Sri Lanka 1998

International staff: 37 National staff: 126 Victims of war and embargo As Sri Lanka celebrated 50 years of independence in February 1998, fighting continued between government troops and the LTTE force seeking autonomy for the Tamil people. MSF works in both government- and LTTE-held territory. A major problem is a military embargo that includes drugs and medical materials. MSF therefore advocates strongly for sufficient medical supplies to continue its work. MSF is responsible for surgery, paediatrics and gynaecology/obstetrics in Mallavi hospital with 132 beds (and 80-100 patients on the floors). This is the referral centre in Vanni region for an estimated 450,000 civilians and lies only 12-15 kilometres from the main battlefield. Another team runs surgery and anaesthesia in Mannar hospital, serving around 300,000 civilians. Both teams also deal with large numbers of civilian war-wounded. MSF is in charge of surgery and paediatrics in Batticaloa hospital (3,400 interventions annually) and had charge in Jaffna until May 1998. Surgery and anaesthesia are also run by MSF in Vavuniya hospital, the largest referral centre in the northern region (2,200 surgical interventions annually). MSF expanded its work in the Tamil IDP camps in Madhu and neighbouring villages where a supplementary feeding programme was required to deal with rising malnutrition levels. Teams provide preventive and curative activities from a 27-bed rural hospital and mobile clinics. Another mobile clinic set up to serve Tamils in villages around Batticaloa is functioning well (51,000 consultations annually).