Sixteen more people have died in Madaya, Syria, as a result of starvation and lack of access to medical treatment, Doctors Without Borders reported. And the humanitarian group warned 33 others were severely malnourished and “in danger of death” if they don't get immediate care in the town that has been under siege since July.

“It is totally unacceptable that people continue to die from starvation, and that critical medical cases remain in the town when they should have been evacuated weeks ago,” Brice de le Vingne, Doctors Without Borders' director of operations, said in the release Friday. “There needs to be a permanent and independent medical presence in Madaya immediately as we expect the medical situation to worsen as access to healthcare for people inside remains extremely limited.”

BBC News reported there were about 40,000 people being kept in Madaya, a mountain rebel-held town about 15 miles from Damascus that's been blocked in by government forces and their allies in the Hezbollah militia for months. Trapped without supplies, children reportedly have been eating leaves to stay alive while doctors have found themselves unable to prescribe anything but salt water. The Syrian regime and Hezbollah, meanwhile, have rejected these reports, claiming they have asked for assistance and blaming the rebels for tough conditions.

Earlier this month, about 50 trucks carrying aid in the form of medicine, flour, oil and blankets were allowed to enter the town. But the 16 deaths cited by Doctors Without Borders occurred after that, giving new urgency to calls for evacuations and humanitarian relief even as peace talks get underway.

“These harrowing accounts of hunger represent the tip of an iceberg,” Philip Luther, the Middle East director for Amnesty International, told CNN recently. “Syrians are suffering and dying across the country because starvation is being used as a weapon of war by both the Syrian government and armed groups.”