Starving and freezing cold residents of Madaya, a Syrian town north west of Damascus, are calling on the world to help provide aid as they run out of food and prepare to face a brutal winter.

According to individual accounts from Madaya, the stranded have resorted to eating leaves and even their pets to survive as they continue to starve. So far more than 30 of the city’s 40,000 residents have died in the last month from lack of food.

“Whether you are a man, woman, child, whether you’re 70 or 20 years old, you will have lost about 15kg (33lbs) of your weight,” Ebrahem Abbass, a former Syrian Army Sergeant told The Guardian.

Residents have been trapped in the city surrounded by land mines, after the city went under siege in July 2015. Photos on Twitter accounts show the horrific conditions.

The siege is reminiscent of the August 2014 siege of Iraq’s Sinjar Mountain by ISIS, where thousands of Yazidis were first starved and then killed.

The citizens of Madaya who have risked leaving the area to scavenge for food have been shot at by Hezbollah fighters and pro-Assad rebels armed with sniper rifles.

Even when food is scarcely available in local black market exchanges, the prices are excessively high and unaffordable for Syrians.