"There are 150,000 people crammed into a 20km square stretch of coastline and jungle. They are crowded together with only extremely basic shelter. They don’t have enough food, drinking water or medicines. On top of all this the monsoon has started and they are living in water up to their knees. They are surrounded by continuous fighting, smoke, shelling and bombing. So they spend a lot of their time in bunkers, and by that I mean they are lying down in ditches. People have told me that they have spent hours, or even days on end, lying in these bunkers or ditches."
A boy in Pmpaimadu camp, one of the 15 camps around the city of Vavuniya where MSF works, distributing food and other basic relief goods. Feb 2009.
Anne Marie Loof has just returned from Vavuniya, northern Sri Lanka, where she worked for international medical charity Médecins Sans Frontières (MSF). Forced to withdraw from the northern Sri Lankan conflict zone, known as the ‘Vanni’, in September 2008, MSF has been working in nearby Vavuniya province to help terrified civilians who have managed to escape the escalating violence.
“Some of these people have been shot at while trying to escape the fighting,” continues Anne Marie. “But the only clinic left in the Vanni has run out of drugs and bandages; the wounded have to wait for the International Committee of the Red Cross (ICRC) boat that comes every two to three days to evacuate the worst cases; but even if they get on board, the journey to hospital can take several hours. Of the people who make it to Vavuniya hospital, where we work, many have gunshot or shrapnel wounds to the arms and legs. We think that means the ones with head and chest injuries simply didn’t make it out alive.”
More than a thousand patients are now crowded into Vavuniya hospital, which has a 400-bed capacity. The lucky ones share beds; others line the floors and corridors. The MSF surgical team is working alongside Ministry of Health staff to perform more than 200 surgeries a week – 90% of patients who have managed to escape the conflict zone have war-related injuries.
Some 65,000 people have escaped the Vanni to Vavuniya so far, but now find themselves confined to ‘welfare centres’, schools and other public buildings that have been converted into overcrowded camps. Many families who escaped the fighting have been separated among the 13 welfare centres. They have no freedom of movement and no way of contacting one another; they have no idea whether relatives they left behind in the Vanni are alive or dead and no word of friends and family who escaped weeks earlier. They have no idea how long they will have to stay in these welfare centres.
The only way to get news from one camp to another is by shouting through the two layers of barbed wire that surround these camps to the local population, who is also desperate for news from friends and family caught up in the fighting.
Everyone who has escaped the conflict has experienced some form of trauma – witnessing the death of a relative or friend; watching people shot at or caught up in shelling; spending hours at a time sheltering from the fighting in roughly dug bunkers. Now trapped in welfare centres, the emotional and psychological toll on these people is enormous.
MSF is providing extra food for children under five and pregnant and breastfeeding women in the camps. However, since September 2008 we have had no direct access to the population who remain in the conflict zone and who are most in need. We are completely helpless to assist these people as long as restrictions on access remain.