P 301215Z MAR 09
FM AMEMBASSY COLOMBO
TO SECSTATE WASHDC PRIORITY 9695
AMEMBASSY KATHMANDU PRIORITY 
AMEMBASSY BANGKOK PRIORITY 
USMISSION GENEVA PRIORITY 
USMISSION USUN NEW YORK PRIORITY 
AMEMBASSY NEW DELHI 
AMEMBASSY DHAKA 
INFO NATIONAL SECURITY COUNCIL WASHINGTON DC
CDR USPACOM HONOLULU HI//J3/J332/J52//
CDRUSARPAC FT SHAFTER HI//APCW/APOP//

UNCLAS COLOMBO 000360 
 
SENSITIVE 
 
DEPARTMENT FOR SCA/INS AND PRM 
STATE ALSO PASS TO USAID 
AID/W FOR ANE/SCA 
AID/W FOR DCHA/FFP FOR JDWORKEN 
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: ASSESSMENT OF DISPLACED PERSONS CAMPS 
 
¶1.  (SBU) SUMMARY:  Two USAID officials recently concluded separate 
trips to the Districts of Vavuniya and Mannar in Sri Lanka's 
Northern Province.  Through meetings with local officials and 
implementing partners, visits to IDP sites ("camps"), and informal 
conversations with IDPs, they assessed the humanitarian response to 
date, including preparations for the large outflow of civilians, 
anticipated in the weeks ahead from the conflict area in Mullaitivu 
District.  In general, they found that most of the basic 
humanitarian needs of the IDPs currently residing in temporary 
transit sites in Vavuniya District were being met.  However, they 
noted growing protection concerns due to overcrowding, a lack of 
freedom of movement, and continued presence of armed Sri Lankan 
soldiers in the camps.  They also observed large-scale 
infrastructure development at Manik Farm, which has become the 
Government's primary site for the flow of IDPs leaving Mullaitivu 
District.  See para 17 for additional concerns identified during the 
visits.   End summary. 
 
USAID Assessment Visits 
----------------------- 
 
¶2.  (U) USAID/Sri Lanka's Food for Peace Officer spent four days in 
Vavuniya and Mannar Districts in the Northern Province.  He met with 
local officials and with UN and NGO implementing partners.  He also 
visited the temporary, IDP transit site at Nelukulam School and 
newly-erected facilities at Manik Farm.  On a separate visit, the 
Southeast Asia Regional Advisor for USAID's Office of Foreign 
Disaster Assistance (OFDA) visited IDP transit sites in Vavuniya 
Town and a long-term IDP camp in Mannar Town.  He also witnessed the 
first arrivals of displaced people to Zone 3 of Manik Farm. 
 
Conditions in Transit Sites 
--------------------------- 
 
¶3.  (SBU) Without exception, the 12 transit sites in and around 
Vavuniya Town are overcrowded.  For example, at the Nelukulam School 
transit site, approximately 3,100 people live in classrooms and 
other on-site buildings, with little or no privacy for individual 
families.  The Food for Peace Officer - accompanied by a World Food 
Program field coordinator - discussed site conditions with a 
civilian administrator assigned by the Government Agent to work with 
the Sri Lankan army to manage the site.  The major concerns cited by 
this official included challenges faced by sick, wounded, and 
pregnant residents in being transferred to Vavuniya Hospital, and a 
lack of adequate food to complement WFP's dry rations. 
 
¶4.  (SBU) On a walk-through of the Nelukulam Transit Site, the USAID 
official noted other concerns.  Striking were the lack of soap and 
acceptable hygiene practices around the latrines.  After going to 
the toilet, some people sloshed their lower legs and feet with 
plastic buckets of water, but there was no hand washing.  On the 
other hand, at two other areas where there were water pumps (well 
water), people were pouring buckets of water over their heads, 
mimicking the time-honored Sri Lankan practice of daily bathing.  In 
an impromptu gathering of IDPs during the walk-through, the most 
common complaints were about the lack of dietary diversity and 
individualhealth concerns (for example, a heart condition, a sick 
child, and a scalp wound). 
 
¶5.  (SBU) The Food for Peace Officer observed the operation of five 
communal kitchens in the Nelukulam Transit site, each kitchen 
serving 500 to 750 residents.   Teams of IDPs do rotations, cooking 
the WFP-provided dry rations (rice, wheat flour, lentils, oil, and 
sugar - mostly Title II emergency food resources).  In addition to 
these dry rations, NGOs had provided some complementary food items, 
in the form of vegetable greens and fish-flavored "soya meat."  The 
IDP cooks complained that the amount of complementary food was 
inadequate to meet the needs of their clients.  NGOs in Vavuniya 
agree with camp residents that the 1900 kcal food ration provided by 
WFP is not adequate to meet the basic caloric and other nutritional 
requirements of the population, especially given their long-term 
deprivation in the conflict area, where they have received 
intermittent and insufficient food aid. 
 
Complementary Food 
------------------ 
 
¶6.  (SBU) In a meeting with a group of NGOs that evening, they 
discussed a strategy to complement the dry rations being provided by 
WFP.  In a proposal now being considered for ECHO funding, the NGOs 
would boost the overall caloric and micro-nutrient dietary intake 
through shipments of complementary food to the conflict area and by 
providing a two-week, 600-kcal boost to IDPs once they arrive at 
transit sites.  The Government too is asking for assistance in 
procuring complementary food.  Although Government policy is to 
allocate money for feeding IDPs, in fact there are insufficient 
budgetary resources to take care of the existing caseload in 
Vavuniya transit sites, not to mention a three or four-fold increase 
predicted for the coming weeks.  The NGOs estimate that it will cost 
approximately five US dollars per displaced person to provide 
complementary food over a two-week period.  Their proposal - 
anticipating ECHO funding as well as resources from the Danish 
government and private sources - would require more than $1 million 
just for an initial, two-week complementary food package.  The 
package could include condiments, fresh vegetables, pasta, meat and 
egg protein, and milk powder.  It is unlikely that the Government or 
other humanitarian agencies will have resources to sustain this 
level of complementary food assistance. 
 
Nutrition Concerns 
------------------ 
 
¶7.  (SBU) The discussion around providing complementary food has 
been prompted by culinary and nutrition concerns.  The UNICEF 
representative in Colombo recently shared with the two USAID 
officials preliminary findings of a joint nutrition study conducted 
in early March by UNICEF, the Ministry of Health, and the Medical 
Research Institute officials.  Sampling approximately 400 children 
under the age of five years in six of the twelve Vavuniya transit 
sites, using a weight-for-height screening methodology, the 
not-yet-released study shows a GAM (global acute malnutrition) rate 
of 25 percent.  UNICEF broke this down between a MAM (moderate acute 
malnutrition) rate of 20 percent and a SAM (severe acute 
malnutrition rate) of five percent.  According to UNICEF, the normal 
MAM and SAM rates for Sri Lanka are 12.5 percent and 2.5 percent. 
Other findings of the nutrition study were high rates of anemia (40 
percent in under five's, 50 percent in lactating mothers, and 40 
percent in pregnant women) and of underweight (33 percent of 
lactating mothers and 40 percent of pregnant women). 
 
¶8.  (SBU) In an interview with USAID officials, the Medical 
Superintendent of Mannar Hospital shared results of a 
weight-for-height survey of 70 children who had recently been 
released from the Mullaitivu conflict area.  In this study, almost 
30 percent of the children had a -3 standard deviation from the 
median score for their cohort (SAM rate). 
 
¶9.  (SBU) Anticipating a possible exodus of 200,000 IDPs once the 
conflict is over, UNICEF is putting together a $1 million proposal 
to address the therapeutic and supplementary feeding needs of 
children under five years, and the micronutrient needs of children 
and lactating and pregnant women.  OFDA is likely to consider 
partial funding of this proposal as part of the emergency response. 
 
Hospital Capacity to Serve Growing Caseload 
------------------------------------------- 
 
¶10.  (SBU) In a recent discussion, UN officials said that 
approximately one-third of the civilians leaving the conflict area 
have war wounds, another third have more minor injuries and other 
health issues (diarrhea and respiratory conditions being common), 
and the remaining third is without physical ailments.  One hundred 
percent are estimated to be suffering from psychological distress. 
 
¶11.  (SBU) Although estimates vary of civilians trapped in the 
conflict area between the SLA and LTTE cadres, there is consensus 
that the existing medical facilities are inadequate to serve a 
 
growing caseload of sick and war-injured patients.  When patients 
leave the conflict area, they are screened by the military and then 
sent to hospital trauma centers in Trincomalee, Vavuniya, and Mannar 
Districts.  The Medical Superintendent for Mannar Hospital explained 
that he had recently begun upgrading his 200-bed hospital to 300 
beds, and that this capacity was being augmented by five ICRC 
temporary wards, with an additional 150 beds.  However, the Ministry 
of Health had instructed him to further increase the capacity of 
Mannar Hospital to an overall total of 1,000 beds.  He was also told 
that he would receive additional staff - 40 nurses, two surgeons, 
one ob/gyn specialist, two pediatricians, and one general 
physician. 
 
¶12.  (SBU) Undoubtedly, other hospital administrators have been 
given similar instructions by the Ministry to temporarily upgrade 
their capacity to deal with trauma patients.  The Mannar Hospital 
Medical Superintendent stated that the Ministry of Health had told 
him that they would provide medicines, equipment, and other 
supplies.  However, he appeared uncertain when asked if he really 
thought that the Ministry would have these supplies on hand for his 
increased caseload. 
 
Manik Farm - Not a Temporary Response 
------------------------------------- 
 
¶13.  (SBU) The USAID officials visited Manik Farm, a 1000 acre site 
divided into three zones at varying stages of development.  In Zone 
One, the Government is working full steam ahead on setting up 
long-term accommodations for a population that could be as many as 
15,000 individuals, once construction is complete.  Reportedly, the 
construction contract has been awarded to the brother of the 
Minister of Resettlement and Disaster Relief Services.  Although 
Zone Two is still uncleared jungle, Zone 3 has row upon row of 
temporary shelters - plastic walls and roof around a wooden frame - 
with latrines and water tanks dispersed throughout the more than 
4,000 shelters constructed to date.  Double strands of razor wire 
surround the various housing blocks of Zone 3. 
 
¶14.  (SBU) The OFDA regional advisor was in Zone 3 when the first 
buses of IDPs arrived from the Omantai checkpoint.  The U.N and NGOs 
were not advised in advance of the arrivals by GSL officials and 
were forced to hastily complete preparation activities.  Many of the 
new arrivals had left the Mullaitivu region less than 48 hours 
earlier.  Several of the IDPs recounted stories of escape and 
continued fighting in the "no-fire zone." 
 
¶15.  (SBU) Both USAID officials concluded, as have other 
international observers, that the Government of Sri Lanka has 
long-term plans for Manik Farm.  The current infrastructure in Zone 
3 is easily convertible to more permanent shelters.  UNICEF is 
working with the National Water Supply Board to provide water from 
the nearby Mathawathi River, at an estimated cost of $800,000 to 
install pumps and lay pipe from the river to the site.  Plans are to 
pump the river water to two distribution points - one where it will 
be treated for drinking and the other for general purposes.  The 
UNICEF representative also spoke of the construction of 18 "learning 
spaces," (schools) in Zone 3, to be staffed by IDPs already on the 
Ministry of Education's payroll. 
 
¶16.  (SBU) Across the road from Zone One is the likely forerunner of 
Manik Farms Zones One, Two, and Three.  In this "model village," 
IDPs have a post office, police station, schools, and a health 
clinic.  However, the IDPs are housed in congested, corrugated metal 
barracks with few livelihood opportunities, and the overall 
appearance is that it is little more than a slum, where movement is 
restricted. 
 
Concerns 
-------- 
 
¶17.  (SBU) Following are concerns identified by the two USAID 
officials during their visit: 
 
- Overcrowding of transit sites: the 12 IDP sites in Vavuniya town - 
 
serving as home for close to 35,000 people - pose major protection 
concerns. 
 
- Lack of freedom of movement:  Except for a few elderly IDPs (over 
age 60), only hospital patients are allowed to leave the sites, and 
they may not be accompanied by family members.  Although the 
Government Agent in Vavuniya indicated that she had begun issuing 
identification cards for the IDPs of Gamini Transit Site (total of 
1,400 individuals) and stated that all 12 sites' IDPs would have ID 
cards by the end of April, this pledge could easily be superseded by 
the military.  This bodes ill for freedom of movement of the 
majority of IDPs for the foreseeable future. 
 
- Deteriorating conditions, deteriorating morale:  The euphoria felt 
by some displaced people after escaping the conflict area is being 
replaced by cynicism and depression brought on by overcrowding, lack 
of movement, and an overall deterioration in services (for example, 
hygiene and the lack of complementary food). 
 
- Uncertain capacity to respond to major medical trauma cases: The 
Ministry of Health appears to be gearing up for a large outflow of 
trauma victims, once civilians are released from the conflict area. 
However, if Mannar Hospital is an indicator, it is doubtful that 
existing facilities can be upgraded fast enough, medical supplies 
provided, and professional, medical staff increased to care for the 
thousands of patients likely to need care in the coming weeks.  In 
an off-the-record comment recently, an ICRC official commented that 
the Government's apparent strategy to deal with trauma cases in 
existing hospital facilities in Trincomalee, Vavuniya, and Mannar 
Districts was misguided, when many of the patients will require a 
level of tertiary care only available in facilities such as Jaffna 
and Batticaloa teaching hospitals.  The consequences, said the 
officials, will be more deaths, worse disabilities, and higher costs 
to the health care system. 
 
- High rates of malnutrition: The recently concluded nutrition study 
in six IDP camps in Vavuniya, and the smaller study done by the 
Medical Superintendent at Mannar Hospital, indicates that the 
civilians trapped in the conflict area are becoming increasingly 
malnourished.  These results make more credible the claims of 
starvation cases by local health officials in the conflict area of 
Mullaitivu District. 
 
- Long-term plans and humanitarian community support:  All signs on 
the ground at Manik Farm point to Government plans to house many 
thousands of IDPs long-term.  UNHCR has started an assessment of 
humanitarian support to date (since January), during a first, 
three-month phase.  Presumably, the assessment will report on the 
temporary humanitarian response, as well as progress on such basic 
humanitarian principles as access by humanitarian actors (UN, NGOs, 
donors), freedom of movement of IDPs, and civilian management of IDP 
camps. 
 
CONCLUSION AND COMMENT 
---------------------- 
 
¶18.  (SBU) Findings of the UNHCR 90-day assessment should provide 
important policy input for the USG in determining whether to 
continue providing humanitarian assistance in the months ahead.  The 
trip by USAID officials to Vavuniya and Mannar Districts raises 
doubts about the Government's ability to adequately cope with a 
growing caseload of tens of thousands of civilians in the weeks 
ahead.  The already overcrowded conditions and lack of freedom of 
movement in the camps in Vavuniya Town raise serious protection 
concerns.  At Manik Farm, the humanitarian community is patching 
together temporary services to help the Government meet immediate 
needs (water, food, shelter) for new arrivals.  However, there could 
be twice as many people as the cleared land and infrastructure under 
construction will accommodate.  Septel describes the March 30 
Coordinating Committee on Humanitarian Affairs meeting at which the 
GSL confirmed plans to meet on March 30 with the UN and local NGOs 
to agree on plans to accommodate the possible influx from the safe 
zone. Access to IDP camps by the UN and NGO implementing partners 
has generally been satisfactory.  However, access to the Northern 
 
Province (including Vavuniya and Mannar) by USG officials continues 
to be uncertain, with each travel request delayed by a combination 
of civilian and military authorities that are unable to set clear 
procedures for obtaining travel approval.  The Government's 
unwillingness or inability to discuss a medium-term returns strategy 
with the international community fuels concerns that IDPs settled in 
Manik Farm may have a long stay ahead of them, despite continued GSL 
insistence that 80 percent of IDPs will be resettled by the end of 
¶2009. 
 
BLAKE