Sri Lanka’s medical facilities overwhelmed by large influx of wounded

BMJ 2009; 338 doi: (Published 23 April 2009) Cite this as: BMJ 2009;338:b1679
  1. John Zarocostas
  1. 1Geneva

    The health infrastructure of Sri Lanka has been overwhelmed by the large influx of wounded and sick civilians evacuated from the escalating conflict in the north east of the island, Red Cross officials said this week.

    “What we are seeing is intense fighting in a very small area overcrowded with civilians who have fled there,” said Pierre Krahenbuhl, director of operations for the International Committee of the Red Cross.

    “The situation is nothing short of catastrophic. Ongoing fighting has killed or wounded hundreds of civilians who have only minimal access to medical care.”

    “We are extremely concerned about the tens of thousands of civilians trapped in the ‘no fire zone,’” Mr Krahenbuhl told reporters. He said that more than 1000 people had been wounded and were in need of medical treatment or evacuation.

    He said that the Red Cross was worried there could be a big increase in civilian casualties as the final offensive by government forces against Tamil fighters (Liberation Tigers of Tamil Eelam) intensified in the shrinking area along the coast, and called on the warring sides to take immediate action to avoid further civilian casualties.

    Mr Krahenbuhl said that his organisation estimates that about 50 000 civilians, including children, women, and elderly people, were still trapped in 10 to 12 square kilometres and emphasised that their lives were “constantly at risk.”

    He said that the number of wounded had been high and noted that since mid-January the Red Cross could confirm that it had evacuated 10 000 civilians from the Vanni area, of which 60% had been injured.

    Jacques de Maio, head of operations for the Red Cross in South Asia, said that wounded people who had been evacuated had been receiving medical treatment in government hospitals and facilities.

    However, he said that although the medical infrastructure has been trying to cope with the influx of war wounded and sick from the conflict “the system is overwhelmed and not able to manage adequately.”

    The Red Cross, which has 80 international staff and 500 Sri Lankan nationals working in Sri Lanka, including 80 in the Vanni conflict area, noted that it had faced problems in trying to bring in medical supplies.

    “However, it is imperative that independent humanitarian organisations also be allowed to provide desperately needed services and relief for civilians still trapped in the ‘no fire zone’ today,” the Red Cross said.

    Meanwhile, United Nations agencies have also increased their humanitarian operations on the island in anticipation of the expected increase in internally displaced people fleeing the conflict.

    Elizabeth Byrs, spokeswoman for the UN emergency relief coordinator, told reporters aid agencies were preparing “to receive large numbers of IDPs [internally displaced people], in addition to the current caseload of approximately 65 000 people.”

    Ms Byrs said there was also a need to increase hospital capacity and to provide for additional mobile teams and disease control.

    A spokeswoman for the World Food Programme said that the agency was preparing to extend its food supplies for up to 100 000 people.

    Ron Redmond, a spokesman for the UN High Commission for Refugees, said that the government of Sri Lanka had informed the agency that an estimated 40 000 had fled areas where the military and the Tamil army were engaged in heavy fighting.

    He said that his organisation was providing emergency shelter support and non-food aid to the new arrivals.


    Cite this as: BMJ 2009;338:b1679

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