International staff: 51
National staff: 230
The 17-year war between the Singhalese government and the northern rebel Tamil army in Sri Lanka is one of the world's most bitter conflicts. The toll on the civilian population has been devastating. Since 1986, MSF has been providing medical assistance to civilians caught in the fighting.
Many Sri Lankans have difficulty reaching medical care, either because of a lack of trained personnel in the north, or because of the danger in crossing the shifting front line. High-altitude bombing by the Sri Lankan forces frequently results in civilian casualties, a situation compounded by difficulty transporting drugs and medical material to facilities in Tamil-held areas.
The Jaffna Peninsula in the north has been the scene of some of the heaviest fighting. In spring 2000, the conflict intensified, and the government restricted the flow of medicines to the region, an act which MSF protested vigorously.
MSF supports pediatric services at the Jaffna Teaching Hospital and provides midwives, nurses and anesthetists to reinforce local medical personnel. A mobile clinic cares for residents outside the main town. At Point Pedro, on the far northern tip of the peninsula, MSF restarted work at the main hospital in January 2000 after an absence of almost three years. Three MSF doctors and a nurse reinforce the sole Sri Lankan doctor.
Below the Jaffna Peninsula, MSF teams are scattered throughout the north. In Mallavi, MSF runs the pediatric, obstetrics and surgical departments in the town's hospital.
In Puthukkudiyiruppu, MSF focuses on mother and child health, providing clinical support to midwives. An MSF mission in Madhu caring for the displaced had wound down in June 1999; however, a fresh military offensive in November caused 17,000 people to seek refuge anew in the town. MSF restarted work in the hospital and also set up mobile clinics.
In Vavuniya, MSF gives surgical support to the hospital. In December 1999, the MSF team operated on 64 wounded civilians here after four rockets hit a church in nearby Madhu, where several thousand refugees were sheltering. Also in Vavuniya, MSF began a mental health program in August 2000 to address the psycho-social needs of people suffering from war-related trauma.
In Murunkan, MSF works side by side with Sri Lankan health workers in the hospital and also runs mobile clinics. In the eastern town of Batticaloa, MSF renovated the surgical unit of the hospital and repaired the roof and walls. Mobile clinics also provide health care to people living in the surrounding area.