for medical care. Earlier last year, she said, she had finished chemotherapy for cancer and was due for a visit to the doctor. But as she attempted to leave in the middle of the night, she said, the smugglers she paid to help her out tripped one of the many land mines apparently planted on the outskirts of the town. One of them was killed.

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.

Read more:

Saudi Arabia says Syrian peace talks remain on track, easing feud with Iran

How the battle against the Islamic State is redrawing the map of the Middle East