Doctor urge Four nations to drop food and Medicine into Sri Lanka

Government officials responsible for food distribution, when contacted by TamilNet, said they only received 60 MT food supplies after 02 April. 2,475 MT supplies are needed for a month for 165,000 civilians according to World Food Programme (WFP) specifications, they said.

The ICRC has responded that it was waiting for Colombo's cooperation in bringing in supply ship. Even the ship that was ready with 1500 MT supplies was diverted to Jaffna, they said.

  A Tamil American doctor and an Illinois legal scholar urged India, the U.S., Britain and France--the nations who can--to air drop food and medical supplies to civilians inside the "safe zone" in northern Sri Lanka. The doctor provided a lengthy description of the public health disaster that is currently going on in the ludicrously named "safe zone." The legal scholar explained that the four countries are obliged under the U.N.'s Geneva Conventions and Protocol to intervene to stop "illegal methods of warfare" and to help the victims.

In her report Dr. Rajaram described the results of malnutrition; bomb blast, shell and gun shot wounds; psychological trauma; lack of preventive health care, and other factors which affect the Tamils encircled in the safe zone.

An urgent need for Intervention

In Srilanka, the escalating war in Northern, Vanni region has caused tremendous burden in the Medical profession.  According to the UN report, over 6,500 civilians have been killed, thousands more injured, and a stream of over 100,000 refugees has recently left their household.  About 165,000 civilians remained trapped in the conflict zone with no access to food and medical care.  About 250,000 civilians have been subject to deprivation of humanitarian assistance and left without food, water, shelter, medical care and clothing.

According to one report all the Hospitals and Primary Healthcare Centers in Vanni have been displaced or destroyed by bombing and shelling. Human rights watch has recorded more than 20 attacks on hospitals and other medical facilities.  The medications, antibiotics, anesthetic medications, oxygen, blood and other medical supplies are not adequately available in the functioning hospitals.  One recent communication from the health care workers requested help from Diasporas to get medications, food and supplies pointed out about the constant shelling and bombing in the safe zone including the hospitals.
 
One report received on 4/29/2009 from a hospital in Vanni to undisclosed recipients said “Mullivaikkal hospital under attack. Today at around 4 pm Mullivaikkal hospital was shell attacked. Ward roof is heavily damaged, 9 patients died and 15 patients wounded. Many patients left the hospital. Today morning ICRC officer visited the hospital at around 11 am”.

As the crisis continues, I like to point out the urgent health care needs.

1. Malnutrition is a major problem as not enough food for the civilians who are constantly on the move and daily shell attacks and bombing.  Children and pregnant women are dying secondary lack of food and nutrition and preventable complications of pregnancy.

2. Diarrhea illness: Water is in short supply and sanitation is poor for the civilian’s overcrowded areas and existing hospitals causing outbreaks. Lack of intravenous fluids, medications, medical personal to care for the patients are major contributing factors.  Deaths have been reported due to diarrhea.

3. Respiratory infections are on the rise:  Use of chemical bombs, phosphorous bombs, cluster bombs and poisonous gas has been reported by civilians in the U tube videos recently. One report said the use of poisonous gas has caused the civilians to be unconscious for more than 90 minutes and when they regain consciousness, they were able to drag themselves to the water and felt like burning sensation in the body with intense feeling on the face requiring rolling on the sand to get relief. Long term sequels of this exposure to chemicals and gases are chronic pulmonary diseases and death. Until the contents of the heavy weapons used and gases and chemicals used in the war by the military it is difficult to predict the outcome.

4. Psychological trauma:  The impact of this war has caused major psychological trauma to the victims. There have been several reports of women being raped by the military on a regular basis. One report suggested all the women and young girls brought to the Vavuniya hospital were raped and they have several bite marks all over the body. They reported of being taken by the military for inquiry and raped when arrived to the displaced camps.  There have been mass rapes daily according to the reports.

Sexually transmitted diseases and HIV and AIDS are major risks for these young girls and women raped by the military. There is no testing or treatment available for the victims. There family structure is destroyed.  These women are usually not accepted by the family which will cause major burden to the victims and society in the future. They have constant fear and some victims are subject to repeated abuses.  Unwanted pregnancies of raped victims are another major problem.

Most of the internally displaced people have been severely traumatized due to continued shelling and bombing and have seen family members and friends killed or brutally injured. Children are is state of shock and panic.
The pictures and report received on April 29, 2009 from an unidentified cook for the military felt the psychological trauma and human rights violations on going in the Kilinotchi area to the young people need some intervention. He sent pictures and a note saying there are several young men and women and children between ages 15-35 are kept in prison like set up in several houses. These are innocent civilians, 2 people are tied together in the hands and legs, nude and left on the floor, so they will not run away. They are given one day a meal and kept naked tied together. The psychological trauma of this type of abuse is tremendous and these youths cannot lead a normal life if ever get released. They will suffer from post traumatic stress disorder to the highest intensity until their death. The illnesses they are going to get from constant mosquito bites are malaria and encephalitis. This area Malaria is endemic and has reported cases of cerebral malaria as well in the past. These torture camps need to be stopped immediately and the concentration camps need to be stopped as well. The civilians need to be allowed to have communication with their families, friends and not to be bar wired and kept under military control for rehabilitation. There is a tremendous need for psychological rehabilitation to the civilians in massive quantity.

5. Breakdown of psychiatric illness and depression: This is on the rise due to fear and depression, unable to have normal family structure and living conditions escalate the psychiatric illnesses and depression.

6. Bomb blast, shell and gun shot wounds with deaths and disability. Hospitals are not able to continue surgeries and treatment. People are left with wounds unattended and partially treated. There are not enough facilities in vavuniya hospitals to accommodate the massive displacement and causality.

7. Lack of preventive health care: Since it is a massive displacement and destruction of normal living conditions, health care infrastructure is destroyed in the area, only the immediate needs are being addressed partially, all the preventive aspects of health being ignored. Vaccinations to children, maternal care, nutrition, education and care for the disabled and elderly are not available.

8. With the ongoing bombing and shelling there is no evaluation done about hearing loss, vision loss and disabilities yet. There are not adequate staffs, not enough reporting or accountability of the disaster and destruction on going at this time.

9. One report from the Mullatheevu district hospital said “Famine deaths among Internally Displaced Camps (IDP’s) in Vanni”. People in Vanni have been facing the threat of losing their lives to hunger. The plight is shocking to note that bodies of 13 people who died due to starvation, including that of elders and children, have been brought to Puthumathalan hospital during past few days. Beside the acute shortage of stable food items and extreme escalation of prices of available food items, many IDP’s have been forced to resort to alternate, unfamiliar food items such as strange leaves and clams. Six people belong to single family was admitted to the hospital in severely dehydrated, shocked condition following vomiting after ingesting some unfamiliar leaves”.

10. Bomb blast, shell and gun shot injuries: According to one report released Sri Lankan Air, Sea and Ground Forces joined brutal attack on Vanni, 143 Slaughtered and 350 severely wounded. In Mullaithivu district where displaced people were living Mathalan, Ambalavanpokkanai, Valagnarmadam and Mullivaikkal areas from the dawn of Friday morning till late evening. The ground, air and sea forces of the Sri Lankan Government concurrently did this attack. In the above attack 98 Tamils were brutally killed and 265 severely injured (Friday, February 27, 2009: 07:25 pm Puthinam Vavuniya).
These victims who survived need treatment surgery and rehabilitation, but not enough facilities available to care for this magnitude of casualties in a small hospital.

11. According to Mercy Corps report (http://mercycorps.org/node/15576):
An estimated 190,000 Sri Lankans are living in camps located in government-controlled areas; at least another 50,000 remained trapped inside the conflict zone, according to the UN. Families escaping the area face overcrowded camps with "overwhelmed” health facilities and a lack of water and sanitation, according to the UN. In the area most densely settled with displaced families in Vavuniya, an average of 18 persons are crammed into tents designed for a family of five, according to the UN's humanitarian team.

One report received from Relief International (www.ri.org ), a global humanitarian organization that focuses on the transition phase between relief and development in over 20 countries around the world. In Sri Lanka, they reported as working with microfinance and livelihoods in the Eastern province and providing psychosocial services to schools in the Vavuniya District of the Northern Province. They confirmed the critical humanitarian crisis that is presently in Sri Lanka’s North. RI is currently working in four transit camps and has daily access to provide items as well as child friendly activities.