IDPs in Sri Lanka: An eyewitness report

Exploring the realities

Dr. Veronica Shanti Chelliah

On July 10, 2009, I got to know that Dr Shermal Perera was travelling to Sri Lanka to visit the IDP camps in Vavuniya. I learnt that he intended to identify orphans and relocate them to an orphanage in Delgoda by the Sri Lanka Buddhist Temple in Sentul, Malaysia. Apparently, the orphanage was approximately 80 percent completed and could house about 200 orphans at full capacity.

I thought this was a noble and kind initiative. However, I was concerned about the following issues:

The children had lost both parents in war and were probably still shaken up and scared. The trip to Colombo may add fear to them

The children may have developed a sense of trust and bonded with their caretakers at the camps and may feel insecure by the transfer and new caretakers

Whether the facilities at the orphanage in Delgoda would be adequate; and

The mental, emotional and psychological state of the children. Whether the transfer would aggravate their emotional and psychological state of mind.

Notwithstanding the above issues, if the Delgoda orphanage offered an improved alternative, then, the relocation and transfer is still a workable option to explore. Furthermore, I also thought about the caretakers and whether there was sufficient manpower with experience to cater to the children’s psychological needs.

I went on to picture the photographs that have been in circulation over the press and internet and the stories from my patients and friends to which I shuddered and began to weep. The fear crept into me at this point thinking about the unknown and imagining the worst.

At this point, I realized that there could be many different scenarios of the current state of affairs of the orphans and decided to make a personal assessment of the orphans and conditions at the IDP camps.

I made a call to Dr Shermal, and the next thing I knew, I was invited to a dinner at Dr Shermal’s house where I met the Deputy High Commissioner of Sri Lanka to Malaysia, Major General Udaya Perera and his wife Thelma, and I.G. Chandran, who I learnt was also travelling with us to Colombo.

Major General was in full support of us going to personally visit the camps in our own capacity. He informed the Defence Ministry of our intentions to visit the orphans and to travel to the IDP camps. He also told us that he would organize the respective Army personnel to facilitate our permits to allow entry into the Vavuniya area.

At this juncture, I would like to declare that I was going on the trip in my personal capacity and not representing any organization as such. We travelled from Kuala Lumpur to Colombo on July 14, 2009. On arrival, Dr Shermal started to communicate with Captain Silva (our contact in Sri Lanka organized by Major General Udaya) to obtain our permits to travel up North. At this point, all our particulars were collected and submitted for approval by the Defence Ministry.

As our permits were being organized, on July 15, we decided to travel to the orphanage in Delgoda to assess its stage of completion and suitability to house the orphans. Although it was 80 percent completed, I was not convinced that any orphans could be admitted over the next one month at least. The classrooms were completed but the accommodation facilities still required additional work.

On the following day (July 16), we started our journey to Vavuniya at 3.30 a.m. Dr Shermal’s close friend, Ranil Pathirana, offered the services of his personal driver, Prasad, and his vehicle for our mission. We arrived at the Vavuniya check point at about 8 a.m. It was interesting to note that we were able to travel freely after this check point. We then travelled to meet Brigadier L.C. Perera, IDP centres Head.

We were warmly greeted by Brigadier Perera at his office where he briefed us on the history and the sequence of events that took place during the war and how the Sri Lankan Tamils were rescued and taken to the camps. He also showed us on the map the locations of the camps and zones into which they were divided into.

We took turns to ask many questions and Brigadier Perera was extremely cooperative and answered all our questions with great ease. Over and above all the statistics and numbers indicated in Dr Shermal’s and Chandran’s writeups, of which I concur, the following are my additional points:

“Personally, the conditions were far better from what I was expecting to see and experience.”

Deaths

An average of seven deaths occurred on a daily basis. There was a medical record that Brigadier LC Perera referred to and read out statistics with details such as age, gender and cause of death. He summarised the main causes of deaths as - Myocardial Infarction, Cerebrovascular Accidents, Pneumonia, Typhoid, Hepatitis A and complications of Diabetes and Septicemia. More than 90 percent of the deaths were due to the above causes and almost 80 percent of the deaths were those above 60 years. Important to note that most of these illnesses were prevalent prior to admission into the IDP camps.

Orphans

We were told that the resettlement of the orphans has now come under the special attention of the Government and the First Lady has taken special interest in this matter. The trip was short, hence, we were unable to get the necessary permits to see these children. It was good to hear that the children were placed under high security protection for their safety.

Medical aid

There were two hospitals that we visited: One by the Indian Government and the other by the Sri Lankan Government - facilities donated by the People of Japan.

All the doctors attending to the patients served with a smile and in a very friendly nature. There were also doctors from local hospitals in Sri Lanka and India. We had the opportunity to meet four doctors to discuss various problems faced by them. Medically and surgically, there seemed to be sufficient relief for the time being.

The availability of medical drugs seems sufficient. However, I am not aware of the availability of any psychologists and/or counsellors at the site. If there is none, then, it is imperative to put this in place.

I am also concerned with the IDPs dietary requirements. Due to the number of poorly controlled diabetics and related complications, I assume that this is due to no provisions being made for a special diabetic diet.

If this is the case, then, there should be a block in each camp to cater for the diabetics. There are laboratory facilities and X-Ray facilities to help in diagnosing the IDPs.

Clinical examination is the main method of diagnosing due to the large number of patients. It is more efficient at this stage to provide prophylactic treatment to those who are ill rather than performing laboratory tests and investigations.

The doctors involved in the IDP camps are well-trained and are able to make clinical judgement and calls with minimal diagnostics.

The medical care is not what you would be faced in a clinical/ hospital in Sri Lanka, or anywhere else in the world, but the standard of care in these circumstances meets the medical need.

Food supplies

We were informed that each person was getting 1,900 Kcal of food daily. This comes in the form of rice, lentils, flour, milk and oil. Efforts are being made by the authorities to increase the calory intake to 2,100 Kcal as per WFPs requirement.

From a medical point of view, there are a large number of cases who appeared malnourished. I believe they may have been malnourished prior to coming into the IDP camps and they would certainly require more than 2,100 calories to alleviate themselves out of this state.

From my observation and understanding with regards to dietary intake, perhaps nutritional supplements and a higher-protein diet could be provided.

Water/sanitation /hygiene

There was no visible rationing of water although there were queues at some hydrants. There were people washing themselves in the open. We were informed that UNICEF supplies 50 million litres of water daily for use at the camps.

In addition, there are also tanks that supply water to the camps. Drinking water is purified from these sources. Of serious concern was sanitation. It was obvious that toilets were insufficient.

This, I foresee may become a problem over time, if not adequately addressed, especially with diseases transmitted by the oral fecal route. This may also increase flies. related illnesses.

In addition, an increase in the incidences of malaria, typhoid and dysentery could occur. I observed that some of the IDPs walked bare-foot and the other common footwear was open sandals. Deworming, if not already carried out as a procedure, should not be precluded.

This may help in the preventive care in the general wellbeing and health of the IDPs. Pest control and fogging activities, if not already carried out, would be a deterrent to many potentially fatal diseases.

Education

I was surprised that there were properly demarcated classrooms based on age in each of the camps. The children at the school appeared in clean clothes with books in hand.

We visited the classes, spoke to the teachers and students, and there was a group preparing for their A-Level exams in December 2009.

They had their revision papers, past question and answers with them. However, the Grade Five students who were preparing to sit their exams at yearend, had not received their revision papers.

Brigadier Perera was disappointed and said he would look into the matter personally. There was a class where the teacher was absent and that seemed to be a common problem. Figure 8: Chandran talking to the children during school times

Conclusion

Overall, it was a great eye opener for all of us. Thanks to all parties concerned that made this trip possible.

Personally, the conditions were far better from what I was expecting to see and experience.

Do they need help? Most certainly... Anyone wanting to offer help in anyway may contact me at [email protected] anytime. Personally, I feel that the following items/services is beneficial for the IDPs: financial aid, food supplements, footwear, umbrellas, de worming treatment, Volunteers - to help at the hospitals, to teach at the schools, to listen and counsel and to assist with the resettlement plan.

The writer is half Ceylonese and half Sri Lankan Sinhalese who owns a private medical practice in Malaysia.