Medical evacuations from Damascus suburbs pause after four are allowed to leave

Deal between Syrian government and rebel faction involves prisoners held by rebels

Syrian staff from the International Committee of the Red Cross take part in a medical evacuation operation in Douma in the eastern Ghouta region on the outskirts of the capital Damascus. Amer Almohibany / AFP Photo

Syrian staff tend to wounded baby in Douma. Abdulmonam Eassa / AFP Photo

About 400,000 people in Eastern Ghouta are besieged by forces loyal to President Bashar Al Assad, and the United Nations and charities have pleaded for his government to allow evacuation of around 500 patients. Abdulmonam Eassa / AFP Photo

The Syrian American Medical Society said four patients were taken to hospitals in Damascus, the first of 29 critical cases approved for medical evacuation. Amer Almohibany / AFP Photo

The Syrian Red Crescent said the evacuations were the result of “long negotiations”. Amer Almohibany / AFP Photo

A Syrian girl lies inside an ambulance. Abdulmonam Eassa / AFP Photo

The United Nations has been waiting for months for the Syrian authorities to provide “facilitation letters” to allow the aid operation to get under way. Hamza Al Ajweh / AFP Photo

Forces loyal to Assad have carried out air raids on Eastern Ghouta, while besieged rebels have fired mortars into neighbouring Damascus. Amer Almohibany / AFP Photo

Following a month of urging by the United Nations, the Syrian Red Crescent and the International Committee of the Red Cross began evacuating critically ill residents from Damascus's besieged eastern suburbs on Tuesday.

The UN has a list of nearly 500 people it says are in need of urgent medical evacuation, though on Wednesday only 29 people were slated to be taken out of Eastern Ghouta -- the string of suburbs where Syrian government forces have besieged nearly 400,000 people since 2013.

As of Wednesday afternoon, four people, including three critically ill children, had been evacuated. In exchange, Jaish Al Islam, one of the dominant rebel groups in Eastern Ghouta, had released five prisoners it held.

It was not immediately clear why the evacuations had been paused on Wednesday.

The siege of Eastern Ghouta has intensified in the last six months as government forces successfully cut routes that had allowed some goods into the area, causing food prices to skyrocket and dozens of reports of deaths related to malnutrition. Shipments of food and medical aid occasionally enter the area but fall far short of what is needed.

Jan Englund, the UN’s humanitarian advisor for Syria, has said that 16 people who were initially on the UN’s list had died while waiting to be evacuated.

November was the last time humanitarian groups delivered aid to Eastern Ghouta, and the current deal does not provide for any further deliveries of aid.

Elsewhere in Syria, Lebanese group Hizbollah's Al Manar television station reported that fighters from Jabhat Fatah Al Sham near the Israeli-Syrian-Lebanese border had surrendered and would be transferred to Idlib province in northern Syria.

Al Manar did not specify how many or exactly when the transfer would take place. The National was unable to reach rebel spokesmen in the area for comment on Wednesday.

Reuters quoted a rebel spokesman in Western Ghouta as saying on Tuesday it was unclear what would happen to thousands of civilians in the area. The spokesman said that about 8,000 civilians remained trapped in the area where the fighters had been surrounded.

In similar deals earlier this year, Fatah Al Sham fighters were moved to Idlib province in northern Syria, which is still controlled by rebels but has been under siege for months. Families of fighters and other civilians were transferred along with the fighters in those deals.

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Hizbollah and Syrian government-affiliated media generally refer to Fatah Al Sham as Jabhat Al Nusra, the group’s former name, which it changed in 2016 in an effort to distance itself from Al Qaeda.

Idlib is one of four "de-escalation" zones agreed to by Russia, Turkey, Iran and Syria, but has been heavily targeted by government and Russian airstrikes in recent days and a ground invasion appears imminent. Hayat Tahrir Al Sham, a rebel umbrella group dominated by Jabhat Fatah Al Sham, is one of the main groups fighting in Idlib.

On Wednesday, Russian foreign minister Sergei Lavrov was quoted as saying that the Syrian government’s key task was now to “destroy Jabhat Al Nusra".

Russia, which has longstanding military and economic ties to the Syrian government, began providing critical air and ground support to the Syrian government's forces in 2015 and announced earlier this week that it would retain a permanent military presence in Syria when the war is finished.

*Additional reporting by Reuters and AFP