As fighting raged earlier this year between the Sri Lankan military and the Liberation Tigers of Tamil Eelam in northeastern Sri Lanka, tens of thousands of civilians were trapped for months in a war zone reduced to a narrow strip of jungle and beach, with no aid and limited medical care. A few months before the final phase of the country’s decades-long civil war, humanitarian aid agencies, including MSF, had to leave the areas most affected by the fighting, at the request of the government. Only the International Committee of Red Cross (ICRC) could continue some crucial medical assistance, evacuating some of the wounded to Ministry of Health hospitals. An MSF surgical team worked since February 2009 in one of these hospitals, in nearby Vavuniya.
In April, thousands of people managed to escape the war zone, many needing health care because of severe shrapnel, gunshot, or landmine injuries. On the 21st April, in just one 36-hour period, more than 400 patients were treated for life-threatening conditions in Vavuniya hospital. In total, from February to the end of June, almost 4,000 war wounded had major surgical interventions in this hospital. The other referral hospitals in the region had also to cope with at least double, or triple, the number of patients they had the capacity for.
In May, just after the end of the government’s final assault, MSF opened a new emergency multi-functional Referral Hospital with surgical facilities in front of the camps in Menick Farm and reinforced the Ministry of Health Surgical and Post Operative care facilities in Vavuniya General Hospital and Pampaimadhu. The medical team also cared for over 60 spinal cord patients in need of rehabilitation.
Government-run camps held up to 280,000 displaced people, the biggest camp being Menick Farm. Inside the camps, access to health care progressively improved, ensured by Ministry of Health. Patients needing hospitalisation were referred to hospitals outside the camp, including the MSF structure. The main cause of hospitalisation among the 3,000 patients admitted to the MSF Menick Farm hospital from June to November was trauma and wounds. In this hospital, MSF treated over 500 trauma cases related to the conflict; over 200 of them needed surgery.
The release of people held in the camps has slowly started since August and families have been gradually leaving the camps in Vavuniya district for their home areas, hoping to rebuild their lives in the aftermath of war. Still many displaced are living with host families in Vavuniya and tens of thousands remain in camps opened since December 2008. MSF works with the Ministry of Health to support the population by providing physical rehabilitation, including reconstructive surgery, and psychological care, in Vavuniya or areas of resettlement.
With its previous experience working in Mannar, Mullaitivu and Killinochchi districts, MSF is ready to support the health system during the period of rehabilitation in the Vanni, where families have started to return.