Médecins Sans Frontières (MSF) and Sri Lankan Ministry of Health medical staff in Vavuniya hospital continued to work round the clock this past weekend. Patient numbers have stabilized at 1,700 over the past two days as some patients are now being diverted to other hospitals to ease the pressure. MSF has offered the Sri Lankan government to scale up its medical activities and is currently in discussions with the authorities for permission.

The thousands of people that were waiting at Omanthai checkpoint on Friday have now been transferred to Manik Farm, an open land area with temporary camps 40 km south west of Vavuniya. There is now a total of 100,000 displaced people in Manik Farm and bulldozers are clearing the land to make space for new arrivals.

Telephone conversation with Paul McMasters on Sunday, April 26

“Medical staff are still working round the clock and the situation is changing day to day. The number of patients admitted requiring emergency surgery had dropped quite sharply before the weekend. On April 23, we had 44 patients, the first day the figure was below 100 since last Sunday. On April 24, we only had 18.

"I have had no indication that fewer casualties are coming from the north but, because we have a backlog, they are now trying to divert patients to other hospitals. There are still people crowded in the wards, in the corridors, on the floor, with fractures, open bullet wounds and blast injuries. There are many people who have been waiting in the wards to go into theatre, some of them for up to 24 hours.

"On Saturday, Tim [the other MSF surgeon] and the Sri Lankan team that arrived last Thursday, were in theatre until late at night getting through the backlog of cases. I spent the whole of yesterday seeing hundreds and hundreds of patients, examining x-rays, stitching wounds, plastering, getting people on crutches and mobile, teaching physiotherapy to nurses [there is only one physiotherapist for the whole hospital].

"Today, Tim stayed in the hospital and I went with other colleagues to Mannar hospital, in the west, to see if they can help with our casualties. All the hospitals are really struggling. Mannar hospital has 350 beds for almost 1,000 patients and some of them are in tents outside the hospital building.

"We also drove to Manik Farm today, 40 km south west of Vavuniya. There are now 100,000 displaced people. Bulldozers are clearing more land to make more room and UNICEF is putting tents up by the hundreds. We went to assess the needs and see what MSF can do there. One man who had arrived to Manic Farm from the north a few days ago came up to us saying 'I have nothing, I have nothing'. He was just standing there, shell-shocked, just telling us, 'I have nothing'.

"I am in Vavuniya this evening and it is pouring with rain so if it is raining like this in Manic Farm, the camps will turn into mud baths. This weekend we have nearly cleared the surgical backlog and the Sri Lankan surgical team left earlier today. We might be getting another one later this week.

"I’ve not heard that the fighting is stopping and I don’t know how many more wounded will come but we are ready for the next wave, if it comes. We take each day as it comes.”