The names of the sources in Syria who are featured in this article have been changed for their protection.
Heba remembers the last day she saw her family's apple orchard, located on the outskirts of her hometown of Madaya. It was June 17 last summer — the day that Hezbollah declared the area around the town to be a "military zone." The Iran-backed Lebanese militia, which is fighting to support President Bashar al-Assad's government in Syria, imposed a full blockade two weeks later, trapping everyone within the town, including a small contingent of anti-regime rebels.
"Leaving at all was just not an option," she told VICE News by phone.
Heba is just one of millions of Syrians whose lives have been upended over the course of the country's nearly five-year civil war. But unlike most of her neighbors, she's able to contrast the destruction around her with the staid suburbs of Pennsylvania.
Though not an American citizen herself, Heba spent six years living outside of Philadelphia, where she gave birth to her three children.
"Life was totally different there," she recalled. "So much more settled, and so much more safe."
Though Madaya is perched in the mountains just 29 miles northwest from Damascus, the six-month military blockade has turned the town into an open-air prison. While fighting intensified in surrounding areas, its population nearly doubled to 42,000 as Hezbollah relocated refugees from nearby villages to the town. Food and medicine are scarce, but escape is virtually impossible — Madaya is ringed with checkpoints and mines.
Heba and her husband Tamir have been trying desperately to get the United States government to help their family get out.
"If we stay here," she said, "it seems to me that suffering will never end."
Humanitarian workers have managed to deliver a few shipments of food to Madaya over the past few months, but the Red Cross, Doctors Without Borders, and the Syrian American Medical Society all confirmed to VICE News that the town remains in the grip of a dire famine.
Local aid operatives have reported 32 deaths from starvation in the past month alone. Basic food staples are exceedingly hard to find. A single biscuit now retails for $15.
"You cannot imagine how difficult it is when your three-year-old is hungry and crying and asking you for food and you cannot bring food to him," Heba remarked. "We are forgotten by everyone."
She moved to the US in 2000 to live with her husband Tamir, a Syrian-American who settled near Allentown and worked as a chef in a Greek restaurant. Tamir is the grandson of an Ottoman subject who emigrated to the US in 1907, fought for the US in World War I, and became a naturalized US citizen — as did Tamir's aunt. Tamir's grandfather returned to Syria after the war, and a branch of his family now lives in Madaya.
Heba was born and raised in Madaya and is not a US citizen, but she gave birth to three children in the six years that she resided in the US. The eldest, who is now 15, attended elementary school in Allentown. The children, she said, still communicate with friends back in the US when the town's intermittent internet connection allows them to.
The health of Tamir's aunt began to fail in 2006, and the family decided to move to Madaya to help care for her. They bought an orchard and planned to grow apples for export, but unrest within the country derailed those plans before long. The orchard now lies just beyond the Hezbollah blockade.
Madaya has been a hotbed of anti-regime activity since protests against Assad first erupted in the spring of 2011 as the Arab Spring was underway.
For the past six months, Madaya and the neighboring town of Zabadani have been caught in a complex game of geopolitical chicken. Many of the anti-Assad fighters holed up in the town belong to a group called Ahrar al-Sham that has laid siege to a pair of pro-regime towns in northern Syria: Fua and Kefraya. Hezbollah only allows food into Madaya and Zabadani when a parallel shipment can be arranged into the northern pro-regime towns.
Locals estimate that there are no more than 300 rebel fighters in Madaya, a tiny portion of the 42,000 residents who are being held hostage. Heba is not particularly political — she didn't participate in anti-regime protests — and expressed neither sympathy nor disdain for the fighters in her town.
"We had nothing to do with this war," she said. "But we are made to pay for it."
When the blockade was first imposed, Heba and her family began to ration their food, eating just one meal a day.
"When it ran out, we collected grass from the yard and ate it," she said. They would often mix herbs with warm water and substitute that for a meal.
As the siege began to tighten last October, Tamir sent a message to the US Embassy in Beirut. VICE News obtained a copy of the email from a cousin of Tamir's, Hussein Assaf. He is a 35-year-old Syrian-American who lives in Philadelphia and has been trying to draw attention to his relatives' harrowing ordeal.
"We stuck we tried to get out of here but we couldn't there is no way out, and the life here is impossible there's no food and no medicine all human needs are unavailable," Tamir wrote in the email, which was sent on October 17. "We almost died from everything please we need your help as soon as possible."
He attached his social security number to the message to verify his citizenship.
The US Embassy replied with what appeared to be a form-letter response that was shared with VICE News. "Dear Sir," it said. "Unfortunately, we are unable to assist you in this issue and you are advised to consider other options. Thank you."
VICE News has also reviewed Tamir's citizenship documents as well as those of his three children and of his aunt, who was blinded when a shell ripped apart her family's house last August and glass shards flew into her face.
VICE News approached the US State Department for comment on the family's situation.
"Privacy considerations prevent us from commenting on specific cases," a State Department official said on background. "Through our Czech Protecting Power, we are making every effort to assist US citizens who are trying to leave Syria."
But Heba said that she's been in contact with diplomats at the Czech Embassy in Damascus — a well-known intermediary for American diplomats — who have told her that nothing can be done to help.
In the meantime, Tamir's cousin Hussein is furious that the US government won't even acknowledge his family's situation. He thinks that his relatives in Madaya should have been considered when the US negotiated with Iran for the release of prisoners who were held in Iranian jails this past month.
"It pissed me the hell off," he said. "It seems like we aren't American enough for them."
Follow Avi Asher-Schapiro on Twitter: @AASchapiro