The Syrian government, with the help of its allies, is doubling down on its “siege and starve” policy to implement an “evacuate or die” strategy in Syria’s besieged areas, forcing residents across the country to submit to truce agreements that offer little protection to those who leave the area, or to those who stay on and return to government control.

Russia’s “final offer” to residents of east Aleppo, giving them an ultimatum to leave the city through “humanitarian corridors” by Friday night, amounts to the largest implementation of the evacuate-or-die policy to date. If rebel fighters and civilians do not leave the besieged area by sunset, Russia has warned of an extensive bombardment. Syrian rebel groups deny that there are any safe corridors by which to leave the city, and civilians who have already resolved to stay in their homes are clinging to hope the ongoing siege can be broken.

Last week’s brutal Russian bombing of a school in Hass, Idlib province, which killed more than 20 children among 35 civilian victims, hit the part of the country where many of the evacuees from across Syria have gone, and demonstrated the vulnerability of those who take that option.

Some 2,000 people arrived in Idlib in late October, bused from the Damascus suburb of Moadamiya. The rest of Moadamiya has been brought back under the control of the government under the truce agreement. Besieged since 2012, the area has been the subject of truce discussions between the government and the local “reconciliation committee,” which saw humanitarian aid granted for “good behavior.” Pressure to make a final agreement increased significantly after the evacuation of the highly symbolic neighboring suburb of Darayya in August.

As the diplomatic discussions and TV broadcasts focus on Aleppo, evacuations like those in Moadamiya and Darayya are quietly being enacted or brokered across Syria, allowing the government to regain control of large parts of the country and ensuring its ability to concentrate military action in Idlib at a later stage.

In mid-October, Qudsaya and Hameh submitted to a similar deal as Moadamiya, with around 2,000 people leaving for Idlib. As has become custom, the evacuation negotiations were reinforced by a heavy military campaign that pushed residents to agree to depart rather than die in their homes.

Al-Waer in Homs was evacuated in late September following intensive pressure, which consisted of a tightened siege, heavy bombing and an aid convoy from SARC that consisted only of body bags and towels, according to residents of the area who said the convoy sent a clear message that they should submit to the government’s evacuation deal terms.

Further evacuations from al-Waer are on hold until the regime produces information about 6,000 detainees, of 7,500 missing from the area, that have so far not been accounted for.

East Ghouta, a large collection of smaller towns in the Damascus suburbs that suffered in 2013’s chemical-weapons attacks, is also in Assad’s crosshairs. Local civil society groups in Douma are negotiating with the government, a conversation that is being reinforced by heavy bombing, including the targeting of a school last week.

The Syrian government has previously played the rival rebel groups Jaish al-Islam and Faylaq Rahman off each other in the Ghouta area, at one point strategically approving aid convoys to areas under the control of one while blocking those to areas controlled by the other, sparking a battle that left over 500 dead. Jaish al-Islam is now reportedly negotiating a truce in areas under its control, which will cause similar pressures, despite the wishes of the citizens of the area who have tried to forge a unified front between the two groups.

Residents of the Asali checkpoint area, near the besieged town of Madaya, have reported being forced to leave their homes by Hezbollah forces, whose snipers shot into the houses around the checkpoint and demanded residents leave. Abu Muhammad, a resident of the area adjacent to the checkpoint, said around 40 families had fled their homes so far.

Khan Elshih, Qaboun, Burza and At-Tal, among others, are all are facing a dual set of levers—restrictions in aid and heavy military force—to push them to negotiate. Combined, the number of localities considering, or negotiating, an evacuation or truce agreement represents a significant percentage of the disputed or besieged areas in zones otherwise broadly under government control.

Despite regularly requesting permission to access these areas since 2012, the United Nations has failed to provide consistent relief to many of them. Darayya received aid only once in more than two years before its people agreed to evacuate the area.

The kind of forced displacement taking place across Syria is unquestionably illegal under international law. A spokesperson for the International Committee for the Red Cross in Syria said that evacuations must be voluntary, and the ICRC’s priority is to ensure residents “are not forced to it, they have to have the choice.” On evacuation, they said there “must be all the necessary guarantees in terms of shelter, food, water.” But the ICRC has confirmed that the evacuations do no meet these requirements.

After heavy criticism of its involvement in the Darayya evacuation, the UN has refused to assist with subsequent evacuations, instead leaving the job to the Syrian Arab Red Crescent (SARC). This means there is no independent oversight to ensure the safety of civilians, or to guarantee that the terms of the agreements are met, and in many cases they are not.

The Darayya Council issued a statement in October saying that local prisoners have not yet been released as promised. Additionally, residents evacuated to a relief center in Damascus are essentially being held prisoner by the government, which will not allow them to leave.

The only NGO being given access to the centre is SARC, which is providing food, shelter and healthcare. When people complain of mental distress they are told to contact their relatives in opposition areas to hear about the situation there, sources told The Daily Beast. Meanwhile, the Syrian government has begun redevelopment plans for Darayya, which are not likely to include homes for any of the evacuated residents.

Moadamiya residents have complained of arrests and disappearances during and since the evacuation. The lack of impartial participants or observers means there is little recourse available in these cases, either during the process or in the years to come.

The hope of an increase in aid is a driving factor for those who stay in their homes and return to government control.

Imad, a dentist from Moadamiya, said the needs were vast: “There was only one field hospital in the city that used to operate between 2012 and 2013 during the siege and armed clashes.” Children, he said, were most in need: “We have 21 schools of which only seven are operating and functional. We have an entire generation of children (6 years and below) in urgent need of medicine and nutrition.”

The government's vice-like grip over aid programs in areas it controls means there is no guarantee that humanitarian organizations will be granted access. NGOs and civil society organizations working illegally inside besieged areas are unable to work once evacuations take place, according to aid workers in Syria who spoke to The Daily Beast on the condition of anonymity.

“It is hoped that the road to Moadamiya will open up, but what use is it if the goods that go in are spoiled before they reach the people who need it, or if the food costs are so high that no one can afford it?” says Sonia Khush, Head of Save the Children, Syria.

“That is why it is important that humanitarian aid goes in.”

Many fighting age men have avoided conscription to the Syrian Arab Army by basing themselves in opposition controlled areas. For them, the evacuations leave several unwelcome options: leave their homes; face the possibility they will be called on to fight in an army that regularly targets civilians; or be treated as captured insurgents—a grim fate indeed.

Once in Idlib, there is no protection from the violence. Aid agencies working in northern Syria told The Daily Beast that there are no immediate plans to ramp up the amount of aid to cope with the influx of new arrivals, many of whom are woman and children.

As the last four years have shown, there is nothing aid organizations, or the UN, can do to alleviate the risks posed by airstrikes, like those in Hass, aside from expressing outrage and condemnation.

Idlib is one of the strongholds of Jabhat Fateh al-Sham (JFS), formerly known as the al-Qaeda franchised Nusra Front, and it is under frequent air bombardment by Syrian and Russian forces. It has also been subject to coalition airstrikes by the U.S.-led coalition which have been deployed against the group since 2014 due to its al-Qaeda ties.

As Aleppo has shown, even a small number of JFS fighters in an area can create a smokescreen for Russian bombing of civilian targets.

Russia and the regime can, and likely will, force evacuate or die truce agreements on civilians then continue to target them once they arrive in Idlib.

As more suburbs are brought back under the umbrella of the government around the major cities of Damascus and Homs, Aleppo becomes the largest and most problematic issue for Syrian and government forces, and the need to try to force a similar solution there becomes critical.

Citizens of east Aleppo protested against civilian and rebel evacuations during Russia's unilateral ceasefire, saying that they fear the same fate as those being forcibly displaced across Syria. Citizens said it was “an attempt to force them from their homes, like in Darayya.” according to Abu Muhammad, a citizen of the east of the city.

Despite Russia's partial mirroring of a plan put forward by the UN's Syria envoy, Staffan De Mistura, during recent talks in Lausanne, time-limited ceasefires and evacuations of the city are rejected by the opposition, who believe the onus should be on lifting the siege.

Rebel groups have taken matters into their own hands this week with a coordinated operation aimed at breaking the siege on east Aleppo, a campaign which is already taking a heavy civilian toll. Events in Aleppo in the coming days will have significant influence on how negotiations in other besieged areas proceed.

While the Syrian government's forced displacement strategy is illegal, there is little else to offer the residents of Syria's besieged areas. There's been no alleviation of their suffering through the UN's humanitarian response, or through political channels, and no success in bringing an end to the violence or siege. While there may be international outrage about the evac or die strategy, it is hard to see who or what might changed that picture on the ground. So it seems likely it will continue unabated.