Tatyana Goryachova and Hal Foster

Special for USA TODAY

DONETSK, Ukraine — Retirees in Donetsk, the largest city in eastern Ukraine held by pro-Russian separatists, are dying of hunger because their pensions have been cut off by the national government, rebel officials and residents say.

Though Ukraine has not publicly discussed starvation deaths, it acknowledges there is a humanitarian crisis in the eastern region because of the conflict and blames the separatists and Russia for supporting the rebels.

The government cut off pensions this month to people in all areas of eastern Ukraine controlled by separatists to undercut support for pro-Russian rebels.

The number of starvation deaths in Donetsk is hard to pin down, largely because the conflict between Ukraine and separatist forces has crippled government functions in the east, including medical and coroners' offices that record causes of deaths.

The siege of the city that began in August has led to 40% of the city's 1 million people fleeing.

Dmitry Ponomarenko, pastor of the City of Light Protestant church, said he believes the starvation toll is in the hundreds, perhaps thousands. His assessment is based largely on accounts from parishioners and 300 seniors who come to his church daily for a free meal. In one month, they reported more than 100 starvation deaths of pensioners in Donetsk, he said.

The Ukrainian Independent Information Agency, citing aid workers, reported that 22 seniors in Donetsk, mostly single men, died of hunger in September.

Irina Prodorova, who volunteers to bring meals to shut-ins, recently found the bodies of two men she had been helping. She said their emaciated condition indicated they died of hunger. Her group has resources to serve only one meal a week to shut-ins, she said.

Alexander Zakharchenko, prime minister of the separatists' Donetsk People's Republic, has acknowledged that retirees are dying of hunger.

In a meeting with Donetsk city officials Dec. 9, he said, "The main topic of discussion was paying social benefits to elderly and disabled pensioners because they are starving and cannot buy medicine."

The average Ukrainian pension is meager — $107 a month — but it can be the difference between life and death for many.

A number of aid groups are fighting hunger in Donetsk and other cities in the war zone, including the United Nations Food Program and the charitable foundation of Rinat Akhmetov, Ukraine's richest man, who fled to Kiev when separatists threatened to kill him. These efforts are sporadic and limited to a few thousand people at a time. They don't come anywhere near replacing the pensions.

The separatists and Russia have decried the pension cutoff as inhumane. Kiev says rebels and criminals have taken much of the money it sends to the eastern region.

The cutoff, announced Nov. 5, means payments will no longer "be stolen by pro-Russian bandits," Prime Minister Arseniy Yatsenyuk said.

Donetsk pensioner Mikhail Potyaka, 69, said the only reason he didn't die of starvation recently was because of a neighbor's kindness. He had been going to the City of Light church to get the one meal a day he eats when he caught pneumonia.

"I lay in bed delirious for three days while my neighbor took care of me," he said.

Although he's better, he said he still has a high temperature because he has no money for medicine. "I don't know what I'll do if I get sick again and can't get to the church for food," he said. "I guess I'll die."

Donetsk's mayor in exile, Alexander Lukyanchenko, who fled to Kiev in August after receiving separatist death threats, has criticized the government for the cutoff.

The only way for residents of neighboring Donetsk and Luhansk provinces to get their pensions back is to go to a city outside the war zone to re-register for benefits. Many retirees lack the health or money to travel so far from their homes, Lukyanchenko said.

Yatsenyuk, the prime minister, said the pensions the government withholds are accruing for the beneficiaries and will be paid once the eastern region is free of separatist control.

Ponomarenko, the pastor, and others who help the retirees fear a lot more will succumb to starvation.

"We have only enough money to help a few pensioners who are able to walk to our church each day," he said, adding that's a small fraction of the retirees going hungry.

Foster reported from Portland, Ore.