The International Committee of the Red Cross in Syria said on Wednesday that medical evacuations from the war-torn enclave of Eastern Ghouta to Damascus has begun.

Around 4,00,000 civilians are trapped in the Eastern Ghouta territory, surrounded by forces loyal to Syrian President Bashar al-Assad, Reuters reported. The United Nations has asked the Syrian government to allow evacuation of around 500 patients, including children with cancer.

On Wednesday, the Syrian American Medical Society, or SAMS, said that evacuations had begun for a group of 29 critical cases. It said four patients were evacuated on Wednesday, and the rest would be evacuated later.

“Only 107 doctors remain in the area to provide care to a population of 400,000, including 130,000 children, while facing a severe shortage of medical supplies,” SAMS President Ahmad Tarakji said. He called on the Syrian government and “all involved parties” in the conflict to “guarantee medical evacuation to all patients in East Ghouta while guaranteeing safety, the right of return and the choice of evacuation destination.”

The Syrian Red Crescent said the evacuations were the result of “long negotiations”, Reuters reported. On Sunday, Turkish President Tayyip Erdogan said Turkey was working with Russia to enable the evacuations.