Sri Lanka: Situation update

Médecins Sans Frontières field hospital, close to Manic Farm. 30/05/2009.
© Anne Yzebe / MSF.

Médecins Sans Frontières is still providing surgical and medical health care to the displaced people in Vavuniya district, northern Sri Lanka. Some war wounded need specific medical care, like orthopaedic surgery, and around 95,000 people remain in Menik Farm camp. Additional medical capacities could be needed in the areas of return, as a result of the resettlement process.

After the release of the last 125,000 displaced people remaining in Menik Farm camp, in northern Sri Lanka, on 1 December, the Médecins Sans Frontières team working in the hospital nearby noticed that many of the displaced intended to stay in the camp until they would be resettled. A few thousand left the camp with their temporary pass, mainly to look for family in the close area. Most of them did not leave. The majority of the displaced has no resources and depends on aid to move and to rebuild their lives in their home areas.

During the last months, tens of thousands of displaced have been resettled in other districts, mainly Jaffna and Mannar. Return has started in a few villages in the Vanni, the former war zone, an area where most of the health structures were damaged during the conflict.

Medical needs gradually shifting from Vavuniya district to resettlement areas
Médecins Sans Frontières has been discussing with the Ministry of Health the medical support it could provide in the areas of return. In Jaffna peninsula, where tens of thousands of displaced people have recently arrived from Vavuniya camps, Médecins Sans Frontières has been working with the Ministry of Health in Point Pedro hospital for years. In the Vanni, Médecins Sans Frontières has previous experience working in Mannar, Mullaitivu and Killinochi districts.

Restoring the health services after years of conflict represents a huge task the health authorities have shown willingness to respond to. As more people return to these areas, Médecins Sans Frontières expects demands for health care services to increase and is ready to support the health system during the rehabilitation period.

Surgical activity for war wounded is not over
Orthopaedic and rehabilitation care remain a main medical priority identified by both the College of Surgeons of Sri Lanka and the Médecins Sans Frontières teams in the General Hospital of Vavuniya and in the Médecins Sans Frontières hospital. Over 50 spinal cord injured patients are treated in Pampaimadhu Ayurvedic hospital and rehabilitation care started one month ago.

During the last six months, one of the main tasks has been to provide surgical care to some of the thousands of war wounded, complementing or within Ministry of Health hospitals. The main cause of hospitalisation among the 3000 patients admitted to the Médecins Sans Frontières hospital from June to the end of November is trauma and wounds. In this hospital, Médecins Sans Frontières has treated over 500 trauma cases related to the conflict. More than 200 of them needed at least one surgical intervention, for example to remove shrapnel pieces.

Consultations and mental health care in Vavuniya
In total, over 1350 surgical procedures have been performed between June and the end of November in the Médecins Sans Frontières hospital.

The number of hospitalisations is quite stable at around 150 per week. The majority of the patients hospitalised come from all the zones of Menik Farm. They are referred by the Ministry of Health medical staff, who works in the medical structures in the camp.

There has been a constant increase in the number of consultations for outpatients, with an average of 750 consultations per week since August. People also came from Menik Farm village in the last weeks. The main morbidity as indicated by the outpatient clinic is respiratory tract infection (20% of the cases), while almost a quarter of the patients come for wound dressing.

Since November, Médecins Sans Frontières specialists have worked with the College of Psychiatrics of Sri Lanka and the Ministry of Health in order to provide qualified mental healthcare for people traumatised by war. Seven months after the end of the fighting, it is urgent that the population who was in the Vanni gets effective access to most needed psychiatric and psychological care, not only in hospital.

Besides, Médecins Sans Frontières is also responding to some gaps in the global aid provided in the camps in Vanuniya district, including supplementary feeding programs for vulnerable members of the population and supplying drinkable water in some zones. Teams have worked on emergency preparedness in coordination with the Ministry of Health in case of epidemics during the monsoon.