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Sri Lanka's Genocidal War - '95 to '01
"French medical agency Medecins Sans Frontieres (MSF) say in a statement that there are increasing health risks to the civilian population in the Vanni because of shortage of medical supplies, food and shelter. During November, civilian deaths in Vannis Mallavi hospital, where a MSF team works, were at a higher level than at any time in 1999.
The mortality rate among the 710 patients admitted was 4%, while the rate for children under 12 years was 6.5%. Some 150 civilians were admitted to the surgical ward, but only 46 major operations were carried out because of lack of medical supplies. Eight civilians died in November from shell blast injury, including two following surgery. Seven children under the age of 12 died in the hospital in November. The wet season has caused increase in malaria and respiratory infections and essential paediatric medicines to treat these diseases are no longer available.
MSF says that beyond security restrictions in the course of the war, unnecessary obstacles are placed creating difficulties for humanitarian assistance and medical evacuations.
Since 2 November, there has been no access to Kilinochchi and Mullaitivu districts across the frontline. The Sri Lankan security forces issued warnings to international agencies that there would no longer be security guarantees within the Vanni and asked them to keep away from LTTE installations, although the agencies are unaware of their locations. MSF further says that approval given by Colombo for supplies to the Vanni have been blocked in Mannar or Vavuniya by the local commands. Inconsistent messages from the Army and the LTTE regarding movement of supplies and personnel across the frontline, lead to confusion, affecting humanitarian intervention." (British Refugee Council Sri Lanka Monitor, November 1999)