In Sri Lanka, our teams are present at Point Pedro, in the Jaffna Peninsula, where the population is still isolated by the conflict. In spite of restrictions imposed by the governmental authorities, MSF pursues its activities in a region increasingly affected by war.
The north of Sri Lanka remains a region of intense confrontation between the government's armed forces (SLA) and Tamil Tiger rebels (LTTE). Recent months have been marked by an upsurge of violence between the two sides. The situation deteriorated further on Wednesday January 2, 2008, when the government officially announced it was withdrawing from the cease-fire signed with the rebels in 2002.
Medical and surgical activities
As the sole international non-governmental organisation present at Point Pedro, less than 20 kms from the front line, MSF has put in place medical and surgical services for the isolated populations of this region. The conflict isolates the Jaffna Peninsula from the remainder of the island, and living conditions for some 450,000 inhabitants are those of a militarised zone in conflict: shortage of products, goods and essential supplies; curfew; military convoys...
In addition, the peninsula's inhabitants are, at all times, in danger of abduction, summary executions, disappearances and armed attacks. In this context, the MSF teams in Point Pedro staff a hospital serving a population of 113,000. Surgical and medical activities, an emergency unit and a gynaecology/obstetrics unit have been set up.
The presence of our specialist physicians means that vital care is available to the populations living in and around Point Pedro. The month of November, 2007, for example, saw a total of 159 admissions, of which only 17 percent were transferred to the Jaffna reference hospital.
In addition, 203 surgical acts were performed, 308 gynaecology/obstetrics consultations were held and 87 births.
Restrictions imposed in militarised zone
In the Jaffna peninsula, the entire population is affected by restrictions, and the free circulation of persons is heavily constrained by numerous checkpoints manned by the armed forces.
Nonetheless, MSF staff manage to refer patients from Point Pedro to Jaffna hospital, for those cases cannot be treated locally. Once military authorisation has been obtained, ambulances perform the transfer, even during military convoys or the curfew imposed on the rest of the population between 19:00 and 05:00.
However, for our expatriates to reach the field, the whole process of obtaining visas and various official authorisations from different ministries can take up to eight weeks. These restrictions - imposed lately by the national authorities - greatly hinder our ability to provide specialists in time for the Point Pedro hospital.