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Tuesday, 21 August, 2001, 14:59 GMT 15:59 UK
Jaffna hospital: A casualty of war
Doctor nurse and patient in hospital ward
Jaffna hospital has coped with two decades of fighting
By Frances Harrison in Jaffna

Doctors in the northern Sri Lankan town of Jaffna say patients are dying because the defence ministry will not allow enough drugs into the area - the scene of two decades of conflict with Tamil rebels.

Unlike any other government hospital in Sri Lanka, defence ministry approval is required for all shipments of drugs and medical equipment to Jaffna Hospital - but doctors say they only receive a fraction of what they need.


According to the hospital director, three babies recently died in the premature baby unit for want of a drug easily available elsewhere in Sri Lanka.

Doctors say there have also been several occasions when newborn babies have died because of a shortage of oxygen. Dr Kumarawerl, the secretary of the Jaffna branch of the Government Medical Officers' Association, says the hospital lacks any working incubators.

Hot water bottles

"We need six incubators because we have more than five babies to be kept in incubators.

"We don't have that, so we just keep them in the open cots with hot water bags.

"Sometimes we burn the babies, sometimes the babies are cold.

"Every half an hour the nursing officers have to check whether it's too hot or cold or if it's necessary to change the hot water bottles."

Jaffna Hospital used to be one of the best hospitals in the country before the war.

Now it lacks everything - staff, medicine and equipment.

Administrators submit a list of the drugs they need to the government but say the defence ministry cuts their allocation drastically - sometimes only sending a tenth of what they ask for.

The concern seems to be that the medical supplies might fall into rebel hands, but doctors say the drugs are never checked in Jaffna itself.

Neglect

Bureaucratic neglect means there have been times when the hospital has had no antibiotics or pain killers to offer patients undergoing surgery, according to another Jaffna staff member, Dr Thevakumar: "Most of the time we don't have analgesics because the government did not allow us to be sent this, especially the opiates.

Mother and child in hospital
The hospital desperately needs more equipment for babies
"Usually we should give all the patients undergoing surgery analgesia but here we give only for major surgery.

"Other patients we just give the anaesthetic agent only, so after the operation most of the patients are suffering from the pain." The doctors joke that in the West - or for that matter in Colombo - their patients could sue them for the pain they have to undergo after surgery.

Staff here have a huge crowd of patients to deal with. Te hospital serves a population of half a million people.

War casualties

The director, Dr Kanegaratnam, says the hospital itself was twice displaced by the fighting and has seen more than its share of war casualties:

"I have seen bodies being brought wrapped in bags after shelling, and there are many landmine cases, victims who come in without legs and arms."

It is only the dedication of the few remaining staff that keeps Jaffna hospital going. It has half the nurses it needs and only four specialists out of 32.

This is a time of relative peace in Jaffna, but if fierce fighting breaks out again it is hard to imagine how the doctors would cope.

They say the only good thing about periods of intense shelling is that the patients cannot reach the hospital at once.

See also:

29 Jul 01 | From Our Own Correspondent
Sri Lanka renews hopeless war
24 Jul 01 | UK
'All hell broke loose'
24 Jul 01 | South Asia
In pictures: Sri Lanka attack
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