BEIRUT/ANKARA (Reuters) - Sick and injured civilians left a rebel enclave in Syria’s eastern Ghouta on Tuesday under the first medical evacuation since one of the deadliest assaults of the seven-year war began nearly a month ago.

In another sign of success in the government’s mission to retake all rebel-held territory near the capital, the army also evacuated hundreds of fighters and their families from a separate small rebel-held pocket south of Damascus.

In the north of the country, on another main front, Turkey’s military said it had encircled the town of Afrin, a big advance in its offensive against Kurdish fighters. Government forces also pounded a rebel-held area in the south for a second straight day, potentially reopening yet another front.

The developments show how the map of control in Syria has been changing in recent weeks, with Turkey and Russia both pressing their advantages since the self-proclaimed caliphate of the Islamic State jihadist group largely collapsed last year.

International attention has been focused in recent weeks mainly on the plight of civilians in eastern Ghouta, where the United Nations believes 400,000 people have been trapped under punishing bombardment, deprived of food and medicine.

Women carrying infants, men hobbling on crutches and an old man in a wheelchair waited at a school near the al-Wafideen crossing, along with dozens who exited the enclave through it, a witness said.

The Syrian Observatory for Human Rights war monitor said more than 150 civilians left eastern Ghouta on Tuesday, as air strikes and shelling of the area continued.

During the army’s offensive, more than 1,100 civilians have died, the U.N. Office of Humanitarian Affairs says. President Bashar al-Assad, whose forces have recaptured most towns and cities in Syria’s heavily populated west, has vowed to reassert his control over every inch of the country.

The government assault on eastern Ghouta has become one of the bloodiest of the war, with rebels on course for their worst defeat since the battle of Aleppo in 2016. The U.N. Security Council has demanded a 30-day ceasefire, but Moscow and Damascus say it does not apply to banned terrorist groups in Ghouta.

They have offered to evacuate civilians and rebels who agree to withdraw from the area, but so far the main insurgent groups have said they intend to stay and fight to the end.

SAFE PASSAGE

The government tactic of offering safe passage to rebels who agree to surrender territory played out on Tuesday nearby in al-Qadam, south of the capital, one of the few areas near Damascus apart from eastern Ghouta still in insurgent hands.

Military Media, a news outlet controlled by Lebanon’s Hezbollah group allied to Damascus, said buses had transported around 300 fighters from the Ajnad al-Sham group and their families to rebel-held Idlib province in the north.

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The Observatory said hundreds of fighters had left on buses over the past 24 hours.

Al-Qadam is surrounded by government-held territory on one side and Islamic State-controlled neighborhoods on the other. The Observatory said there was fighting between government forces and Islamic State fighters in that area.

In eastern Ghouta, Russian-backed Syrian forces have captured swathes of the pocket of satellite towns and farmland, splintering it into three separate zones in recent days.

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Yasser Delwan, a political official with the Jaish al-Islam rebel faction, said the patients who left the town of Douma on Tuesday were the first of several groups and were on a U.N. list of nearly 1,000 people needing emergency treatment.

State media said others followed the first group, which included about 35 people. They would go to a shelter nearby on the outskirts of the Syrian capital Damascus.

State TV accompanied some evacuees and broadcast interviews in which they said rebels had blocked them from leaving.

Moscow and Damascus say their forces only target armed militants and seek to stop mortar salvoes by insurgents that killed dozens of people in the capital. They accuse the rebels of using civilians as human shields, which the fighters deny.

Troops pressed on with the assault on Tuesday and took some farmland around the town of Jisreen, Hezbollah’s Military Media reported. The Civil Defence in Ghouta, a rescue service in rebel territory, said air strikes hit Jisreen, Zamalka, and Irbeen.

TURKEY CLOSES IN ON AFRIN TOWN

Turkey’s military and its rebel allies have encircled the northern Syrian town of Afrin, the Turkish armed forces said on Tuesday, a substantial advance in Ankara’s offensive against Kurdish fighters across its southern border.

Turkey launched its operation “Olive Branch” in northern Syria nearly two months ago to sweep the Syrian Kurdish YPG from the Turkish border. Turkey sees the YPG as a terrorist group and an extension of the outlawed Kurdistan Workers Party (PKK).

The Observatory said Turkish forces and their Syrian militia allies had encircled 700,000 people in Afrin and nearby areas.

Redur Xelil, head of foreign relations for the Syrian Democratic Forces, a U.S.-backed bloc including the YPG, accused Turkish forces of carrying out “demographic change” by settling Turkmen and Arab families in Kurdish areas captured in Afrin. A senior Turkish official denied this as “absolutely false”.