Feature Article

Doctors call for attack free zones surrounding displaced hospitals

[TamilNet, Tuesday, 13 January 2009, 23:45 GMT]
In a systematic well planned militarily and politically crucial campaign, the Sri Lankan Government directed military forces are pursuing attacks on densely populated areas east of the A9 in Vanni. Often in close proximity to relocated hospitals and camps of the fleeing population, its strategy seems to be one of aerial bombardment followed by immediate ground attacks, involving heavy artillery and mortar attacks that have caused increased civilian casualties. Above statistics and ground reports, echo a plea from government service doctors in Vanni, who have called for 'attack free zones' surrounding displaced hospitals.

A patient being treated outside the makeshift hospital at Visuvamadu Maha Viththiyaalayam School. Hospitals were struggling to cope with the increased number of patients with injuries caused by Sri Lankan artillery shells. Photo taken on 13 January, 2009.

Amidst the escalating military campaign forged by the Sri Lankan military forces through systematic, sustained aerial bombing and ground attacks, an alarming rise in casualties and fatalities is being witnessed by doctors on the ground.

Latest status reports reveal that following attacks on Ki'linochchi and Mullaiththeevu districts, there has been a loss of usable, sustainable facilities in the major District Hospitals of Maangku'lam, Mallaavi, Poonakari (Pooneryn), Akkaraayan and Ki'linochchi. With civilians fleeing east from these areas past the A9 Highway under continuous aerial and artillery barage, the remaining doctors and health workers in government service have had to flee with the civilian population in order to continue servicing their needs and the rising casualties.

Shelling on 13 January, 2009
Puthukkudiyiruppu hospital attacked
Since alternate facilities have not been set up for civilians by the occupying military nor the ICRC, makeshift clinics and arrangements in schools and standing buildings are currently treating the injured in Visuvamadu, Tharmapuram, Kallaa'ru, Punnaineeraavi, Ka'n'nakinakar and Redbarna village in the Ki'linochchi District. Doctors say that these facilities are sparsely equipped and limited in their capacity to provide comprehensive medical care and rehabilitation. Current practices are mainly emergency in nature dealing predominantly with trauma injuries.

According to reliable medical sources, in the period 16th to 31st December 2008 this area alone had 57 admissions with 8 fatalities. Of those injured, 12 were below age 18. Significantly, more males between ages 19 and 60 sustained critical injuries. The increasing intensity of military action has led to 213 casualties including 28 fatalities in these areas alone between 1st and 13th January 2009. More than 10 of those severely injured have been children and youth.

Shelling on 13 January, 2009
Patients were forced to leave the ward and seek shelter fromt he attack at Puthukkudiyiruppu hospital
Reports identify blast injuries, head and neck trauma, spinal and back injuries, loss of limbs and amputations, facial thoracic and abdominal blasts and lacerations, loss of vision and multiple fractures. Many of these patients are non ambulatory requiring critical care facilities and intensive care units. An acute shortage of blood is hampering emergency medical and surgical management of trauma victims.

The greatest number of casualties and injuries were reported on days of aerial bombings specifically targeting Vaddakkacchci, Kanakaambikaikku'lam, and Murasumoaddai areas. These were high density civilian locations where fleeing IDPs had relocated. These targets for aerial bombardment are all within 5 to 10km of makeshift hospitals located in the densely populated areas of Visuvamadu, Tharmapuram and Punnaineeraavi. Repeated statements by Sri Lankan military officials, including the SLA Commander Lt. Gen. Sarath Fonseka, have claimed that civilians will not be targeted in their military operations.

Above statistics and ground reports echo a plea from government service doctors at these locations who have called for 'attack free zones'. As closely followed artillery and shell attacks are adding to the casualty and fatality toll, local doctors have called on the ICRC and the Sri Lankan Minister for Health for urgent provision of supplies of medicines and surgical items, to ensure hospitals are protected from attack and for safe passage and transfer of the injured to Vavuniyaa District Hospital for essential comprehensive medical care. Meanwhile due to the unsustainability of Mullaiththeevu Hospital from previous attacks, Puthukudiyiruppu hospital plus a makeshift hospital at Vallipunam are currently reported to be accommodating patients from the Mullaiththeevu region which is under frequent attack by deep penetrating units from the south.

Visuvamadu hospital
A patient being treated outside the makeshift hospital at Visuvamadu Maha Viththiyaalayam School. Hospitals were struggling to cope with the increased number of patients with injuries caused by Sri Lankan artillery shells. Photo taken on 13 January, 2009.
According to latest reports, fresh attacks east of the A9 have fuelled a massive civilian movement along the roads and are forcing the population to displace again towards Puthukkudiyiruppu. Local health authorities working with poor back up support are expressing fears of fresh outbreaks of communicable diseases as existing amenities and support mechanisms are rapidly being destroyed.

As civilians are under attack and on the run, many are facing psychological and trauma related conditions with most local NGO's being fragmented, overstretched and desperately trying to cope with unprecedented demands.

Severe shortage of vegetables, grain and food supplies is deeply undermining an already struggling malnourished population.

SLA shelling at PTK
Family members and relatives at hospital mortuary
Doctors and humanitarian aid workers who experienced first hand the daunting post tsunami crisis in North east Sri Lanka, fear for the long term chronicity of this current campaign and ensuing medical crisis.

As the situation looks increasingly grim, Tamils across the diaspora are beginning to agitate and protest internationally for an immediate cessation of the military campaign and for international aid agencies to urgently intervene in the massive civilian tragedy that is unfolding. Away from the scrutiny of the international media and observers who have long since been denied access to 'a war behind closed doors', expatriate Tamils feel that the international community needs to urgently cast another eye on not only Gaza but on an equally ruthless bloody war in Sri Lanka that similarly spares none in it's wake.

Civilians displacing towards PTK
Civilians displacing towards Puthukkudiyiruppu. Photographed in Visuvamadu on 13 January, 2009.



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