MSF urges respect for the safety of civilians safety caught in Sri Lanka fighting

Press release: May 16 2000, Colombo, Sri Lanka - The emergency medical organisation Médecins Sans Frontières (MSF) today expressed grave concern for the safety and medical care of the civilian population in Sri Lanka as a result of increased fighting in the Jaffna peninsula and vicinity. Recent attacks have resulted in civilian casualties. The location of potential military targets next to health facilities further endangers the patients and health personnel and may prevent the access of the civilian population to medical care. The free movement of civilians away from military combat areas should be granted by all parties. The refusal to allow MSF and the Ministry of Health to bring in sufficient medical supplies into the Wanni and Jaffna has made treatment of such casualties especially difficult. One of the military bases in Jaffna is located inside the old hospital compound. Presently the boundaries of the military base is less than 15 meters from the paediatric ward of Jaffna Teaching Hospital. Soldiers regularly go through the hospital on their way out of the military base. The location of other military installations in the peninsula are near displaced camps, schools, health facilities and other places of civilian use. Since May 9th night a curfew was declared in Jaffna and Chavakachcheri Municipalities day and night, it has been lifted some days between 9am and 12pm. Since then and up to May 14th Jaffna Teaching Hospital was not functional for lack of nursing and attendant staff. Only the doctors had passes to go to the hospital. On May 14th, 60 to 70 passes were issued for health personnel to go and work in the hospital. Although now Jaffna Teaching Hospital starts to be operational again, the staff is still insufficient to provide minimum emergency care to the population of Jaffna. On the afternoon of May 12th, jets bombed the fishing village of Pallikuda, near Pooneryn. Five members of one family died immediately, including two children aged three months and two years. Doctors at Mallavi Hospital provided treatment for eleven other victims of the bombing, including four who required life-saving operations. Three of the total were children, one of whom, age seven years, lost an arm. Further treatment was hindered by a critical shortage of medical supplies, especially emergency surgical items, dressing materials and antibiotics. Five patients needing post-operative care were transferred to Vavuniya hospital, a difficult journey that takes at least six hours. According to local villagers, on the morning of May 13th, a boat with 5 fishermen was gunned in a known fishing spot South of Silivaturai (Mannar District) by a Sri Lankan Navy (SLN) patrol. The five fishermen were recovered by the villagers, the patrol of SLN approached the village coast and fired at the village for 30 minutes approximately. Three people on the boat were injured (one 72 years old one 54 and one 47) and brought to Murunkan Hospital and then transferred to Vavuniya and Mannar Hospitals for surgery. On the afternoon of May 15th, three or four shells landed in Columbuthurai West killing five people and injuring six. On May 14th and 15th, there were reports that groups of civilians who wanted to leave Jaffna town were prevented doing so at military checkpoints. Both parties have made appeal on several occasions for civilians to move out of possible target areas, the LTTE for parts of Jaffna and the Sri Lankan Army for major towns in the Wanni (May 15th) . Warning civilians of military operations does not take away the responsibilities of the safety of civilians International humanitarian law prohibits both sides to an armed conflict from indiscriminately attacking the civilian population. It clearly forbids putting civilians in danger by using their presence to shield military objectives from attacks. It also clearly provides for the duty to care for wounded and sick and to allow medical assistance to those in need; MSF strongly urges both the Sri Lanka government and the LTTE to respect humanitarian law, especially those laws protecting the safety of the civilian population. MSF also calls upon the Sri Lankan government to permit adequate medical supplies into the region, to allow emergency civilian treatment to continue at hospitals in rebel-controlled areas and to expedite the transport of these supplies without further delay. Since March, the transportation of medical supplies has been severely restricted by the Security Forces. Over the last weeks, more than 40 patients have had to be transferred or discharged without adequate surgical treatment and more than 3,700 out-patients have been sent home without medication.

MSF in Sri Lanka In total MSF teams in Sri Lanka include 46 expatriates and 140 Sri Lankan national staff. MSF has been present in Sri Lanka since 1986, providing assistance to the civilian population victims of the armed conflict. Up to this month, MSF was running a project in Jaffna Teaching Hospital (JTH) with the provision of two paediatricians and a midwife, presently there are one paediatrician one nurse and one logistician. In Kyats and Chavakachcheri, MSF was running paediatric clinics up to the end of april, in Point Pedro there is a surgical team comprising a surgeon, anaesthetist, OT nurse and medical doctor, as at present there are no fully qualified doctors in Point Pedro Hospital. In Vavuniya, MSF provides a surgeon and an anaesthetist, and is conducting an evaluation to improve surgical care in Vavuniya Hospital. In Madhu, a doctor, midwife, nurse and logistician provide care to assist the displaced population of Madhu and Tatchanamadhu, and ensure referral of patients to Vavuniya or other hospitals. In Murunkan Hospital, MSF has a doctor and nurse to improve the quality of care in the hospital and a logistician to improve the basic facilities of the hospital, notably in hygiene and sterilisation. Mobile clinics are also carried out in remote areas of Mannar District. In Batticaloa, there is a project of surgical assistance with two surgeons, an OT nurse and a logistician to provide rehabilitation of the operation theatre and a mobile team which conducts clinics, in government and LTTE controlled areas of the district with difficult access to existing health structures. In Mallavi, MSF provides surgical, paediatric and obstetric/gynaecology services with the provision of a surgeon, anaesthetist, paediatrician, obstetrician, nurse and logistician. In Puthukkudiyiruppu, MSF works in ante-natal and well-baby clinics to support community health staff with an MSF doctor and nurse.