Food began to flow into a Palestinian refugee camp near Damascus Saturday, after a several-month long siege left residents starving and the UN scrambling to provide aid.

Some 200 food parcels were sent into the Yarmouk camp outside of Damascus, said Chris Gunness, a spokesman for UNRWA, the UN agency for Palestinian refugees. Gunness said the Syrian government requested the delivery.

Yarmouk is one of the areas hardest hit by food shortages in Syria. Residents there say 46 people have died since October of starvation, illnesses exacerbated by hunger or because they couldn’t obtain medical aid. The Britain-based Syrian Observatory for Human Rights, which has a network of activists around the country, said an elderly man died in the camp earlier Saturday because of the food shortage.

In the Syrian capital of Damascus, Anwar Raja, a spokesman for the Popular Front for the Liberation of Palestine-General Command, said hundreds of boxes of food entered the camp. He said much of the material was carried by members of PFLP-GC members and committees in the camp.

“The process is moving slowly since they are being carried on the shoulder to avoid sniper fire,” Raja told The Associated Press in Damascus by telephone.

PFLP-GC members are fighting against Syrian opposition fighters who control most of the camp.

Gunness said the UN laid down an express condition that the food “must be distributed exclusively to civilians in need of assistance” and that fighters shouldn’t receive it. He also said the area should be opened for regular access by humanitarian groups.

Gunness said the delivery was a ‘trial,” according to a report in the Palestinian Ma’an news agency.

More aid convoys and evacuations of students are expected Sunday, the agency reported.

On Friday, UN High Commissioner for Human Rights Navi Pillay says said in a statement that badly needed food and medical aid is not reaching malnourished children, women and elderly people close to starvation because of “a quagmire between besieging Syrian government forces and affiliated militias surrounding the Yarmouk camp, as well as anti-government armed groups operating inside.”

She said the siege could amount to a war crime.

On Monday, a six-truck supply convoy bearing enough food to feed 10,000 people was supposed to enter the camp with permission from the Syrian authorities. When it neared Yarmouk, gunmen opened fire on it and it was forced to turn back.

In recent days, Arab media outlets have published disturbing photos of bloated corpses and children dying of starvation in the camp. Despite the efforts to get humanitarian aid into the camp, the Assad regime and Palestinian organizations affiliated with it had refused to cooperate and allow it inside.

On Monday, a procession of camp residents marched toward one of the checkpoints in hopes of breaking the siege. Syrian troops opened fire on them, killing three.

The dire conditions at the Yarmouk camp are a striking example of the catastrophe unfolding in rebel-held areas blockaded by the Syrian government. US and Russian diplomats said last week the warring sides are considering opening humanitarian corridors to let in aid and build confidence ahead of an international peace conference on Syria.

Interviews with residents and UN officials, as well as photos and videos provided to The Associated Press, reveal an unfolding tragedy in the sprawling camp, where tens of thousands of Palestinian refugees and displaced Syrians are trapped under an intensifying blockade.

“There are no more people in Yarmouk, only skeletons with yellow skin,” said 27-year-old resident Umm Hassan, the mother of two toddlers.

“Children are crying from hunger. The hospital has no medicine. People are just dying,” she told the AP by telephone, adding that her 3-year-old daughter and 2-year-old son were rapidly losing weight from lack of food.

The camp and other blockaded areas pose a stark challenge for Syria’s government and the opposition, who agreed to consider opening humanitarian access in the run-up to a peace conference this week in Switzerland that could bring the sides together for the first time.

Some 160,000 Palestinians once lived in Yarmouk, a strategic prize for rebels and Assad forces for its close proximity to Damascus. They remained mostly neutral when the uprising began against Assad’s rule in March 2011.

But clashes erupted between pro- and anti-Assad Palestinian gunmen in December 2012, and most residents fled. The poorest, some 18,000 people, remained behind, according to UN estimates, along with tens of thousands of Syrians displaced from rebel-held areas that were seized back by the regime.

Civilians walk past vehicles destroyed by fighting between rebels and Syrian troops in the Yarmouk camp for Palestinian refugees in south Damascus, Syria, in 2012. (photo credit: AP)

Civilians walk past vehicles destroyed by fighting between rebels and Syrian troops in the Yarmouk camp for Palestinian refugees in south Damascus, Syria, in 2012. (photo credit: AP)

Pro-Assad Palestinian factions set up checkpoints around Yarmouk and progressively tightened a blockade of the area. By September, they banned residents from leaving, or food from entering.

It also meant residents couldn’t reach UN aid that was distributed outside the camp. The UN stopped operating inside Yarmouk in December, because of the fighting.

As months have passed, Yarmouk’s poorest have run out of food, according to residents and the UN.

Families now dissolve spices in water and feed it to their children as soup. Some found animal feed, but residents suffered food poisoning after eating it.

A woman desperate to feed her children sneaked into a field surrounded by Syrian snipers to forage for mallow, a green herb. She was shot in the leg and hand, she said in a video uploaded by activists.

Lying on a bed, the woman’s bloodied hand shook as she wept, recounting how her children pleaded for food. She rushed into the field but heard gunfire and fell to the ground, bleeding and wounded. “For some mallow,” she wept. “To save us from death.”

The videos appear to be genuine and consistent with AP reporting on Yarmouk.

Within the camp, misery lives amid fear and defiance. Civilians shrink into their homes at dusk, as armed gunmen roam the streets.

In recent months, local truces have partly resolved blockades in other rebel-held areas, with gunmen agreeing to disarm in exchange for allowing in food for residents.

The Yarmouk blockade appears to be the harshest yet, and the most intractable. Months of negotiations for rebels to disarm have failed, residents said.

Palestinians in the West Bank have been running a campaign to raise awareness of the siege.

Protesters recently gathered outside the office of Palestinian Authority President Mahmoud Abbas in the West Bank city of Ramallah, demanding he find a solution.

“History will curse us if you allow Yarmouk’s people to die of hunger,” one sign read.

Meanwhile Saturday, violence continued. The British-based Syrian Observatory for Human Rights said a government air raid on the northern city of Aleppo killed 23 people.