Sri Lanka 17 years of humanitarian actions Report Released by Médecins Sans Frontières in june 2003 Document en provenance du site internet de Médecins Sans Frontières http://www.msf.fr Tous droits de reproduction et/ou de diffusion, totale ou partielle, sous quelque forme que ce soit, réservés pour tous pays, sauf autorisation préalable et écrite de l’auteur et/ou de Médecins Sans Frontières et/ou de la publication d’origine. Toute mise en réseau, même partielle, interdite. Sri Lanka : 17 years of humanitarian actions the french section of Médecins Sans Frontières close all its projects in Sri Lanka. contents Background & context page 3 With the hope of lasting peace, the situation This document was inspired by a simple is slowly changing in the northern and eas- idea: how to mark the end of our missions 17 years of MSF programmes page 5 tern areas of Sri Lanka. The health system in after 17 years in this unique region of the these former zones of conflict is being resto- world. Trincomalee page 6 red and doctors and nurses are returning to We wanted to put something down in writ- take up long vacant positions. After suffering ting and to thank those who were there and Jaffna & Point Pedro page 8 the consequences of the conflict, the popula- contributed to the programmes. tions are also returning to their villages in But we also wanted to share the experience Batticaloa page 11 the hope of building a new life. with those who did not necessarily partici- pate. Vavaniya page 17 Outside the zones of conflict, the Sri-Lankan So we decided to set about gathering the health system has always been highly develo- experiences and memories of those who Madhu page 18 ped and effective, with competent staff. Most were in Sri Lanka, as a way of helping others importantly the health system is free of char- to understand what it was like. Personnal memories page 20 ge and therefore accessible to the poorest There are no analyses, no comments, no cri- members of society. What could be better ticisms… We have compiled this account of Human resources page 25 than applying this system throughout Sri facts and emotions experienced by all those Lanka, to all Sri-Lankans? The reasons for working in Sri Lanka and have published Thanks page 26 MSF’s presence in the areas isolated by the without commentaries. conflict no longer exist. MSF France has the- We would like to thank all those who contri- refore decided to close its programmes by the buted to this document, near or far, directly end of June 2003 but MSF Holland continues and indirectly. to support the obstetrical and gynaecological Many thanks to all institutional donors who services in the hospital of Puthukkudiyiruppu. help to finance the mission. Photos : Front and back pages : D. Lefèvre - P. 3 : D. Lefèvre MSF-Holland is also training the hospital - P. 4 : E. Bouvet - P.5 : D.Lefèvre - P.6 : Y. de volunteers there. A new programme in the Our apologies to those who we were unable Fareins - P. 7 : D. Lefèvre, MSF - P. 8 : MSF - P. 9 : D. Lefèvre, MSF - P.10 : MSF, D. Lefèvre - P. 11 : D. hospital of Mullaitivu will start soon. In to include, because of time or distance. Lefèvre, S. Crisan/MSF - P. 12 : MSF - P. 13 : G. Vavuniya, near the former front-line, MSF- We also apologise to any of the national staff Myers/MSF, MSF - P. 14 : MSF, S.Crisan/MSF - P. 15 : Holland is running a community-based and volunteers whose names may have been MSF - P.16 : MSF, Y. de Fareins - P. 17 : MSF - P. 18 : C. Perera/Gamma - P. 19 : D. Lefèvre - P. 20 : MSF - psychosocial project focusing on war trauma. forgotten at the end of the document. P. 21 : MSF - P. 22 : E. Bouvet - P. 23 : MSF - P. 24 : MSF. We would particularly like to thank the Front page: Rédacteur en chef: Anne Fouchard national professionals without whom our Patients waiting for consulta- Rédaction: Isabelle Ferry 17 years of work would not have been pos- tions. Trincomalee hospital. Co-rédaction: Remi Vallet 1997. Graphisme et fabrication: TC graphite sible. Réalisation: juin 2003 Back page: Translation: C. Serraf, L. Brumer, D. Chanley Tamil family waiting for the SLA to release their sons. Many thanks to evryone who contribuated to this Point Pedro 1997. brochure: Arnaud L., Anouck S., Anoulack P., Diana T., Guillermo B., Karine P., Kate D., Sean H., Stéphanie P. and especially Chris B. et Yves C. 2 two Sri Lanka Welcome to Paradise ! Facts and figures Sri Lanka, surrounded by the Indian the British, after independence they were toward peace have followed. Air and road Official name: Ocean, is an island paradise just 50 km off marginalized. In 1956, Sinhalese was pro- links between the Jaffna peninsula and the Democratic Socialist the coast of India. Marco Polo once said of claimed the country’s sole official language rest of the island have been reopened. The Republic of Sri Lanka this island, 430 km long and 225 km wide, causing anger amongst the Tamil commu- disarmament process has begun and the > Land area: 65,610 sq that it was the most pleasant island of its nity. In 1972, the rebellion army, the Tamil two sides have exchanged prisoners of km. 1,340 km of coastline size. All the guidebooks acclaim the treasu- New Tigers (TNT) was founded by war. On a political level, the Tamil Tigers > Capital city: Colombo res of this island the size of Ireland: the Vellupillai Prabhakaran, who later formed have abandoned their claim for an inde- > National holiday: fine architecture, archaeological treasures, the Liberation Tigers of Tamil Eelam pendent state, and the government accep- 4th February (celebra- mysterious traditional dances, sandy bea- (LTTE) in 1976. These movements called ted, in an agreement signed in December ting the country’s inde- ches lined with palm trees, tea plantations for an independent constitution for the 2002, the principle of autonomy in the pendence in 1948) as far as the eye can see, topical forests, an provinces of the north and east of Sri northern and eastern regions. New rounds > Population: 19 576 783 abundance of wild fauna, and above all, the Lanka. Violent confrontations began, trig- of talks were due to take place in Japan on > Sinhalese: 74% friendly and welcoming people. Twenty gered notably with the TNT assassinating 9th– 10th of June. But LTTE decided to Tamils: 18%, Moor: 7% years of civil war have not put off holiday- the mayor of Jaffna, a town in the heart of boycott them. Although tensions still sub- other: Burgher, Vedda, makers: in 2000, when clashes between the the Tamil peninsula in the country’s north. sist, hope has returned to Sri Lanka. Malay: 1% army and Tamil rebels claimed 4000 lives, > Religions: the island’s southern beaches were visited However, it was not until 1983 that the Buddhist: 70% by over 400,000 overseas tourists. civil war really began. Thirteen Sri Lankan Hindu: 15% Muslim: 7% army soldiers were killed in an LTTE Christian: 7%. ambush. Riots broke out at the soldiers’ A COVETED ISLAND funeral in the capital Colombo and 3000 The natural beauty and riches of Sri Lanka Tamils were killed, meanwhile in the have long been coveted. Under Indian north the army launched massive retalia- influence between the 14th and 16th cen- tion strikes around Jaffna. 20 years of turies, the island later became a conflict have left more than 60,000 dead Portuguese colony in the 16th century. It and hundreds of thousands of people refu- then fell into the hands of the Dutch in the gees or missing. 17th century before coming under British control in 1796, which lasted 152 years. In 1948, the island of Ceylon finally gained HOPE OF PEACE its independence, but it was not until 1972 After three failed rounds of peace negotia- that the island was renamed Sri Lanka tions, the current talks seem to be promi- under the new constitution. sing. In February 2002, the government (whose president Chandrika Kumaratunga This new constitution, which made is from the People’s Alliance and whose Buddhism the national religion, stirred prime minister Ranil Wickremasinghe is tensions between the Sinhalese communi- from the opposing United National Party) ty (mainly Buddhist) and the Tamils signed a permanent ceasefire with the (mostly Hindu). Although the Tamils held Tamil Tigers which paved the way for new most of the administrative positions under peace talks. Since then further steps three 3 Médecins Sans Frontières in Sri Lanka War Timeline > 1972 New constitution. Buddhism becomes the State religion. Birth of the Tamil New Tigers (TNT), Tamil armed rebel movement. > 1976 The TNT becomes the LTTE (Liberation Tigers of Tamil Eelam). > 1982 Tamil party boycotts presidential elections. > 1983 Civil war begins. > 1985 First peace negotiations collapse. > 1987 Armed military offensive. The LTTE ON BOTH SIDES In the zones under LTTE control and the retreats to the Jaffna OF THE FRONT LINE so-called “grey zones” (those controlled peninsula. Deployment MSF set up missions both in towns under by the army but with pockets of LTTE of an Indian peacekee- ping force. Since 1986 Médecins Sans Frontières has government control and in zones held by resistance) MSF endeavoured to provide > 1987-1990 been working in Sri Lanka pursuing the the LTTE. We worked in public hospitals access to care for people in vulnerable Repeated LTTE attacks same objective: providing assistance to (some in the hands of the government situations, including many displaced peo- against Indian soldiers. populations directly victim of or isolated by others controlled by the Tigers – like ple.
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