GENEVA (Reuters) – Five people have starved to death in the last week in the Syrian town of Madaya, where a single biscuit sells for $15 and baby milk costs $313 per kilo, despite two emergency United Nations aid deliveries to the besieged town, a UN report said.

Local relief workers have reported 32 deaths of starvation in the past month, and last week two convoys of aid supplies were delivered to the 42,000 people living under a months-long blockade.

Dozens more people need immediate specialized medical care outside Madaya if they are to survive, but aid workers from the U.N. and Syrian Arab Red Crescent have managed to evacuate only 10 people, the report said.

“Since 11 January, despite the assistance provided, five people reportedly died of severe and acute malnutrition in Madaya,” said the U.N. humanitarian report, published late on Sunday.

U.N. Secretary-General Ban Ki-moon said on Thursday Syria’s warring parties, particularly President Bashar al-Assad’s government, were committing “atrocious acts” and he condemned the use of starvation as a weapon of war in the nearly five-year-old conflict.

The United Nations says there are some 450,000 people trapped in around 15 sieges across Syria, including in areas controlled by the government, Islamic State militants and other insurgent groups.

The U.N. made seven requests in 2015 to bring an aid convoy to the town, and got permission to deliver aid for 20,000 people in October, the report said. After several more requests, the Syrian government allowed a life-saving aid delivery on Jan. 11 and another on Jan. 14.

About 50 people left the town on Jan. 11, the report said.

The U.N. has asked Syria to allow the evacuation of a number of others needing immediate care, it said.

Syrian government forces and their allies have surrounded Madaya and neighboring Bqine since July 2015 and imposed increasingly strict conditions on freedom of movement.

The U.N. said the humanitarian workers who entered the town last week heard that landmines had been laid since late September to stop people leaving, but many civilians continued to try to search for food on the outskirts, and some had lost limbs in landmine explosions.

The controls on movement also meant many children had been separated from their parents, leading to symptoms of trauma and behavioral disorders.

Chairs and desks in schools are being used as firewood and there have been unconfirmed reports of women being harassed at military checkpoints and of gender-based violence, the U.N. said.

(Reporting by Tom Miles; Editing by Dominic Evans)