SRI LANKA: STRUGGLE TO PROVIDE LIFE-SAVING ASSISTANCE IN

UNCLAS COLOMBO 000473 SENSITIVE SIPDIS DEPARTMENT FOR SCA/INS AND PRM STATE ALSO PASS TO USAID AID/W FOR ANE/SCA 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 AND POL SBERRY USMISSION GENEVA FOR NKYLOH USUN FOR ECOSOC DMERCADO E.O. 12958: N/A TAGS: EAID PREF PGOV PHUM CE SUBJECT: SRI LANKA: STRUGGLE TO PROVIDE LIFE-SAVING ASSISTANCE IN NORTH ¶1. (SBU) SUMMARY: From April 21 to 25, USAID Si Lanka Mission Director and USAID's Office of U.S. Foreign Disaster Assistance (USAID OFDA) actin regional advisor traveled to Northern Sri Lanka to assess the humanitarian situation of thousands of internally displaced persons (IDPs) who fled the so called No Fire Zone (NFZ) and arrived en masse over a period of days in Vavuniya District. The assessment team encountered disorder and confusion, with aid and government agencies struggling to provide humanitarian assistance to newly-arrived IDPs relocated throughout various locations in Vavuniya. The Government of Sri Lanka (GSL) lacks a discernable plan for rendering life-saving assistance to the newly arrived IDPs, as well as the IDPs still en route to Vavuniya. The GSL's new coordinator for IDPs, appointed Apirl 23, has had an impact in his first week on the job, quickly mobilizing badly needed resources. Further, despite an obvious need for immediately enhanced humanitarian assistance efforts, particularly in the areas of health, food, shelter, water, sanitation, and hygiene, GSL impediments continue to hinder aid agencies from operating effectively. Advocacy on myriad fronts must continue and be strengthened as the humanitarian crisis unfolds. Without tremendous effort, prolonged suffering of the already traumatized IDP population will be further exacerbated in a short span of time. End Summary. -------------- WHERE WILL IDPS GO? -------------- ¶2. (SBU) From April 20 to April 26, the total IDP population outside the NFZ rose from roughly 63,000 to 150,000, according to the Office of the U.N. High Commissioner for Refugees (UNHCR). An estimated 30,000 more people were en route from the conflict zone. The UNHCR indicated that between 50,000 to 100,000 people remained in the conflict area and would be moving into GSL-controlled territory over the coming days. Transit sites visited - mostly public schools - lacked adequate sanitation facilities and were overcrowded, with an average of 52 people sleeping per small classroom. The principal constraint to accommodating these new IDPs is the GSL's insistence that the IDPs all be located in Vavuniya district only and their failure to clear adequate amounts of land in Vavuniya or other districts. To little avail, the humanitarian community has repeatedly requested the GSL to allocate additional land, particularly in Mannar District, and to speed up clearance of previously allocated land in Vavuniya. Due to inaction on clearing the land in Manik Farms Zone II, relief agencies were setting up tents and pit latrines at the same time that IDPs physically arrived by GSL bus transportation and then had to stake out their own plots by sitting in them. Riots and clashes over plots and shelter purportedly erupted over the past days, when the GSL relocated an estimated 40,000 to 60,000 people to land meant to house a maximum of 30,000 people. When asked how the GSL planned to house the arriving IDPs, the GSL responded that the government would create zones IV, V, and VI in Manik Farms and use an additional 46 schools in Vavuniya. (Note: U.N. agencies have already refused to work in zones IV, V, and VI for various reasons, including the fact that the land is considered unsuitable due to a lack of a viable water table.) ¶3. (SBU) Although UNHCR identified three viable sites for camps in Mannar, the GSL has continued to refuse to allow any settlement in Mannar, other than at schools and then only if necessary and for short periods of time. As of April 26, the GSL has reportedly determined to relocate 1,500 families initially, and 20,000 others ultimately, from Manik Farms Zone II to Pulmoddai in Trincomalee District. However, no cleared land is available yet and it is unknown where newly-arrived IDPs would relocate. -------------- WHAT HAPPENS ONCE IDPS ARRIVE? -------------- ¶4. (SBU) Basic assistance provided to the approximately 63,000 IDPs prior to the influx was deficient in several areas. The GSL made several improvements, including the addition of phone service and the erection of visitation centers; however, both interventions were sporadic and varied from one site to another. For instance, in one site IDPs needed to have a national identity card to use the phone. In another site IDPs could only use the phone for two minutes and in a third site, the traveling phone only arrived intermittently. In terms of the new influx, whatever the status of the registration system may have been previously, it has seemingly unraveled totally since the influx. Without being registered, the IDPs cannot receive any non-food relief items. Furthermore, newly-arrived IDPs are not receiving relief assistance with any punctuality or regularity. For example, on the second day of the trip, the assessment team encountered a thousand IDPs who had been relocated to a school in Vavuniya that had not been previously used as a site. Despite the harrowing journey from the NFZ through the various GSL checkpoints, they arrived at the temporary IDP site without food, adequate water, or toilet facilities. ¶5. (SBU) The assessment team followed the progress of an IDP transit site population and the assistance being provided for the next two days. According to the team, the site had no organization in charge of management, and no IDP registration had taken place. Organizations on the ground had not distributed emergency relief supplies, partly because there had been no IDP registration and because no organization had been tasked to carry out distributions in that particular camp. As for sanitation, no latrines, apart from the two existing school latrines, had been constructed. Open defecation was rampant. In terms of medical assistance, several IDPs complained of festering wounds and unattended medical needs. Malnutrition was evident. Though people had received food, distribution was irregular and food delivery was delayed by more than twelve hours following arrival. Water for bathing and drinking was provided to the entire population through a 2,000 gallon tank provided by OXFAM. Remarkably, the effort to encircle the site with barbed wire had not even been made; a true testament to just how slowly things were moving. -------------- WHO'S RUNNING THE SHOW? -------------- ¶6. (SBU) The GSL has made a point of demonstrating to the international community that the GSL is in charge of humanitarian operations, not the UN. This point has been demonstrated by the government's previous reluctance to grant visas to the U.N. Office for the Coordination of Humanitarian Affairs (OCHA) staff. OCHA staff do not have permission to enter the IDP sites. As a consequence, it is not clear that there is central leadership within the U.N., and there appears to be a complete lack of a central coordinating agency or mechanism overall. The U.N. cluster system, recently crippled by its replacement with 'Task Forces' by the GSL, seems a wounded beast still trying to understand its new identity or how to function. Disparities exist between information in the field and headquarters, such as the number of emergency relief supplies available. The result is a void of coordination and much-needed cohesion. ¶7. (SBU) Attempting to address the lack of cohesion, the GSL has announced the appointment of Major General Chandrasiri as the Competent Authority for coordination of the IDP operation, as well as dispatching of three more Government Authorities. The U.N. Resident Representative reports that Chandrasiri has had a decisive impact in his first week on the job, demonstrating the ability to quickly mobilize some of the resources needed to cope with the large influx. The U.N. is sending the Head of OCHA in the short term, and both OCHA and UNHCR are sending surge staff from Geneva, with promises of finding someone to fill the void for a longer period of time. -------------- THE HUMANITARIAN COMMUNITY -------------- ¶8. (SBU) Prior to the April 20 IDP influx, there were schisms on several fronts within the humanitarian community. There were divisions between organizations in Vavuniya and those in Colombo; problems between U.N. organizations and non Governmental Organizations (NGOs); and issues between local and international organizations. The GSL has hindered relief assistance through bureaucratic hurdles and invectives. These divisions have not paralyzed humanitarian relief efforts, but galvanizing a united front and modalities for operation in the face of this crisis has not been a simple matter. In terms of resources, the humanitarian community is requesting donor assistance and the U.N. is preparing a prioritization paper, to be presented on April 30. While it is clear that more resources are required to deal with the new influx of IDPs, it is imperative that the community remembers the principles of engagement set out in the UNHCR Aide Memoire and other documents pertaining to assistance in Sri Lanka. -------------- GOVERNMENT STYMIES ASSISTANCE -------------- ¶9. (SBU) Several GSL commitments have been floundering, including clearing land, draining camps and gullies, disposing of trash, and providing food for three days following the arrival of IDPs the contested zone. Had the GSL cleared land at Zone II and drained land in Zone III of Manik Farms in a timely manner, the current dire situation could have been somewhat mitigated. The GSL announced to the U.N. World Food Program a few days ago that the government no longer intended to supply the promised three-day food ration, and would instead distribute a one-day food ration. As of this writing, the problem had not yet been resolved. However, the GSL is reportedly supplying food. The GSL has further hindered assistance by holding hostage much needed equipment at the Medawachchiya checkpoint, including water bowsers and the pipe required by the U.N. Children's Fund (UNICEF) to construct the water source for Manik Farms. They have put IDPs' lives in jeopardy by not approving visas of critical medical staff, preventing humanitarian access to IDPs at Kilinochchi, and not providing adequate food and water at Omanthai checkpoint. -------------- - SUFFERING INCREASES AS THE HEALTH SYSTEM FAILS -------------- - ¶10. (SBU) The amount of wounded and deceased people is increasing as the situation in the NFZ intensifies, with estimates that some 20 out of every 27 people have at least one injured family member. The assessment team visited three health facilities in Vavuniya, Mannar, and Cheddikulum, two of which were clearly overwhelmed. All three facilities were operating at least three times over their capacity in terms of patients, and two facilities had patients lying under beds. Patients, including many children and babies, were emaciated and exhibited signs of malnourishment. Many had been separated from their companions. The proportion of patients with amputated hands, feet, and legs is staggering. Others had been transferred through several facilities. Post-operative care had virtually ceased with patients being discharged if able to walk. ¶11. (SBU) Several newly-arrived IDPs that the team interviewed complained of festering wounds and injuries that had thus far gone unattended by medical personnel. It appeared that either medical personnel had not visited IDP sites, as had been intended, or the lack of IDP registration had impeded IDP visits to hospitals. During a meeting with the GSL Regional Director of Health Services (RDHS),the RDHS informed the team that medical staff in Vavuniya had threatened to go on strike over fears for their safety following the murder of one of the hospital's doctors. The RDHS had managed to keep the staff from walking out, but talked about the need for an emergency task force to coordinate health efforts, as well as a need for greater support and appreciation from the Colombo level. ¶12. (SBU) The RDHS further discussed the urgent need for additional staff, as well as more medicine and at least 200-250 more beds. The RDHS referred to the mental health needs of many of the IDPs, and the team recognized that there would be a great need for the rehabilitation of the large numbers of amputees in the future. While several efforts were being made to address the deteriorating health situation, including augmenting existing wards, building new ones and adding beds to facilities, the RDHS did not believe the efforts were sufficient. In a subsequent meeting with the GSL Minister of Health in Colombo, the Minister indicated that 1,000 more beds were required. The Minister further advised that he was sending about 285 new doctors to the north and opening up access to five southern facilities for patients. THE ADVOCACY MUST CONTINUE -------------- ¶13. (SBU) There are several areas in which the international community must continue to advocate, including: ¶A. Assistance to IDPs still trapped in the NFZ: The last significant WFP shipment of food and medicine reached those IDPs remaining in the NFZ on April 2. Approximately 30 metric tons of food went in April 28 and again on April 29 an ICRC medical evacuation boat, and a similar quantity is expected April 30; however, these shipments do not put put the supply of food on a sustainable basis. There are numerous credible reports that food stocks have dwindled to near zero. When asked why they left the NFZ, IDPs stated that they left because they were hungry and had been repeatedly fired upon. ¶B. Access to Kilinochchi and Omanthai screening points: Given the noticeably deteriorating conditions of the arriving IDPs, it is critical that more assistance is given to IDPs as they move from the NFZ to transit sites and camps. While organizations have attempted to gain access to both Kilinochchi and Omanthai, only ICRC and UNHCR have regular access for monitoring (though UNHCR has noted they cannot speak to IDPs). No organization has regular access to provide relief items. ¶C. Screening: Improved screening modalities could drastically reduce overburdened camps and transit sites, as well as minimize costs of camp upkeep dramatically. With a more sophisticated screening process, the Government would be able to track IDPs irrespective of where IDPs moved to. Further, in order to reunite families, tracing and sharing of registration information with UNHCR and the International Committee of the Red Cross must commence. The team heard a report of a pile of unidentified bodies at the Vavuniya Hospital morgue, and nearly every IDP interviewed referred to missing family members. Family reunification is critical to mental health. ¶D. Registration of IDPs must recommence for the newly-arrived to receive emergency relief supplies and medical assistance in a timely manner. (Note: The team met people who had been at Manik Farms for over a week and were receiving their first emergency relief supply kits because they had only recently been registered. End note) ¶E. Information to IDPs: The team interviewed IDPs who had received little or no information about their whereabouts or future. ¶F. Allocation and clearance of land: Given the increasing number of IDPs and the concomitant scarcity of land, the GSL must immediately allocate and clear land, preferably in Mannar, Jaffna and Kilinochchi. ¶G. Visas for expatriates: The dearth of available medical professionals requires that the GSL grant visas to expatriate medical staff as soon as possible. Further, agencies on the ground are overwhelmed with relief efforts and need to augment existing staff. ¶H. Clearance of equipment: Bowsers and other equipment held up at Medawachchiya checkpoint and other locations must be cleared immediately if agencies are to be equipped to provide assistance. MOORE