The limited number of staff available to care for routine cases alongside war casualties has become a critical issue for several hospitals in northern Sri Lanka. In addition, the lack of regular deliveries of supplies from the country’s health ministry has resulted in clinics and hospitals in the Vanni (the four northern districts of Sri Lanka) running out of basic medicines such as paracetamol, antibiotics and vaccines.

By agreement with Sri Lanka’s health ministry, the International Committee of the Red Cross (ICRC) is providing hospitals in Anuradhapura, Batticaloa, Jaffna, Kilinochchi, Mannar, Mullaitivu and Vavuniya districts with medical equipment and supplies for the treatment of sick and war-wounded people. In addition, it has supplied devices to Murankuran hospital to stabilize broken limbs.

The ICRC is also lending its support to the health ministry’s child immunization programmes and to ante-natal care provided for pregnant women in Vavuniya North. Almost 50 children were vaccinated and nearly 20 women received ante-natal care during the month of March.

“We accompany Ministry of Health staff – one doctor and two midwives – to Nedunkerni and Kanakarayankulam, where they run clinics for pregnant women and ensure that children follow the prescribed immunization programme,” says Yvonne Ginifer, an ICRC health delegate based in Vavuniya.

Under international humanitarian law applicable in armed-conflict situations, people not involved in fighting, including the wounded and sick, whether they be civilians or fighters, must be given any medical care they may require as quickly as possible.

Jaffna residents cannot obtain certain health-care services on the peninsula. To ensure that appropriate levels of health care are nevertheless available to them, the ICRC airlifts patients between Jaffna and Colombo twice a week. In March alone, 54 patients requiring specialized surgery, medical tests or treatment, accompanied by 35 caretakers and 10 medical staff from the Jaffna Teaching Hospital, were transported to Colombo on ICRC-chartered flights. In addition, medical equipment, vaccines prescribed for children through the national immunization programme and drugs for pregnant women were routinely transported on Jaffna-bound flights.

“The ICRC flights are a great help for patients, especially those with complicated illnesses. For them, access to appropriate care is a matter of life and death,” says a doctor working at the Jaffna Teaching Hospital who accompanies patients on the flights. Jaffna’s health-service personnel also use the ICRC-chartered aircraft to travel to other parts of the country for their medical training.

“Vaccines must be stored and transported at a certain temperature. The only way to bring them to Jaffna while meeting this requirement is by air. Transporting them by ship is not an option because of the lack of cold-chain facilities and the length of time needed,” says Toon Vandenhove, the ICRC’s head of delegation in Colombo.

Serving as a neutral intermediary at Omanthai crossing point

ICRC staff are on hand six days a week at Omanthai crossing point to facilitate the smooth passage of vehicles and civilians between areas controlled by the government of Sri Lanka and those controlled by the Liberation Tigers of Tamil Eelam (LTTE). In March, the ICRC ensured the safe passage through the crossing point of over 3,000 vehicles and 33,000 civilians, including more than 170 ambulances and almost 900 patients crossing in both directions.

By conveying the remains of fallen fighters across the front lines, the ICRC has helped to clarify what became of many who might otherwise have remained unaccounted for. The remains are transferred only with the agreement of both sides. In March, the ICRC transferred the remains of some 50 fallen fighters from Kilinochchi, Mannar, Vavuniya and Welioya through the Omanthai crossing point. To help preserve the bodies, the ICRC upgraded the cold storage facilities in the mortuary of Anuradhapura hospital and started carrying out similar work in Padaviya hospital.

Protection of civilians and of persons held in connection with the conflict

The ICRC has continued to monitor violations of international humanitarian law affecting civilians throughout the country and to discuss them with the parties to the conflict. There have been regular reports of missing or arrested relatives, extra-judicial killings and ill-treatment.

With the cooperation of both government officials and the LTTE, the ICRC has been visiting a growing number of people arrested for security reasons. The aim of the visits is to monitor treatment and conditions of detention. On nearly 60 visits to 40 places of detention, ICRC delegates met with almost 730 detainees and provided them with recreational items, clothing and toiletries.

The families of more than 400 detainees recently received financial assistance to visit their loved ones in various places of detention. More than 30 released detainees received funds to return home via public transportation.

Restoring family links

In cooperation with the Sri Lanka Red Cross Society, the ICRC has taken steps to ensure that members of families separated by the conflict can maintain contact with one another. It collected over 400 family messages and distributed 230 during the month of March.