A senior United Nations official has raised concerns about children awaiting evacuation from the rebel-held area of Eastern Ghouta, near Syrian Capital Damascus, being used as bargaining chips, the BBC reported on Thursday.

Jan Egeland, the chairperson of the UN Task Force on Humanitarian Access in Syria, said the deal that rebels and the forces of President Bashar al-Assad reached would fail if the rebels are forced to release government workers in exchange for the children.

About 4,00,000 residents have been living under a siege by government forces since 2013.

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“Let us hope that the agreements are good when they come,” Egeland told the BBC. “There can also be bad agreements. It is a not a good agreement if they exchange sick children for detainees that means children become bargaining chips in some tug of war.”

Four patients were evacuated on Tuesday, and another 12 patients were taken to safety on Wednesday. Thirteen more urgent cases are expected to be evacuated on Thursday.

Mohamad Katoub, a doctor with the Syrian American Medical Society, said that things were moving slowly for those who require urgent medical attention. “The last one was a girl from the list,” he said. “This morning [Wednesday], when the local staff reached the family to tell them that finally the approval to evacuate your little daughter arrived, the family said that their daughter died a few days ago.”

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Egeland said that Eastern Ghouta had very little medical facilities left. “Too many hospitals have been bombed, have been hit on both sides, hundreds of doctors and nurses have been killed or wounded so what is left in Eastern Ghouta for the 400,000 civilians is not that much,” Egeland added.

The Syrian Red Crescent said the evacuations were the result of “long negotiations”. On Sunday, Turkish President Tayyip Erdogan said Turkey was working with Russia to enable the evacuations.