Images and anecdotes from Madaya are perhaps some of the Syrian war's most confronting.
People nibbling leaves, licking salt - literally starving to death.
Last month aid finally made it through, and braving the front line in the first convoy into besieged IS-controlled territory was Pawel Krzysiek.
"In these eyes you could see a glimpse of hope that something is happening in this place despite the siege after so many months they were weak but you could see very big smiles."
The Polish-born humanitarian has crossed frontlines in some of the world's most dangerous conflicts including Iraq and South Sudan but says he regards Syria as the worst.
"When we were entering it was very emotional, very heart-breaking moment. Regardless of who is fighting who the civilians should not be victims of this war."
Ceasefires were negotiated by all sides, allowing aid access.
But with more than 80 humanitarian workers already killed in this war, Mr Krysiek says there are no guarantees.
"I don't know if this is adrenalin or fear - I know that you feel something, I mean you feel that you need to get there. Too many people in this conflict are trapped in the fighting, caught up in the endless fighting."
Now taking a well-earned break in Beirut is Australian aid worker Sarah Davies, after living in Syria for almost two years.
She says she loves the challenge of humanitarian work.
"It's really rewarding - I've always wanted to do work where I felt like I was making a difference."
The PHD-qualified sanitation and water engineer could command a sizable income in the corporate world, but has devoted her life to disaster and conflict relief.
She's helping to build and restore toilet and water facilities across the country, saving countless civilian lives in the process.
"They really appreciate that somebody chooses to come at a time - just the presence helps them feel that they're not alone or abandoned."
Even in this war's bleakest moments Sarah Davies sees the good (side) - she says she has to.
"Sometimes in these situations you see perhaps the worst of humanity but at the same time you also see people who make great sacrifices and you get to see the best parts of humanity as well."
