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MSF in Sri Lanka, 2008
Field Staff: 128
Reason for Intervention:
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The conflict between the Sri Lankan army and the Tamil Tiger rebels (LTTE) escalated in 2008. In January, the government pulled out of the six-year ceasefire between the two parties and stepped up its military attacks against the LTTE, progressively regaining control of key rebel-held territories in the north of the country.
Heavy fighting resumed on the front lines and added to the plight of civilians who had already been oppressed for years by various militia groups operating with impunity. Subject to abductions, unlawful executions, arbitrary arrests, and restrictions of movement, people lived in a constant state of fear and intimidation, which seriously limited their access to health care.
In 2008 MSF supported local hospitals in the government-controlled areas close to the conflict in Point Pedro, Vavuniya, and Mannar. MSF also worked in Kilinochchi, in the Vanni, an LTTE-held territory, until the government ordered all NGOs to leave the conflict area in September 2008. The projects offered medical and surgical support, obstetric and gynecological treatment, and emergency care. In 2008 MSF conducted 2,550 deliveries and assisted in 1,885 surgical interventions in partnership with the Ministry of Health. MSF has been asking the authorities for access to the area since it was expelled, to provide medical assistance to the thousands of trapped civilians.
In Point Pedro, at the northern tip of the Jaffna Peninsula, the hospital serves a population of 100,000 people but lacks qualified health specialists, medical equipment, and drugs. Security restrictions on movements impede the referral of patients; Jaffna teaching hospital is the only facility for referral. Antenatal and surgical consultations were conducted in two other local hospitals in partnership with Ministry of Health staff. MSF trained the hospital staff to be prepared for mass casualties, in emergency medical and paramedical care, and gave specific nurse training on hygiene, dressings, and patients observations.
In Vavuniya district, MSF has been supporting the general hospital since 2006 with medical specialists including at different times surgeons, anesthetists, and lab technicians. A general nutritional assessment was conducted in the district and more than 150 children were treated in MSF’s mobile feeding program. MSF has also been supporting a local NGO specializing in mental health by training its staff and offering clinical supervision to improve the quality of care available.
Until September 2008, MSF worked in Kilinochchi, in the LTTE-controlled area. Most of the people in the conflict area had to flee their homes and live in basic conditions. In November, heavy flooding destroyed paddy fields, which led to further deterioration of living conditions in the Vanni. Floods also displaced thousands of people in Point Pedro. MSF set up an emergency response and distributed relief items such as food, blankets, and buckets. MSF’s surgery and emergency obstetric care in Mannar hospital was closed in December 2008.
MSF has worked in Sri Lanka since 2007.