SRI LANKA: STRUGGLE TO PROVIDE LIFE-SAVING ASSISTANCE IN

UNCLAS COLOMBO 000474

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 Sri Lanka Mission
Director and USAID's Office of U.S. Foreign Disaster Assistance
(USAID OFDA) acting 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, quicklymobilizing badly needed resources.
Further, despie an obvious need for immediately enhanced
humantarian assistance efforts, particularly in the ares 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.

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WHERE WILL IDPS GO?
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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.

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WHAT HAPPENS ONCE IDPS ARRIVE?
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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.

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WHO'S RUNNING THE SHOW?
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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.

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THE HUMANITARIAN COMMUNITY
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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.

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GOVERNMENT STYMIES ASSISTANCE
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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.

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SUFFERING INCREASES AS THE HEALTH SYSTEM FAILS
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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
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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