As the refugee problem in the camps at Madhu reaches near crisis point, the spread of disease and most disturbingly malnutrition among children needs to be addressed. Tharuka Dissanaike reports
As dawn breaks in a cloudless sky, heralded by the chirping of birds, thousands of refugees at Madhu wake up to another hopeless day. As light filters through the dusty scrub forest that surrounds them, the children tumble out of shelters and mud walled huts in their hundreds, wandering aimlessly in groups. Many would go without breakfast, probably even lunch. And it showed in their thin emaciated bodies and protruding bellies. While we were there, many tried to beg money from us, like street children in the city.
In the refugee camps of Wanni, hunger and resulting illness is the order of the day. Food supplies sent in by the government through UNHCR (United Nations High Commission for Refugees) are largely inadequate to feed the refugee population. Authorities at Madhu put estimates of the displaced population at around 60,000 , in five camps scattered around the area in two AGA divisions. But official food supply is sent only to a fraction of these people and is shared by all, creating a huge shortage of food supply. Added to this misery, is the lack of medicine. The meagre supply of drugs and medicines sent here contribute to the widespread incidence of malaria, dysentery and typhoid
But the most disturbing fact here is the alarming statistics of child malnutrition. A large segment of children under five years in these camps is malnourished. In Madhu hospital, run today by doctors of the French Medecins Sans Frontiers (MSF), malnutrition deaths are common. A hospital aide told us that the number could roughly be around six-seven a month. These were only the recorded cases. There are many camps established ad hoc in the jungles and the refugees do not have easy access to a hospital or any kind of health care.
Organisations like the UNICEF have realised and recognised this problem. UNICEF is trying to help establish feeding centres in hospitals in and out the government -controlled areas in the Wanni. As one official of UNICEF pointed out the Wanni area before the conflict did not have a problem with malnutrition. Now, progressively the problem is worsening.
Anjan, 13 years, displaced from Mannar, now living at Madhu woke up hungry that morning. But his mother could not afford to provide a morning meal for the children. Anjan has four younger brothers and two elder sisters and an elder brother who does not live with them. Their father is dead.
So with empty stomach he attended the morning mass at Madhu church, after which he accompanied us to his dwelling, a two roomed mud hut built by UNHCR.
Immediately the house was crowded with neighbours, fellow refugees. Anjan's brothers played with other youngsters in the sandy yard. Even in their poverty the family offered us a very diluted but hot milky drink. Since he had no other occupation, Anjan followed us around that whole day.
Not every one had huts to live in. Some occupied the church's houses, which were rented out to pilgrims before the war broke out. As many as five families, at times, occupied one room in these houses. Others made do with cadjan huts and some with tents provided by UNHCR.
Refugees at Madhu came mostly from the Wanni. But the Administrator of Madhu Church Fr. Devasahayen told us that the population swelled when Jaffna was under siege two years ago. Many of the Jaffna residents have returned to their homes. Leo Anderson said he fled Jaffna with his fiancee, and their families when Operation Riviresa began. Leo is still at Madhu, married now with a three month old baby. He has no plans yet of returning.
In contrast another family from Jaffna are yet to move from the refugee camp because of the children's schooling. S. Puvanentran ( not his real name), a retired government servant, having served in a number of areas in the country, had to move to Madhu due to the operation. "Within half an hour we had to vacate our houses," he remembers. With two daughters and a son, he came to Killinochchi and thereon to Madhu by a Tiger run bus service which charged them Rs. 300 per person for the trip.
Last year his son, Sanchayen who earlier attended St. Patrick's in Jaffna did his O/L exam at Madhu. Despite the lack of teachers and facilities in this very 'bare' school he managed to score 3 distinctions and 5 credits. The youngster wants to do his A/Ls and go to medical college. But since the school at Madhu does not offer the opportunity of offering bio-science for A/Ls, Sanchayen is now thinking of moving to Mannar to continue his studies. The family cannot move back to Jaffna as Sanchayen's sister is sitting for her O/Ls this year.
Living in these camps are people who have lived and worked in the South of Sri Lanka. V. Saundararajah worked for an estate in Kegalle and moved to Vavuniya with his family hoping to earn a living independently by farming. But his hopes were shattered and his own brother died in a bomb blast in Vavuniya. Today he, his wife and three children have become refugees with little to call their own. At the time we were there Saundararajah had secured a temporary job at the church canteen.
George was born in Colombo and speaks perfect Sinhala. But he moved to the Wanni to cultivate and married from a village close to Mallavi. He has three children. "I go often to Colombo. But because my wife and children were born here I cannot take them. So we have become refugees," he said when we asked him if he cannot take his family and move to Colombo.
They all had two main complaints- food and medicine.
Government food rations reach these people every two months. The UNHCR is resposible for distributing them to the refugees. It was unclear as to the exact amounts the refugees were entitled to as it appeared to vary each time. But whatever they did receive was inadequate for the families to live on. Without cultivation or any type of work at hand, resulting in a lack of money, most refugees suffered from abject hunger and illness.
It is nearly impossible to buy food stuffs in the small market places near the refugee camps. The prices are exorbitant. A bottle of kerosene- 750 ml- is sold at Rs. 150, two panadols go at Rs. 10, a coconut is around Rs. 35-40, a match box sells around Rs. 10 and two rings of mosquito coils at Rs. 10-15. We met an old woman returning home with her day's shopping, a bunch of yellowed leafy onion leaves and a tiny bottle of kerosene. "Even this vegetable cost six rupees," she said shaking her wizened head. Didn't she buy any meat or fish ? She smiles at us, almost condescendingly at our ignorance "Where is the money to buy those things?"
Due to the short supply of medicine illness and disease was very common. Only a government approved quota of drugs is allowed into these hospitals and camps. Needless to say the quantities are insufficient. No aid agency or traveller into the Wanni is allowed to carry extra medicine into the "uncleared" areas.
Malaria is rampant. There is no anti- malaria campaign and medicine for treatment is scarce. Hospital sources at Madhu said that malaria, dysentery and typhoid were the most common diseases encountered in the camps, aggravated by sanitary conditions and the lack of water.
"These camps maintained by UNHCR are in some kind of order, but there are others in the jungle which are not so organised," one volunteer said. The lack of food and disease have led to severe malnutrition among the children in these camps. It is not uncommon to see children with spindly bodies and big bellies, or those with odd-shaped heads. Most children are under- weight. UNICEF is supporting a programme initiated by Dr. Yoganathan of Mannar Hospital to promote supplementary feeding through the hospitals, clinics and volunteer network in the camps, for children under five years, hoping to arrest the problem of child malnutrition. A locally produced nutritive called Jeevaharam is to be used. But this project is still in its infancy. MSF already has a nutrition programme at Madhu. At Madhu hospital, the children's ward is almost filled with under nourished babies and mothers.
The sheer magnitude of the refugees makes it difficult for aid agencies to deal with the manifold problems without the support of the government.
These refugees live day after day under the very real threat of war. Most children have not known another life, but that of a refugee camp with sparse rations and illness. They are going to be the future workforce, parents and leaders. The entire country owes them a better tomorrow.
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