(CNN)Evacuations of the first critical medical cases from a rebel-held region east of Damascus have begun, aid agencies say.
The Syrian Red Crescent and International Committee of the Red Cross announced, on their official Twitter accounts Tuesday, that the first patients were to be taken out of the rebel-controlled area of Eastern Ghouta.
Eastern Ghouta is a rebel-held suburb of Damascus and has a population of 400,000. The UN officials warned last month that the area was experiencing the worst outbreak of child malnutrition since the civil war started six years ago, and hundreds of people in need of urgent medical attention are trapped there.
The evacuations began after long negotiations with the Syrian government, according to the Syrian Red Crescent.
Saying that the medical situation in the area, which borders Damascus to the east, has “reached a breaking point,” the Syrian American Medical Society (SAMS) said in a statement that of the 29 patients, four people have been evacuated from the beleaguered suburban enclave.
Thousands besieged in Syria’s Eastern Ghouta
The other 25 patients would be moved “over the coming days,” the statement said. But SAMS warned that the planned evacuations were a fraction of the critical cases that needed to be moved to areas where they could receive adequate medical attention.
In a tweet, the group urged all parties to “guarantee medical evacuation to the remaining 637 patients” in the suburb.
At least 17 patients have died over the past few months in Eastern Ghouta because they were not able to access medical care, the group said.
In the statement, SAMS said that among the 29 evacuees are 18 children and four women “suffering from heart disease, cancer, kidney failure and blood diseases, in addition to cases requiring advanced surgery that are not available in the besieged area.”
It added that this is “just a small fraction of the current number of 641 critical cases in need of urgent medical evacuation.”
Medical professionals are scarce in the region, and there is currently a ratio of only one doctor for almost 4,000 residents, the group asserts.
Russia, Turkey discussing evacuations
Turkish and Russian reports from the weekend suggested that Moscow and Ankara are discussing the relocation of hundreds of people from the suburb, citing Turkish President Recep Tayyip Erdogan.
“We are discussing with [Putin] how to evacuate them to our country without problems and provide them with medical assistance,” Sputnik quoted Erdogan as saying.
Various rebel groups control Eastern Ghouta, and the suburb has been surrounded by Syrian regime forces for more than four years. Eastern Ghouta is part of four de-escalation zones negotiated by the Russian, Iranian and Turkish governments in May.
In theory, residents in the area should be in a safe zone free from airstrikes, shelling and fighting. But they have suffered from both a lengthy siege and continued bombardment.
This has come amid a climate of peace talks and a victory declaration from Moscow in which Russian President Vladimir Putin said his military forces would begin to withdraw.