Hot water for dinner!

Manal boils water on the stove in the besieged Syrian town of Hamouria, hoping to convince her four children that she is cooking, but she has no food.

She puts the pot on the flame as a ruse, waiting for the children to fall asleep in the dilapidated house before they realise there is nothing for dinner.

In the rebel-held Eastern Ghouta region where she lives, over 1,100 children are suffering acute malnutrition, and hundreds more are at risk because of food shortages caused by a government siege.

Aid agencies warn the situation is worsening, despite an international agreement to implement a "de-escalation zone" in the area, which has decreased violence but led to no new access for food, medicine and humanitarian aid.

"They haven't eaten anything but bread for the last three days," Manal told AFP in tears.

Eastern Ghouta, which lies outside the capital Damascus, was once a prime agricultural region.

But the rebel stronghold has been under a tight government siege since 2013, causing shortages of food and medicine, and pushing up prices for what remains on the market, produced locally or smuggled in.

Basic services for the region's estimated 400,000 residents are virtually non-existent, with electricity produced only by generators and the water available often dirty and a vector for illness.

Manal's husband Abu Azzam is unable to work because of a serious injury he sustained in a shelling attack in their old home elsewhere in Eastern Ghouta several years ago.

The attack killed one of their children, and left another, Azzam, missing a foot and dependent on crutches to get around.

The family are desperately poor and have sold most of their furniture to afford food.

"All I want is to see my children with full bellies," said Abu Azzam.

"I hope the day will come when we'll be able to eat three meals a day."