Amidst ongoing violence in Sri Lanka, MSF opens three surgical programmes

In July 2006 MSF opened a medical programme in Point Pedro Hospital in the north of the country, but was obliged to close two months later due to visa restrictions and false accusations leveled against MSF in the media. MSF has now been allowed to return to the north of the country, and has sent three surgical teams to hospitals in Point Pedro, Vavuniya and Mannar. Gwenola François, MSF Field Coordinator in Point Pedro, provides this account of the situation since her arrival in December 2006:

© Roland Luzuy

What is MSF currently doing in Point Pedro Hospital?

When we returned to Point Pedro Hospital on December 21 there was no surgeon, no anesthetist and no emergency physician: all of this for a population of 150,000 people living in an area of armed conflict.

The hospital staff was awaiting our arrival and we were able to start surgery the following day. So far our surgeon has carried out 40 interventions, mostly emergencies, as well as many other minor interventions. Our anesthetist also works with the hospital team in the gynaecological and obstetrics ward where 50 interventions, mostly caesareans, have been carried out since we arrived.

Our two priorities in the hospital right now are fixing two oxygen machines and bringing in a doctor for the emergency room. In this way we'll be able to reduce the number of transfers to Jaffna Hospital which is not far from Point Pedro but always represents a risk for the patient. Transfers are also more difficult to organize at night during the curfew, and can be very complicated if the security situation deteriorates.

© Gwenola François

What are the conditions on the whole of Jaffna peninsula?

The peninsula has been practically cut off from the rest of the country since last year when the main highway was closed due to the conflict.

Around 500,000 people live in this enclave, many of them with depleted resources since commerce by land is no longer possible. Access to the peninsula is only by air and sea so most of the supply is carried out by boat, but this can take several months.

If there are delays in the supply of food or other basic items then the situation can deteriorate rapidly for the people. There is also a great deal of violence on the peninsula. Fighting between government forces and the Tamil Tigers, as well as assassinations and grenade attacks have lead many people to flee.

As a result, many medical specialists have fled to Colombo, whilst others are unwilling to come to the peninsula to replace them. For example, there is only one pediatrician for the whole peninsula nearly half a million people.

How has the situation evolved since MSF was in Point Pedro in October?

Before MSF left in October 2006, there had been major fighting in and around Point Pedro there are still incidents, such as mine and grenade explosions, or assassinations. Everyone must be back home for the curfew by 17h00 or by 19h00 depending on the day, so all the shops close by three in the afternoon.

On the other hand, the food situation has improved these past few weeks, as some ships with basic food supplies such as lentils, rice and potatoes arrived recently in Point Pedro. There hadn't been any potatoes in the peninsula for two months, so everyone was talking about it.

The arrival of more food has brought the prices down a little in the market, as it was very expensive before. This may last for some days until reserves run short and provisions may deteriorate again.

In general terms, the relative calm in Point Pedro can change very, very rapidly. Last weekend there was fighting in Point Pedro harbor killing a mother and wounding her two children, so it is a very fragile situation for the people.

Until there is a durable ceasefire I think our work will be absolutely necessary here in order to provide specialized medical care for a population that is going through a very difficult crisis.