At least 16 more people have died of starvation in the Syrian town of Madaya since an aid convoy was allowed to enter earlier this month, according to Médecins Sans Frontières. The humanitarian group, also known as Doctors Without Borders, warned that dozens of other residents are in “danger of death” as a result of severe malnutrition, AFP reported. These deaths bring the number of people reported to have died of starvation in Madaya since December to 46. However, the medical charity fears that the real toll is higher.

The Syrian government recently allowed aid convoys to enter the besieged town of Madaya in Damascus province, after graphic images of starving adults and children surfaced. Residents were reportedly surviving on grass as nothing else was available. At least 49 trucks reached the town on January 11, carrying blankets and packages of rice, lentils and oil – enough to last 40,000 people for a month, United Nations officials said. The UN estimated that around 4,00,000 people in Syria were living under siege as the Islamic State, Syrian rebels and forces supporting President Bashar al-Assad continue to fight.