The evacuation of critically ill patients has begun from the Syrian rebel-held enclave of Eastern Ghouta, CBS News partner BBC News reports.
Some of the evacuations had been negotiated between the Assad regime and Syrian rebel group Jaish al-Islam, SAMS advocacy manager Mohamad Katoub said in a tweet. Other cases include 18 children and four women. The Syrian government army command declared ceasefire in this area on June 22 but, according to SANA news agency, illegal armed groups have violated it a couple of times since then.
Red Cross regional director Robert Mardini said he was "encouraged to see the beginning of a life-saving operation".
The Syrian Arab Red Crescent (SARC) announced early on Wednesday that medics had started to transfer patients from the Eastern Ghouta "after long negotiations".
UNICEF reports that 137 children are among those in Eastern Ghouta need of urgent medical care.
"That number is going down, not because we are evacuating people but because they are dying", Jan Egeland, the UN's humanitarian advisor for Syria, said last week.More news: Giants Landon Collins on Eli Apple
A region consisting of towns, villages and countryside abutting Damascus, eastern Ghouta has been a bastion of jihadi factions for the past three years.
United Nations reports and Al Jazeera interviews in Eastern Ghouta confirmed reports that residents are drinking large amounts of water to suppress hunger, with food intake reduced to one meal a day.
Until the jihadi offensive, eastern Ghouta had been relatively quiet. Shipments of food and medical aid occasionally enter the area but fall far short of what is needed.
Residents and aid workers said the government has tightened the siege in recent months in what they called a deliberate use of starvation as a weapon of war, a charge the government denies. Hayat Tahrir Al Sham, a rebel umbrella group dominated by Jabhat Fatah Al Sham, is one of the main groups fighting in Idlib.
The Syrian American Medical Society (Sams) said four patients were taken to hospitals in Damascus, the first of 29 critical cases approved for medical evacuation, and the remainder would be evacuated over the coming days.
The Syrian army, backed by Russian air power and militia allies, has systematically cleared of insurgents the northern, western and southwestern approaches to the city and re-established control.