Sri Lanka: High incidence of combat wounds among evacuees

Relief workers in Sri Lanka report hundreds of war wounds among people fleeing the last pocket of the long-running conflict. "There are people with shrapnel injuries, others with limbs that need to be amputated," Sarasi Wijeratne, a spokeswoman for the International Committee of the Red Cross (ICRC), told IRIN. Many of their wounds were either infected because bandages had not been changed or they had not been treated properly with antibiotics, she said. Since February, the ICRC has evacuated more than 13,700 sick and wounded civilians from the rapidly shrinking combat zone along the northeastern coast, where Sri Lankan forces have surrounded the last remnants of the Liberation Tigers of Tamil Eelam (LTTE), who have been fighting for an independent Tamil homeland for more than two decades. However, on 15 May, the organisation announced the temporary suspension of further evacuations. Wijeratne told IRIN: "We hope to restart once security conditions allow." The UN estimates there are about 50,000 civilians still trapped inside the 3 sq km strip of land and has condemned the LTTE for its continued use of civilians as human shields. According to the UN Office for the Coordination of Humanitarian Affairs (OCHA), almost 196,000 Tamil civilians are being accommodated in 43 camps in four districts, including Vavuniya, Jaffna, Mannar and Trincomalee, as of 14 May. "At least one-third of the people we have treated were injured by some kind of weapon," Eric Chevalier, a spokesman for the French Foreign Ministry, told IRIN, referring to a French field hospital in the northern town of Vavuniya where most of the displaced were now staying. Since 28 April, the hospital has treated more than 1,000 patients and undertaken some 140 operations, Chevalier said. Médecins Sans Frontières (MSF) also reported many war-related injuries. "A lot of amputations; some patients have lost both their legs and arms," Paul McMaster, an MSF surgeon working in Vavuniya, said. On 14 May, TEAR Fund, a Christian relief agency, reported it too had witnessed many children with amputated limbs inside the war zone after being hit by shells, with children as young as three suffering gunshot wounds. "Grave concern" The news comes a day after the 15-member UN Security Council expressed its "grave concern" over the humanitarian crisis, and Secretary-General Ban Ki-moon called upon both sides in the conflict to stop using heavy-calibre weaponry, including mortars, in areas with high civilian concentrations. Ban's spokesman said he was deeply concerned by the continued use of heavy weapons in this situation, adding that the "reckless disrespect" shown by the LTTE for the safety of civilians had led to thousands of people remaining trapped in the area. "Although it is impossible to quantify the number of casualties accurately due to lack of access, it is clear that thousands have been killed since the beginning of the year, and that the civilian population is in urgent need of food, medicines and other basic relief supplies, while the evacuation of the sick and the wounded needs to be continued," Stephanie Bunker, a spokeswoman for OCHA, told IRIN from New York. Fewer patients Meanwhile, MSF said the number of patients arriving at hospitals in Vavuniya had decreased from the thousands witnessed in the week after 20 April when more than 110,000 fled the fighting, according to OCHA figures. "The number of wounded arriving directly from the conflict zone at Vavuniya hospital has decreased to barely a trickle: for this last week, 16 wounded patients have come directly from the conflict zone to Vavuniya hospital," MSF said in its latest situation report released on 12 May. "The reasons are that fewer people are able to leave the conflict zone and those who do are being transferred to other hospitals or straight to the camps," it said. The agency said it was planning to set up a field hospital at Menik Farm outside Vavuniya, the largest camp housing more than 120,000 newly displaced. Sri Lanka's Ministry of Health said medical facilities at the camps had been increased with more than 200 doctors and 500 nurses on standby. "We have begun conducting visits to the camps to meet the people and get an assessment of the situation," Palitha Mahipala, deputy director (public health) at the ministry, said from Vavuniya. The establishment of field hospitals such as the one MSF is setting up will help IDPs to receive quick assistance, Mahipala said.