Sri Lanka – Medical and surgical activities assisting populations isolated by the conflict

In Sri Lanka, our teams are present at Point Pedro, in the Jaffna Peninsula, where the population is still isolated by the conflict. In spite of restrictions imposed by the governmental authorities, MSF pursues its activities in a region increasingly affected by war.

The north of Sri Lanka remains a region of intense confrontation between the country's armed forces (SLA) and Liberation Tigers of Tamil Eeelam (LTTE). Recent months have been marked by an upsurge of violence between the two sides. The situation deteriorated further on Wednesday 2 January 2008, when the government officially announced it was withdrawing from the cease-fire signed with the rebels in 2002.

Medical and surgical activities

As the sole international non-governmental organisation present at Point Pedro, less than 20 kilometres from the front line, MSF has put in place medical and surgical services for the isolated populations of this region. The conflict isolates the Jaffna Peninsula from the remainder of the island, and living conditions for some 450,000 inhabitants are those of a militarised zone in conflict: shortage of products, goods and essential supplies; curfew; military convoys...

Additionally, the peninsula's inhabitants are at all times in danger of abduction, summary executions, disappearances and armed attacks. In this context, the MSF teams at Point Pedro staff a hospital serving a population of 113,000. Surgical and medical activities, an emergency unit, and a gynaecology/obstetrics unit have been set up.

The presence of our specialist physicians means that vital care is available to the populations living in and around Point Pedro. The month of November 2007, for example, saw a total of 159 casualty admissions, of which only 17% were transferred to the reference hospital (Jaffna). In addition, 203 surgical acts were performed, 308 gynaecology/obstetrics consultations were held, and 87 births took place.

Restrictions imposed in militarised zone

In the Jaffna Peninsula, the entire population is affected by restrictions, and the free circulation of persons is heavily constrained by numerous checkpoints manned by the armed forces. Nonetheless, MSF staff manage to refer patients from Point Pedro to Jaffna hospital, for those cases not able to be treated locally. Once military authorisation has been obtained, our ambulances perform the transfer, even during military convoys or the curfew imposed on the rest of the population between 7 p.m. and 5 a.m.

However, before being able to enter the peninsula, from now on MSF expatriate volunteers will have to await official authorisations from various ministries. Applications may take up to eight weeks. These restrictions -- imposed lately by the national authorities - greatly hinder our ability to bring quality and continuous care to the populations of Point Pedro.