P 241346Z FEB 09
FM AMEMBASSY COLOMBO
TO SECSTATE WASHDC PRIORITY 9449
AMEMBASSY KATHMANDU PRIORITY 
AMEMBASSY BANGKOK PRIORITY 
AMEMBASSY NEW DELHI PRIORITY 
AMEMBASSY ISLAMABAD PRIORITY 
AMEMBASSY DHAKA PRIORITY 
USMISSION GENEVA PRIORITY 
USMISSION USUN NEW YORK PRIORITY 
INFO NATIONAL SECURITY COUNCIL WASHINGTON DC
CDR USPACOM HONOLULU HI//J3/J332/J52//
CDRUSARPAC FT SHAFTER HI//APCW/APOP//

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