At least 23 people have already starved to death in the besieged Syrian town of Madaya, aid workers said Friday, as those trapped with no food urged the international community not to ignore their plight.

“We don't understand how the world could do nothing to resolve this crisis after witnessing such tragedy,” said Abu Khalil, an internal refugee in the town, which has been cut off by government forces for months.

“Civilians, including women and children, are dying because of the use of this cowardly weapon," Khalil added in reference to the use of starvation as a tactic of war.

On Thursday, the government in Damascus finally agreed to allow international aid into Madaya amid warnings from the United Nations that international humanitarian law prohibits “the targeting of civilians and their starvation” as a weapon.

The U.N. welcomed the belated move to make way for much-needed food and medicine to be transported into the town, but added that almost 42,000 people — half of them children — remained in Madaya and are still at risk. It added that credible reports had been received of people starving to death or being killed trying to leave the besieged town.

Pictures of skeletal residents and emaciated children have been widely distributed in recent days, drawing fresh attention to the plight of civilians in the years-long civil war.

Doctors Without Borders, known by its French acronym (MSF), said that of the 23 people they knew of who have died of starvation, six were less than a year old, and five were above 60. The starvation deaths occurred at the local MSF-supported health center, the charity said.