CORRECTED COPY (NEW SUBJECT) SRI LANKA: IDP ARRIVALS AT

UNCLAS COLOMBO 000208 DEPARTMENT FOR SCA/INS AND PRM STATE ALSO PASS TO USAID AID/W FOR ANE/SCA AID/W FOR LPA AID/W FOR DCHA/FFP FOR JDWORKEN, JBORNS AID/W FOR DCHA/OFDA FOR ACONVERY, RTHAYER AND RKERR BANGKOK FOR USAID/DCHA/OFDA WBERGER KATHMANDU FOR USAID/DCHA/OFDA MROGERS USMISSION GENEVA FOR NKYLOH USUN FOR ECOSOC - DMERCADO E.O. 12958: N/A TAGS: EAID PGOV PHUM PREF CE SUBJECT: CORRECTED COPY (NEW SUBJECT) SRI LANKA: IDP ARRIVALS AT TRINCOMALEE HOSPITAL ¶1. SUMMARY: The International Committee of the Red Cross (ICRC) has transported 1,611 people from the Mullaitivu conflict area to a reception center at the Trincomalee Hospital in northern Sri Lanka. USAID Office of Foreign Disaster regional advisor (OFDA R/A) was given access to the hospital, which is currently under Government of Sri Lanka (GSL) military control, to assess humanitarian conditions. The OFDA R/A found that wounded arrivals requiring emergency assistance are receiving adequate care. The Trincomalee hospital currently has sufficient medicines, staff, and non-food and food supplies to meet the needs of the arrivals. Hospital officials, in response to the increased demands, have organized sufficient triage and care protocols to treat the incoming caseload. Evacuees that do not require emergency care receive food and non-food assistance at the hospital before relocation to the transit sites in Vavuniya. End Summary. Background -------------- ¶2. The ICRC has transported 1,611 civilians since February 10 by barge from the "safe zone" in the Mullaitivu area of northern Sri Lanka to the main hospital in Trincomalee. The evacuees are fleeing intense fighting between the LTTE and GSL forces where there is little humanitarian access. The ICRC plans to continue the evacuations of the wounded from Mullaitivu for as long as access is available. ¶3. The OFDA Regional Advisor traveled to Trincomalee from February 22-23 to assess humanitarian conditions in the hospital. Access to the hospital grounds has been closed to the INGOs since the start of the ICRC-led evacuation. OFDA supports non-food assistance to the evacuees through partner World Concern, the only international NGO that currently has access to the hospital. With the assistance of World Concern, the regional advisor received full access to the hospital, accompanied by hospital staff and GSL military personnel. USAID/OFDA has provided $6 million in 2008-2009 to support the conflict displaced in Sri Lanka. Critical Care -------------- 
¶4. The hospital has organized an effective triage system to meet ICRC barges upon arrival in Trincomalee. All evacuees go from the boat to the outpatient staging area where they are segregated based on need. OFDA partner World Concern reports that 467 of the 1,611 total number arrivals (nearly 30%) required some level of surgical assistance. ¶5. OFDA R/A saw numerous burns, amputations and gunshot wounds in the several post surgery wards in the hospital. Caseloads included an apparent equal number of men and women in the wards; however, several children were receiving assistance. Pain management appears to be effective as there was little wailing or screaming in any of the wards during the unscheduled visit. OFDA R/A confirmed adequate access to water and latrines for the interned. ¶6. The majority of arrivees not requiring medical assistance receive a non-food kit from World Concern, including sleeping mats, before eventually being transported to Vavuniya. R/A noted that family members of the critically wounded (children, spouses) were not separated and allowed to remain together until the patient was well enough to travel to Vavuniya. Staff and Supplies -------------- ¶7. The hospital in Trincomalee appears to have sufficient supplies of pharmaceuticals, fluids, and bandages. OFDA R/A visited supply stores and found a variety of curative stock with good expiration dates. All of the wounded assessed appeared to have clean bandages and intravenous fluid and blood bags hung from several beds. The GSL military personnel at the location reported that the Ministry of Health in Colombo had shipped three trucks of medical supplies to the hospital last week. The 390 hospital beds at the facility were occupied; however, all the beds were complete with linens, pillows and generally appeared clean. The local GSL Public Health officer in Trincomalee was on location overseeing the kitchen and hygiene activities at the hospital. ¶8. The hospital leadership reported that four additional doctors arrived from Colombo to assist with the new caseload. OFDA R/A did see numerous Sri Lankan Red Cross volunteers, nurses, nuns, and continuous cleaning crews at work in the several wards, including the critical care unit. Military personnel are stationed at the entrances to the hospital, and at the transfer area where the non-wounded boarded public buses to Vavuniya. Hospital management reported that three psychologists were on-site to counsel children and the traumatized. Food and Non-Food Support -------------- ¶9. Civilians staying in the hospital or waiting for transport to Vanuviya are receiving generous amounts of non-food support. Each individual, including children, receives a gender-specific kit containing clothing, hygiene items, mineral water, and some packaged food items after clearing the triage station. OFDA is supporting non-food assistance to the evacuees through partner World Concern. World Concern is the only INGO with complete access to the hospital and new arrivals. The intervention is critical as the new arrivals come to the hospital with only the clothes on their backs. ¶10. Evacuees are provided food from a "wet feeding" or kitchen facility located at the hospital. Meals, including meat, starches, vegetables and fruits are prepared daily and complement the packaged foods given upon arrival in the non-food kits. The WFP has agreed to provide USAID-donated commodities to the hospital kitchen to support future caseloads. Conclusions -------------- ¶11. The Trincomalee Hospital appears to be responding sufficiently to the needs of ICRC transported evacuees from the Mullaitivu "Safe Zone." Medical care, complemented with food and non-food support, is provided to the new arrivals. ¶12. Evacuees not requiring extended medical assistance are transported quickly to the Vavuniya transit camps via public buses or ambulance. The transfer process at the hospital is well-organized and done in a dignified manner. MOORE