Turkey-backed Free Syrian Army fighters advance in Der Mismis village at the south east of Afrin, Syria, Tuesday, March 13, 2018. Turkish troops and allied Syrian opposition fighters have begun a siege of the Syrian Kurdish-held town of Afrin, the Turkish military said Tuesday, marking a significant advance in Ankara's seven-week operation that also almost fully encircles hundreds of thousands of civilians.(Hasan Kirmizitas/DHA-Depo Photos via AP)

Turkey-backed Free Syrian Army fighters advance in Der Mismis village at the south east of Afrin, Syria, Tuesday, March 13, 2018. Turkish troops and allied Syrian opposition fighters have begun a siege of the Syrian Kurdish-held town of Afrin, the Turkish military said Tuesday, marking a significant advance in Ankara's seven-week operation that also almost fully encircles hundreds of thousands of civilians.(Hasan Kirmizitas/DHA-Depo Photos via AP)

BEIRUT (AP) — Turkey said Tuesday its troops and allied Syrian fighters have encircled the Kurdish-held town of Afrin in northern Syria, putting hundreds of thousands of civilians under siege and marking a significant military advance in the seven-week operation.

Turkey launched its assault on the border enclave on Jan. 20 to drive out Syrian Kurdish forces that it views as “terrorists” linked to Kurdish rebels fighting inside Turkey. The Turkish military said the siege of Afrin, the main town in the enclave of the same name, began Monday after the military took control of “critical areas.”

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A passage out of Afrin remained partially open, and thousands of people have reportedly fled the town, heading toward nearby areas controlled by the Syrian government. Syria’s Al-Ikhbariya TV showed cars, trucks and tractors loaded with civilians driving out of the town.

Panic was spreading in the town as the Turkish forces approached, and some civilians came under fire when they tried to leave, according to residents and Syrian Kurdish officials.

Azad Mohamed, a 32-year old resident, said his relatives were fired upon as they tried to escape Monday, forcing them to turn back. He said he can’t decide whether to risk the journey out of Afrin with his two children or to remain in place.

“Most of the time, I swear, I am acting like a mad man. When I sit down for two minutes, I get up again and start pacing to ease the tension,” he told The Associated Press in a series of text messages. “Every time I remember they (Turkish forces) are closer, I think of my wife and kids and parents. I am afraid and I feel like there is a volcano in my belly.”

Col. Moataz Raslan, commander of one of the Turkey-allied opposition groups, said the Kurdish fighters in Afrin should surrender or leave the area. He said it was the Kurdish fighters who were preventing civilians from leaving and firing on those who do.

But Mohamed said most of the Kurdish fighters come from the area and would never give up their hometown. “Their families will never forgive them if they leave,” he said.

A top Syrian Kurdish official, Fawza Yousef, described intense Turkish shelling of the town and said Turkish forces were expected to “invade” soon.

Elsewhere in Syria, dozens of civilians were evacuated from the besieged, rebel-held Damascus suburb of eastern Ghouta, arriving on foot and in buses at an army checkpoint set up by the Syrian and Russian militaries.

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The Syrian American Medical Society, which supports health facilities in eastern Ghouta, said 31 patients were evacuated along with their families, amounting to 170 civilians. It said another 1,034 people still inside the enclave need immediate medical evacuation.

The United Nations says it observed the evacuation of 147 civilians, including 10 critical cases, from Douma, the largest town in eastern Ghouta. U.N. spokesman Stephane Dujarric told reporters there are plans to send another humanitarian convoy to Douma “in the coming days.”

Some 400,000 people are estimated to be trapped in eastern Ghouta, which has been under a crippling blockade and heavy bombardment for weeks. Syrian government forces have split the region into three separate sectors in recent days in rapid advances against rebels.

The largest rebel group in the area, the Army of Islam, reached a deal with Russian forces to evacuate the wounded, but nevertheless vowed to fight to the end.

“We will stay in our Ghouta to defend it until we achieve one of two good things,” spokesman Hamza Bayraqdar said in a video statement, using an Islamic expression that means victory or martyrdom.

Opposition activists say more than 1,100 civilians have been killed since the latest offensive began in February. In Douma, residents and displaced families were sleeping in shops and in the streets as basements and underground shelters filled up.

The Britain-based Observatory for Human Rights and the opposition’s Syrian Civil Defense reported airstrikes and shelling Tuesday morning on several towns that killed and wounded more than 20 people.

Hamzeh Hassan, a local physician, said he treated four people in the town of Arbeen with wounds from suspected incendiary bombs that left deep burns. One of the survivors was a woman who had to have her arms amputated. At least four people died in that attack, he added.

The Syrian American Medical Society said the incendiary bombs have been repeatedly used in Arbeen over the past week.

The Syrian government, meanwhile, said troops had seized control of Qadam after militants and civilians were evacuated from the district south of Damascus. The government-run Central Military Media said buses and vans carrying more than 1,000 people left for the northern province of Idlib as part of a surrender agreement, including more than 300 militants from the extremist Ajnad al-Sham group and their families.

The Islamic State group controls two pockets of territory adjacent to Qadam. The Central Military Media said the army launched raids on IS-held areas in Yarmouk and Hajar al-Aswad.

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Fraser reported from Ankara, Turkey. Associated Press writers Philip Issa and Bassem Mroue in Beirut, Maamoun Youssef in Cairo and Edith M. Lederer at the United Nations contributed to this report.