Letters

Conflict in Sri Lanka

BMJ 2002; 324 doi: http://dx.doi.org/10.1136/bmj.324.7333.361a (Published 09 February 2002) Cite this as: BMJ 2002;324:361

Sri Lanka's health service is a casualty of 20 years of war

  1. Brigg Reilley, epidemiologist,
  2. Isabel Simpson, head of mission,
  3. Nathan Ford, access to medicines adviser (office@london.msf.org),
  4. Marc DuBois, humanitarian affairs adviser
  1. Médecins Sans Frontières, Colombo, Sri Lanka
  2. Médecins Sans Frontières, London EC1R 5DJ
  3. Médecins Sans Frontières, Amsterdam, the Netherlands
  4. Department of Psychiatry, Faculty of Medicine, University of Kelaniya, PO Box 6, Ragama, Sri Lanka

    EDITOR—Sri Lanka's 20 years of war has killed over 60 000 people and displaced hundreds of thousands more. The LTTE (the Liberation Tigers of Tamil Eelam) has been fighting for its own state, resulting in areas of permanent conflict in the north and east of the country. Civilians are caught in crossfire; landmines and unexploded ordnance pose a constant threat; hospitals have been destroyed.

    Médecins Sans Frontières runs a substitution medical programme in the northern rebel controlled area, known as the Wanni, supplying specialists, including a surgeon, a paediatrician, an obstetrician, and an anaesthetist. Most medical professionals have fled: 21 of the 27 vacancies for government doctors in the region remain vacant, and only 34 of the 108 midwife positions are filled (rates of maternal and neonatal death are higher than the national average). Government training of medical workers has not taken place in the region …

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