Syria War: Eastern Ghouta Medical Evacuations Begin
Medical evacuations are taking place from a rebel-held area on the outskirts of the Syrian capital, Damascus.
Four critically-ill patients were reportedly taken out of the Eastern Ghouta overnight by teams from the International Committee of the Red Cross and Syrian Arab Red Crescent.
Another 25 are expected to be evacuated in the coming days, though hundreds more are in urgent need of treatment.
Some 400,000 residents have been under siege by government forces since 2013.
The Eastern Ghouta has been designated a "de-escalation zone" by Russia and Iran, the government's main allies, along with Turkey, which backs the opposition.
But hostilities intensified six weeks ago, when the Syrian military stepped up air and artillery attacks on the enclave in response to a rebel offensive, reportedly killing dozens of civilians.
There are also severe shortages of food, fuel and medicines, and the cold winter weather is threatening to worsen the hardship.
The Syrian Arab Red Crescent (SARC) announced early on Wednesday that the medical evacuations from the Eastern Ghouta had begun.
Teams had started to transfer patients "after long negotiations", it said.
It gave no further details, but photographs it posted on Facebook appeared to show several young children waiting to be evacuated along with family members.
The Syrian American Medical Society (SAMS), a medical relief organisation that supports hospitals in rebel-held Syria, later said a total of 29 critical cases had been approved for evacuation.
Four patients were evacuated late on Tuesday night, and the remainder would be evacuated over the coming days, it added.
The 29 cases include 18 children and four women suffering from heart disease, cancer, kidney failure, and blood diseases, in addition to cases requiring advanced surgery that is not available in the Eastern Ghouta, according to SAMS.
SARC official Ahmed al-Saour told AFP news agency that the first four patients to leave were a girl with haemophilia, a boy with the autoimmune disorder Guillain-Barre, a child with leukaemia, and a man in need of a kidney transplant.
The main rebel group in the Eastern Ghouta, Jaysh al-Islam, meanwhile said on Twitter that the government had agreed to the evacuations in exchange for the release of 29 of its prisoners.
Last week, the UN's humanitarian co-ordinator for Syria, Jan Egeland, said 494 people were on the priority list for medical evacuations submitted in November.
"That number is going down, not because we are evacuating people but because they are dying," he said. "We have tried now every single week for many months to get medical evacuations out, and food and other supplies in."
Mr Egeland said the UN had been waiting for the Syrian government to provide "facilitation letters" to allow ambulances and aid convoys into the Eastern Ghouta.
SAMS said the area's medical infrastructure had been "decimated" by the government's siege and bombardment, and that only 107 doctors remained there to provide care for an estimated 130,000 children and 270,000 adults while facing a severe shortage of medical supplies.
Recently, the UN reported that the rate of malnutrition in children under the age of five had increased to 11.9% - five or six times what was reported in January, and the highest so far recorded in the country since the civil war began in 2011.