Sri Lanka: Inside the country

MSF intervenes in the north (Jaffna, Vavuniya, Mannar, Kilinochchi and Mullaitivu districts) and in the east (Batticaloa and Trincomalee) supporting the health care service and filling hospital posts for the many specialists who have fled the war. Years of guerrilla warfare have damaged the public health care service, which although free of charge and properly run, is desperately lacking staff and medicine and medical materials.

The many groups of people who find themselves living in LTTE-held zones have been isolated by war and have little access to health care structures. Until the end of June 1999, MSF provided assistance to people living in Madhu in Mannar district, which was in rebel hands until the end of March 1999. Of the 64,000 people living there, the vast majority are displaced.

MSF runs mobile clinics in the area around Batticaloa town where 200,000 people live in LTTE-controlled territory. In many of the government hospitals in the north and east of the island, there is a serious lack of doctors and paramedical staff. During 1998 and 1999, MSF has supplied many of the big hospitals with staff, namely : Batticaloa Teaching Hospital, Vavuniya Base Hospital, Jaffna Teaching Hospital, Mallavi PU and Mannar Base Hospital. In Batticaloa, Jaffna and Mullaitivu districts, MSF has sent surgeons to carry out operations on war wounded and has hired surgical nurses. MSF teams try to upgrade the health care provided in the northern and eastern hospitals by focusing on hospital hygiene and sterilisation.

Many of the hospitals also lack medicine and medical material, which MSF provides. In Puthukkudiyiruppu and other parts of the north, MSF is also running an anti-malaria campaign in collaboration with the government and is supporting public health activities, focusing primarily on ante-natal and child health care.