SRI LANKA: STATUS OF FIELD HOSPITAL REQUEST AND USG HEALTH

UNCLAS COLOMBO 000528

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: STATUS OF FIELD HOSPITAL REQUEST AND USG HEALTH
ASSISTANCE


1. SUMMARY: Following several weeks of discussion with Ministry of
Health (MOH) and other Government of Sri Lanka (GSL) officials, the
US Government (USG) for a variety of reasons has decided not to
provide a field hospital in the conflict-affected North. Key
factors considered included rapidly enhanced MOH capabilities on the
ground, the expansion of the network of hospitals that IDP
populations can access, an increase in the number of health actors
with access, and a changing ground reality with regard to medical
needs. The USG has provided a robust response in the health sector
with plans to provide $1.6 million in-kind supplies and medicines.
End Summary.

The Situation


2. When the initial influx of IDPs commenced on April 20, we
recognized the immediate need to enhance medical facilities to serve
them. In response, USAID's Office of Foreign Disaster Assistance
(OFDA) negotiated a grant with the International Organization for
Migration (IOM) to rapidly deploy 10 large primary health care units
next to IDP populations. Each unit has the capacity to provide
diagnosis, emergency care, and health education for 10,000 patients
and to refer and transport more critical patients to hospitals
through three ambulances. Prior to this intervention, OFDA had
provided the MOH with five WHO health kits, each with enough
medicines and supplies to assist 50,000 people. The kits are now
being used in MOH-run medical facilities. The value of the two
projects is $960,000.


3. On April 25, after several weeks of discussion, the Minister of
Health, Nimal de Silva, met with USAID officials and asked that the
USG provide two field hospitals for the North. He said that the MOH
was amenable to the U.S. military providing personnel along with the
hospitals, as long as they were not in uniform. On April 29,
Embassy received a formal request from the Secretary in the Ministry
of Health, Dr. Athula Kahandaliyanage, stating the request had the
endorsement of the Office of the President. Embassy noted that the
Ministry of Health letter stated that "Ministry of Health would
provide personnel to the hospitals," and requested "names of
accompanying technical personnel to install the hospitals." This
language indicated that the deployment of U.S. medical personnel
still had to be negotiated and clarified with the Sri Lankan
Ministries of Health and Defense. When the Charge raised this issue
with the Minister of Foreign Affairs and the Presidential
Secretariat, he was assured that there was no issue with
non-uniformed military personnel, but we would receive nothing
further in writing.


4. Simultaneous to these discussions, USG officials had undertaken
to assess existing medical needs as the situation in the North
evolved. Through field assessments and conversations with health
actors, the USG learned that MOH capacity had improved significantly
vastly in terms of staff and facilities: Doctors and nurses from all
over the country were sent to the North, IDPs now have access to 14
hospitals, the MOH has set up a 10,000 square foot dome hospital in
the most populated zone of IDP camps in Vavuniya, and several
hospitals and clinics have been augmented with wards and beds. The
USG further understood that the long-negotiated Norwegian Red Cross
and Medecins Sans Frontieres (MSF, or Doctors Without Borders)
France field hospitals and staff were being allowed into the
country, in both Mannar and Cheddikulum respectively, and that MSF
Holland staff and equipment were being allowed in to augment
hospitals. Beds were therefore being increased, as were equipment,
staff, and surgical capacity. These two field hospitals were in
addition to field hospitals, with military medical support
personnel, provided by the governments of India and France.

The Agreement


5. On May 10, USG officials met with MOH officials, including
Minister de Silva and Secretary Kahandaliyanage. During the
meeting, MOH officials said that the realities and consequent needs
on the ground had changed, and that they would prefer that the USG

provide a long term hospital focused on obstetrics and pediatrics.
The USG officials responded that providing such a hospital would
probably not be possible at this time and suggested that the USG
continue to provide assistance in upgrading the water, sanitation
and hygiene (WASH) conditions at the camps. Minister de Silva
responded that improving the WASH conditions could solve "90 percent
of our problems," and agreed with the recommendation. The USG
representatives further advised that they would be willing to
consider the provision of the $1.6 million in-kind request for
medicines and medical supplies made by the MOH earlier. (Note:
USPACOM has identified $1.6 million worth of excess medical goods
that they could provide). The MOH officials agreed with this,
saying that they would be willing and able to waive any taxes
associated with bringing the goods into Sri Lanka.


6. On May 11, USAID sent a letter to the MOH summarizing p the
meeting and reaffirming our commitment to assist the MOH and GSL in
humanitarian assistance efforts. We further stated that
understanding the direct correlation between water, sanitation and
hygiene with health, we would continue to focus our assistance in
these sectors to mitigate disease outbreak.

MOORE