Tens of thousands of people confined to a rapidly-shrinking area have headed for the coast to escape the fighting, in search of safety, food and medical care. But numbers in the coastal belt held by the LTTE have increased drastically over recent weeks, and clean water is scarce. The area is affected by shelling every day, and the cramped conditions and the lack of water and proper sanitation are putting people at risk of epidemics.

"The humanitarian situation is deteriorating by the day," said Paul Castella, head of the ICRC’s Colombo delegation. "Many of these people are forced to shelter in trenches. They are in considerable physical danger. After having been forced to move from place to place en masse for weeks or even months, they depend entirely on food from outside the conflict area."

The sick and wounded continue to arrive at Putumattalan, where local people have helped set up a makeshift medical facility in a community centre and a school. Medical staff from the ministry of health do their best to cope with a constant influx of people injured by the fighting, but there are not enough medical supplies to meet the needs.

With the agreement of the government and the LTTE, the ICRC has continued to evacuate patients from Putumattalan (which is in the LTTE-held area) to Trincomalee (in the government-held area). The ICRC-chartered Green Ocean ferry has evacuated over 4,000 sick and wounded people, together with their carers, since evacuations started on 10 February. The evacuees included over 1,400 people in need of surgery, so an ICRC medical team consisting of a surgeon, an anaesthetist and a nurse are helping Trincomalee Hospital to handle the influx.

Since mid-February, the ICRC has on 12 occasions facilitated the movement of food shipments from Trincomalee to Putumattalan, delivering a total of over 700 tonnes of flour, dhal, sugar and oil provided by the government and the World Food Programme. On three occasions it was possible to deliver some medicines provided by the ministry of health, but the quantities were too limited by comparison with the needs.

"With patients continuing to arrive at the improvized medical facility in Putumattalan, it is essential that evacuations take place regularly and without interference. It is encouraging to see food and medicines going into the conflict area, but they must be delivered regularly if they are to have an impact," said Morven Murchison, who coordinates the ICRC's health activities in Sri Lanka.

The civil and military authorities have helped with the medical evacuations and the food shipments, as have local people. Offloading food onto the beach in Putumattalan may involve up to 275 people transporting the food in fishing boats and carrying it ashore. These are dangerous and complex operations. The fighting is one hazard, but bad weather and heavy seas often make things worse.

With the help of the Sri Lanka Red Cross Society, the ICRC was able to give 130 sick and wounded evacuees personal hygiene kits, emergency household kits, kitchen utensils and baby-care parcels. These people received medical treatment at hospitals in Trincomalee and Vavuniya.

ICRC staff member killed

ICRC employee Vadivel Vijayakumar was killed by shelling on 4 March just north of Valayanmadam, on the coastal belt of the territory held by the LTTE. His nine-year-old son was injured in the same incident. This is the second time in less than three months that an ICRC staff member has been killed in Sri Lanka. Mr Vijayakumar leaves a wife and three children.


Acting as a neutral intermediary between the government and the LTTE

The conflict has disrupted traffic through Omanthai, formerly the only crossing point between government and LTTE areas, However, in January the ICRC facilitated the passage of 360 civilians, including 70 patients seeking treatment in Vavuniya hospital and nearly 125 vehicles, including ambulances. ICRC staff also transported the bodies of 100 fighters over the same period, 99 of them in January. The last ICRC-escorted land convoy took place on 29 January. Since 10 February, the ICRC has been facilitating the movement of the sick, the wounded and humanitarian aid between the LTTE- and government-held areas by sea.

Emergency aid for villagers following attack

An attack on a village in Ampara district in February left 14 dead and 10 injured. The ICRC provided a total of 143 families with personal hygiene kits and baby care parcels, while 20 families displaced by the attack received basic household requisites. Five families whose houses had been burned down in the attack also received a tarpaulin, kitchen utensils and a kerosene cooker.

Protecting civilians and detainees

The ICRC continues to monitor allegations concerning violations of international humanitarian law affecting civilians throughout the country. In January and February, over 3,900 people contacted the organization with allegations concerning missing persons, arbitrary arrests, recruitment of minors, unlawful killings and ill-treatment of civilians by arms bearers. In order not to endanger the people reporting such violations, ICRC staff discussed their reports bilaterally with the parties involved.

With the cooperation of government officials and the LTTE, the ICRC has been visiting people arrested in connection with the armed conflict to monitor their treatment and conditions of detention. ICRC delegates held private talks with over 1,400 security detainees in over 70 places of detention throughout the country and provided them with clothes, toiletries and recreational items. The ICRC paid for 10 detainees to return home by public transport after release, and for the families of 635 detainees to visit their detained relatives.

Working with volunteers from the SLRCS, the ICRC has been providing water and sanitation facilities for displaced persons in transit centres in Vavuniya and Jaffna. Over 150 toilets have been built, along with tanks to store water.