Evacuated children on the government side of the Wafideen checkpoint outside Damascus (AFP)
Some 150 people were bussed out of East Ghouta on Tuesday in the first evacuation of civilians from the rebel-held zone since Syria's government began a fierce assault three weeks ago.
Separately, hundreds of rebel fighters left the district of Qadam, south of Damascus, in a deal negotiated with the government.
The area's 400,000 residents have lived under a devastating siege for five years that has made food scarce and left hospitals unable to cope.
On Tuesday, civilians, including wounded residents, were transported out of the rebel-held town of Douma, Ghouta's largest, by the Syrian Arab Red Crescent and into government-held territory.
After reaching the government-held Wafideen checkpoint on the edge of the rebel enclave, 56-year-old Ratib Sheikh Bakri burst into tears.
His right leg had been amputated at the hip and he had been waiting for a medical evacuation from Douma for a year and a half to seek treatment.
"I am coming to be treated in Damascus before my second leg goes too," he told AFP, wiping his eye with a tissue.
Bakri said the living conditions were "dire" in Ghouta, where his three daughters and two sons are still trapped.
On Monday, the United Nations said more than 1,000 people, mostly women and children, were in urgent need of medical evacuation from Ghouta.
The area has been under a Russian-backed government offensive that has killed more than 1,100 people and wounded thousands more.
It has also split the enclave into three isolated opposition-held pockets.
Jaish al-Islam, the rebel faction that holds Douma, said on Monday it had negotiated a deal with Russia and the UN to evacuate sick and wounded residents out of the town.
Inside Douma on Tuesday morning, residents could be seen lugging duffel bags and suitcases to a group of waiting buses and ambulances.
Red Crescent workers checked their names against a list, as women and children waved goodbye to a crowd of male relatives who would remain in the town.
An AFP correspondent there saw 30 sick and wounded people.
A Syrian military source on Tuesday gave a similar number, saying a total of 24 men, 44 women and 78 children were evacuated. The source said 10 sick people were among them.
Another military source had told AFP earlier that "no fighters" would be evacuated as part of the convoy.
Meanwhile, the army evacuated several hundred rebel fighters from a small pocket it had held for years south of Damascus on Tuesday and bussed them to the north of the country, a monitor said.
The Syrian Arab Red Crescent confirmed the evacuation from the district of Qadam. AFP's correspondent in the northwestern province of Idlib, the last to largely escape government control, saw some of the estimated 300 fighters arrive.
"An agreement reached in September 2017 between the regime and Islamist factions, including Hayat Tahrir al-Sham (HTS), was implemented today," the Syrian Observatory for Human Rights said.
HTS is made up mostly of former members of al-Qaeda's ex-affiliate in Syria. The other main group present in Qadam was Ajnad al-Sham.
"At least 1,300 people, including fighters with their relatives, have been transferred," said Rami Abdel Rahman, the Britain-based observatory's head.