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Sunday, April 21, 2024

Dr. Veerakanthipillai Shanmugarajah’s Affidavit on conditions in the Vanni

Dr. Veerakanthipillai Shanmugarajah,refugee Medical Superintendent , Mullaitivu General Hospital, being a Hindu, honestly , sincerely and solemnly swear and MAKE OATH as follows:

1. I  am Dr.Veerakanthipillai Shanmugarajah, presently Medical Superintendent ,Mullaitivu.  I was born on 11 June 1968 and am presently 44 years old. I am a graduate of Jaffna University’s faculty of Medicine, and hold the qualification of Bachelor of Medicine and Bachelor of Surgery. I have had additional training in obstetrics and gynaecology and anaesthesia. I have worked as a Medical Officer at the Jaffna Teaching Hospital, the District General Hospital in Killinochi and the Mullaitivu General Hospital. I was the Medical Superintendent at Mullaitivu General Hospital and the acting Medical Superintendent in charge of the obstetrics ward at the hospital. I am married, and have three children aged 13, 10 and 4.

 2. For all my career, I practised medicine in the north of Sri Lanka, and particularly in the Vanni, which is made up of Killinochi, Mullaitivu, Mannar and Vavuniya districts. This area had been caught up in a war between the government and the “Liberation Tigers of Tamil Eelam”’ the LTTE. Also known as the “Tamil tigers”. While the LTTE controlled large parts of the Vanni, The Government of Sri Lanka  continued to provide education, medical and other services to the population.

3. I can confirm that I have been offered the assistance of Stephen Williams, a solicitor of the Supreme court qualified to practice in England and Wales who has helped me to prepare this affidavit.

4. Between January and May 2009 my work involved a mixture of administration, emergency surgery and providing non emergency medical treatment.

5. From 2002 onwards there was a ceasefire in the Sri Lankan conflict. This ceasefire deteriorated and from 2006onwards the conflict began to intensify. From 2007 onwards the war began to affect the Vanni. Government forces gradually recovered areas previously controlled by the LTTE and much of the population of the Vanni moved into other LTTE areas. As doctors within the government medical service and in accordance with a previously agreed disaster protocol, from  late 2008 onwards we moved with the population from district and general hospitals to a series of makeshift hospitals which were established in areas into which the population had been relocated.

6. After the fall of Killinochi to government forces and the displacement of the civilian purposes into other LTTE-controlled areas, my colleagues and I followed the population with the medical services and established a series of hospitals, and in which I served, which were:-
1.Mullaitivu District General Hospital until 5th January 2009.
2.Vallipuram makeshift hospital from 5th January 2009 to 27th January 2009.
3.Thevipuram makeshift hospital form 28th January 2009 to 15th February 2009.
4.Mullaivaikkal West from 15th February 2009 to 3rd May 2009.  There was also a small mediacl unit operating  from Anuabapuram from15th February 20 1st March 2009
5.Vellamullivaikkal from 3rd May 2009 to 5th May 2009

7. These makeshift hospitals were usually situated within school buildings.  As doctors and medical administrators we had already prepared a disaster contingency plan.  The war had previously disrupted the provision of medical services and we had also had the experience of coping with the Tsunami disaster and its effects on  hospitals and medical services in our area.  In early 2008, we had already discussed a disaster plan with the Government Agent in Mullaitivu.  Doctors and administrators had received training in disaster management from non-governmental organisations such as Oxfam and others.

8. In the medical team for which I had responsibility, we had more than ten doctors, several of whom were senior surgeons having graduated  from medical school in the early 1990’s.  The most junior surgeon that we had on the team had 5 years surgical experience.  We also had about 15 trained theatre nurses.  I am proud to say that we maintained as much of a medical and surgical presence as possible all the way through the crisis up to 14th and 15th May 2009.

9. We would receive those who had been injured into our temporary hospitals and provide them with the medical and surgical treatment as necessary.  The patients would then be evacuated by the International Committee of the Red Cross.  IN the earlier part of the crisis they were evacuated by road to government hospitals in Vavuniya.  Toward the end of the crisis, the ICRC evacuated our patients by ships to hospitals in Trincomalee.   I am proud to say that we were able to save most of the people who came into our medical centres at the time.  We stopped operating on the evening of the 13th May and for 14thand 15th May we were only able to offer first-aid services.  The war ended on 15th May.

10. The number of people arriving on a daily basis at our temporary medical points from January 2009 onwards fluctuated.  On some days there would be no casualties, and on others one or two but this escalated and toward the end of the crisis we were receiving as many as one hundred casualties per day but the figures fluctuated with the ebb and flow of the fighting.  Of these, perhaps thirty percent would be LTTE combatants, and the rest civilians.

85b-08_02_09_03   86b–19_02_09_01

11. Some comment has been made about the prevalence of malnutrition in the area in which I was based.  I can say that I saw very few cases of malnutrition.   They were too mild to moderate in nature.

H 112b -09_05_09__Mulli-vaaykkaal_06   H 111a -queues 27 April 09 H 111b 28_04_09_foodshortage_03 H 112a -09_05_09__Mulli-vaaykkaal_12

12. The patients we dealt with were suffering from a variety of injuries, including close-fighting injuries such as gunshots as well as shrapnel wounds from shelling.  We also dealt with a range of routine medical matters, including the delivery of babies.

13. As a matter of course we kept meticulous records of casualties and fatalities during this period.  Our computerised records were lost in the last days of the fighting but I would say that there were between 500-600 deaths in March 2009 and in all about 2,500 deaths up to the end of the crisis that I was aware of.

14. During the course of the conflict I either experienced or was advised of several incidents of shells falling either in or in the immediate vicinity of our makeshift hospitals.

15. In January 2009 at Vallipuram hospital two shells landed, one outside the outpatients department, the other at the back of the hospital.  I understand that 2 people were killed and 4 were injured in that attack.

16. At  Puthukudiyiruppu hospital there were two occasions in which shells fell, one on the hospital building itself and one in the hospital grounds with there being 3 deaths and 10 injuries.

17. Vellamullivaikkal hospital also received incoming shell fire on one occasion which left 5 dead and 10 injured.

18. Mullaviakkal hospital received shell fire to the grounds immediately in front and behind the hospital building leaving 4 dead and 10 injured.

19. I had at various points in the conflict remonstrated with LTTE commanders about munitions being placed near to hospital buildings. Sometimes they were sensitive to the need to remove these munitions and at other times my objections were ignored.  During the last two weeks of the fighting there was a breakdown in the command structure of the LTTE forces nearest to the hospital and no requests that I made to move munitions away from the hospital were listened to.

20. I was on several occasions put under pressure by the LTTE International co-ordinator to give false death and casualty figures to the International Media.  On one occasion, the death toll that day had been 34 but I was instructed to tell the media that the death toll was 534.  This was not true but I knew that to disobey the direction of the LTTE would result in immediate punishment.  My colleague D. S refused to obey an LTTE request and that resulted in his being shackled by the ankles and placed in prison for a month.

21. As part of our disaster management plans, we had stockpiled medical supplies an drugs from 2008 onwards.  In 2009 we had 30 fridges dedicated for the use of drugs.  This then went down to 14 fridges as we relocated to a series of makeshift hospitals.

22. In terms of ordering medical supplies we had a medical committee which met every month to review the situation and order medical supplies.  In December 2008 we received a large shipment of about 60% of the supplies requested for the next 12month period and we thereafter were supplied once every 3 months and in the later stages of the war these supplies came by ship via the ICRC.  There was a problem with supply during the last 5 days of the conflict when all ship movement was disrupted.

23. We had approximately 6 generators for hospital use but by the end of the conflict we only had three that were still working. These maintained power to the temporary operating theatres, drug fridges and other essential needs. The generators were single-phase and ran a simple line. We also stockpiled fuel with which to keep our generators going. These supplies were added to when the United Nations withdrew their presence in September 2008;  we received some of their fuel supplies. These supplies moved with us as we moved our medical operations to makeshift hospitals. We had named officials who were in charge of supervising medical supplies, fuel and transport. We did face attempts by criminals to steal our fuel.

24. I have seen both of the Channel 4 programmes about the last months of the war in Sri Lanka. I was  surprised at the claims made in both of these programmes. I was present as a medical doctor, surgeon and administrator all the way through the events featured in the programmes, up to the final days of the conflict. I am also mentioned in the first programme, and my image features in the second.

25. I am very surprised that Channel 4 never once attempted to contact me regarding either of the programmes as I was very well placed to provide accurate and clear information about the provision of medical services within the conflict area during the latter stages of the fighting.

26.  I am particularly surprised they did not attempt to contact me with regards to the claims made by Vany Kumar in the first programme. Vany Kumar and a companion were brought to the hosjpital by the LTTE on  or about 21 April 2009. I asked her about her experience and she told me that she had no medical qualifications. She agreed to help to dress wounds and clean the medical areas. I do remember her watching an epidural procedure.

27. Vany Kumar states that she witnessed me amputating the leg and arm of a six year-old without anaesthesia. This is a complete fabrication and I am amazed at such a claim for several reasons. Amputations were carried out in the makeshift medical centres during this period, but they had been performed by other surgeons and doctors. I performed no amputations at all during the crisis: the last time I had performed an amputations of any sort had been in 2005. I had performed more than 1,000C-sections from 2005 until May 2009, and had been the supervisor of staff involved with more than 5,000 deliveries. I carried out a C-section as late as 12 May 2009.

28. I am also appalled at Vany Kumar’s suggestion that any major operation, especially an amputation, would have been carried out without anaesthesia. Because of our emergency disaster planning our stock of medical drugs and anaesthetics lasted us until the end of the crisis and anaesthesia was available right up until we ceased surgery on about the 13th May 2009.

29. Vany Kumar also claimed that surgery was carried out with a kitchen knife. I also find this to be a false and amazing statement. We had ample supplies of surgical instruments, and used seperate surgical blades on each patient. We had  a stockpile of 5,000 surgical blades as of January 2009. We also had the full range of instruments, including bone-cutters.

30. When we moved from the district hospitals into other parts of the Vanni we took with us more than 30 truck-loads of equipment and supplies, equipment and supplies which we then moved with us as and when we set up makeshift and temporary medical centres.

31. Vany Kumar also claimed that she helped to filter blood coming out of a patient through a cloth before feeding it back into their veins. This again is totally untrue. Whilst it is true to say that we had some problems screening our blood supplies as the fighting came to an end, we never had to resort to the type of practice that Vany Kumar identifies and to my knowledge she was never involved in the transfusion of blood. Blood was collected from the local population to be used in transfusions and Vany Kumar may have seen patients who underwent operations having blood removed and reinfused into them. She was not directly involved in any of these procedures.

32. The International Committee of the Red Cross were aware of the precise location of all our makeshift and temporary hospitals. They would often be briefed in the positions to which we would be relocating. The ICRC would then log GPS co-ordinates. It was not our job as doctors to do so and we did not have the equipment with which to do so.

33. I am surprised that Channel 4 did not contact me before making the claims they then televised. I was back working in the Vanni from October 2009 onwards and would have been easily and readily contactable by telephone at any of the hospitals at which I worked. It would have been very easy to contact me by telephone.

34. Similarly, I am aware of the claims made by Gordon Weiss regarding the number of shellings hospitals in the conflict area suffered. These claims are wrong. It is also the case that at no stage did Mr. Weiss try to contact me to discuss any of the events in the Vanni that he sought to describe.

35. I have never had the opportunity of telling my story. My contact with the international media has been disappointing. They have only been interested in casualty figures and were not at all concerned about the broader history of the provision of medical services in the conflict zone towards the end of the fighting.

SWORN at Colombo Sri Lanka                   Signature of Dr.V.Shanmugarajah


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