"MSF worked in Sri Lanka during 17 years of war, but we have never seen a situation like this." – Judith Soussan, MSF head of mission in Sri Lanka

Since August, major fighting in northeastern Sri Lanka has forced more than 200,000 persons to leave their homes. It has become increasingly difficult to deliver aid to populations affected by the conflict and several regions have been cut off entirely from outside aid. Judith Soussan, Doctors Without Borders/Médecins Sans Frontières (MSF) head of mission in Sri Lanka, elaborates.

What is the situation today for people living in the conflict areas?

They have become isolated in combat areas, where bombing is often very intense. As a result of insecurity and a blockage of humanitarian aid very little assistance is reaching residents. This is particularly serious in the areas controlled by the Tamil Tigers (the Tamil rebels). The Sri Lankan government will not authorize any humanitarian groups to enter the area. In the eastern part of the country, we can no longer provide aid because of that lack of authorization. However, there are at least 40,000 displaced persons in the area under Tamil Tiger control, which is close to regions still experiencing bombings. This population is completely deprived of aid and cannot flee.

We have managed to open a project only in the Jaffna peninsula, where major fighting has occurred since August 11. This area was already dangerous, with several people killed every day, but the situation has worsened sharply. Bombing occurs regularly, leading to the displacement of 50,000 people on the peninsula, out of a total of 500,000. Simultaneously, access to the peninsula remains blocked. The road is closed and air and water traffic have been nearly shut down as a result of restrictions imposed by the rebels and Sri Lankan authorities. The price of food has already quadrupled and the shelves have been stripped of basic necessities as the population tries to stock up. If this blockage continues for several more weeks, there will be nothing left—and, particularly, no food. In addition, the curfew limits hospital access and is lifted for only a few hours each day.

What is MSF doing in the Jaffna peninsula?

A three-person team is working in the Point Pedro hospital, primarily in the emergency room. But although MSF has managed to maintain a presence in the hospital, our activities remain very limited. An MSF surgeon and an anesthetist have been blocked in Colombo for three months for lack of authorization, and there is no surgeon at the hospital. As a result, we have to refer our patients to the Jaffna hospital for surgery. However, we are very frustrated by the transfer process as the Ministry of Defense will not allow our doctor to accompany patients in the ambulance. Even our movements within the peninsula are limited.

How do you analyze the restrictions that constrain aid operations?

Lately a wave of radicalism is dominating the country. Sri Lankan politicians and media outlets accuse international organizations of supporting the Tamil rebellion. As a result, some authorities seek to evict humanitarian groups from conflict areas. However, many hospitals that fall under the Ministry of Health have requested our help. In addition, the killing of 17 ACF (Action Contre la Faim) members in the eastern part of the country is an unprecedented crime against the humanitarian community in Sri Lanka. This crime, which remains unsolved, shows the extent to which the people's right to receive aid has been disregarded. MSF worked in Sri Lanka during 17 years of war, but we have never seen a situation like this.