Longitudinal UNICEF Survey of Nutrition in the IDP Camps in 2009

Michael Roberts

In the course of presenting a seminar on the topic “Humanitarian Work obscured by the Fires of Propaganda War: The IDP Camps, 2009-12” at the premises of ICES on 7^th November 2012, I was met by a hostile challenge from Mirak Raheem of the Centre for Policy Alternatives  who raised three points of criticism – one based on empirical material that I had presented about a few IDPs who were bussed in from Nandikadal and the Vanni Pocket – a four-five hour journey I believe – being dead on arrival. Information from the UTHR report , from such individuals as Narendran Rajasingham (who met escaped IDPs in March-April) and the doctors at Manik Farm (e.g. Safras, Woodyard) reveal that there were a few IDPs who could best be described as “walking dead” (and some kin reported the trauma of leaving grandparents behind because they were not fit to move).

     Despite the evocative photographs presented re the abnormal conditions encountered for several months by the Tamil populace corralled together in a revolutionary act of blackmail by the LTTE, Raheem had clearly NOT comprehended the abnormal circumstances of that moment in April-May 2009 and the looming possibility of a humanitarian disaster among the large clusters of IDPs assembled (some 250,000 all told) in the Vavuniya locality in numerous temporary schools-used-as-camps as well as the Mänik Farm Zones. This outstanding failure was – and remains — a measure of the ideological blindness located in advocacy circles in Colombo. It marks an obduracy that is founded upon (1) enclosure within air-conditioned cocoons in Colombo; and (2) a visceral hostility to the Rajapaksa regime that cannot allow for any good emanating from a range of official (and unofficial)  agencies. One can even envision the advocacy circles in Colombo as a cluster that has created its very own siege bunker in the morally righteous cloister way up in the clouds.

One of Raheem’s charges pertained to the attempts of IDPs to trace missing kinsfolk and their struggles to do so. When death by starvation and illness was the momentous issue in April-May, this was – relatively speaking – a marginal issue that was only relevant for subsequent months. However, it so happened that Reza Hossaini of UNICEF was present at the seminar. He was good enough to meet Raheem’s charges – turning around from up front and addressing Raheem.

This encounter had a pleasing result: it led to further exchanges with Hossaini and UNICEF. He has pointed me, and thus all those who read this note, to a website that conveys the result of UNICEF surveys of nutritional levels throughout the island. These are invaluable at a more general level. SEE http://www.unicef.org/srilanka/media_6623.htmhttp://www.youtube.com/watch?v=s04o6bnl-Oo
As vitally, this data contains a graph depicting the improvements in nutritional health within the IDP camps between April and September 2009. Hossaini’s note to me, dated 18 November 2012, said that

• “The graph clearly shows the impact of targeted intervention in reducing child malnutrition in a short span of time.”
• And clarified the meanings of the technical terminology thus:

SAM: Severe acute malnutrition
MAM: Moderate acute malnutrition
GAM: Global acute malnutrition

Note that several of the zonal camps that constituted Mänik Farm had UNICEF nutritional tents beside the Field Hospitals of the Ministry of Health; while the grama niladhāris (invariably Tamil personnel for the most part) from the civilian administration also maintained offices within the camps and updated their notice boards regularly.

    

In any event I, as a lay person aware of my limitations, sought the expert advice of Professor Arjuna Aluwihare, (recently retired from the Medical Faculty of the University of Peradeniya) in gaining a fuller understanding of the chart and the whole range of reports from UNICEF. In an email dated 1 December 2012, this was his evaluation:

“I think the situation can be summarized very briefly for the ‘lay’ public!

1 The levels of nutrition and other health indicators vary between districts — the best being Colombo, and the worst being Vavuniya, Jaffna (at some times) and Moneragala.

2 In 2009 the Vavuniya figures were affected by the IDP situation.

3. The epidemics in the camps (viruses of various kinds, chest infection, diarrhoea) came in with the people from the areas in which they had been living and moving in (in great hardship) in the months preceding the end of the fighting. The nutritional status, and infant, child and maternal mortality also reflected that [abnormal circumstance].

4. In the camps mortalities and nutritional status were clearly worse than national or even regional rates at the beginning. Effective action (nutrition action and others), monitoring based — especially by the various personnel in the Ministry of Health, and also professional colleges and NGO’s — led to a dramatic improvement.

5. The worst decline in standards occurred in the 3 months before the end of the fighting, and this was reversed around 3 months after the fighting ended, and by the end of the year nutrition and mortalities were in accord with the district as a whole and were close to the national averages.

6. The action of all those concerned was highly commendable, and could only have been achieved with the ready cooperation of the people in the camps, and with the improvement in water and sanitation that was also secured.
7. Having visited the camps for a few days I feel that the infrastructure was in place to ensure that the data provided was correct and the interventions described were actually carried out.

Yrs Arjuna”