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Viewing cable 09COLOMBO528, SRI LANKA: STATUS OF FIELD HOSPITAL REQUEST AND USG HEALTH

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Reference ID Created Released Classification Origin
09COLOMBO528 2009-05-14 09:46 2011-08-25 00:00 UNCLASSIFIED Embassy Colombo
VZCZCXYZ0001
OO RUEHWEB

DE RUEHLM #0528/01 1340946
ZNR UUUUU ZZH
O 140946Z MAY 09
FM AMEMBASSY COLOMBO
TO RUEHC/SECSTATE WASHDC IMMEDIATE 9974
RUEHKT/AMEMBASSY KATHMANDU PRIORITY 6901
RUEHBK/AMEMBASSY BANGKOK PRIORITY 3828
RUEHNE/AMEMBASSY NEW DELHI PRIORITY 3032
RUEHIL/AMEMBASSY ISLAMABAD PRIORITY 8666
RUEHKA/AMEMBASSY DHAKA PRIORITY 1664
RUEHGV/USMISSION GENEVA PRIORITY 3517
RUCNDT/USMISSION USUN NEW YORK PRIORITY 1181
INFO RHEHAAA/NATIONAL SECURITY COUNCIL WASHINGTON DC
RHHMUNA/CDR USPACOM HONOLULU HI//J3/J332/J52//
RHMFIUU/CDRUSARPAC FT SHAFTER HI//APCW/APOP//
UNCLAS COLOMBO 000528 
 
SIPDIS 
 
DEPARTMENT FOR SCA/INS AND PRM 
STATE ALSO PASS TO USAID 
AID/W FOR ANE/SCA 
AID/W FOR DCHA/FFP FOR JDWORKEN, JBORNS 
AID/W FOR DCHA/OFDA FOR ACONVERY, RTHAYER AND RKERR 
BANGKOK FOR USAID/DCHA/OFDA WBERGER 
KATHMANDU FOR USAID/DCHA/OFDA MROGERS AND POL SBERRY 
USMISSION GENEVA FOR NKYLOH 
USUN FOR ECOSOC DMERCADO 
 
E.O. 12958: N/A 
TAGS: EAID PREF PGOV PHUM CE
SUBJECT: SRI LANKA: STATUS OF FIELD HOSPITAL REQUEST AND USG HEALTH 
ASSISTANCE 
 
1.  SUMMARY: Following several weeks of discussion with Ministry of 
Health (MOH) and other Government of Sri Lanka (GSL) officials, the 
US Government (USG) for a variety of reasons has decided not to 
provide a field hospital in the conflict-affected North.  Key 
factors considered included rapidly enhanced MOH capabilities on the 
ground, the expansion of the network of hospitals that IDP 
populations can access, an increase in the number of health actors 
with access, and a changing ground reality with regard to medical 
needs. The USG has provided a robust response in the health sector 
with plans to provide $1.6 million in-kind supplies and medicines. 
End Summary. 
 
The Situation 
 
2.  When the initial influx of IDPs commenced on April 20, we 
recognized the immediate need to enhance medical facilities to serve 
them.  In response, USAID's Office of Foreign Disaster Assistance 
(OFDA) negotiated a grant with the International Organization for 
Migration (IOM) to rapidly deploy 10 large primary health care units 
next to IDP populations.  Each unit has the capacity to provide 
diagnosis, emergency care, and health education for 10,000 patients 
and to refer and transport more critical patients to hospitals 
through three ambulances.  Prior to this intervention, OFDA had 
provided the MOH with five WHO health kits, each with enough 
medicines and supplies to assist 50,000 people.  The kits are now 
being used in MOH-run medical facilities.  The value of the two 
projects is $960,000. 
 
3.  On April 25, after several weeks of discussion, the Minister of 
Health, Nimal de Silva, met with USAID officials and asked that the 
USG provide two field hospitals for the North.  He said that the MOH 
was amenable to the U.S. military providing personnel along with the 
hospitals, as long as they were not in uniform.  On April 29, 
Embassy received a formal request from the Secretary in the Ministry 
of Health, Dr. Athula Kahandaliyanage, stating the request had the 
endorsement of the Office of the President.  Embassy noted that the 
Ministry of Health letter stated that "Ministry of Health would 
provide personnel to the hospitals," and requested "names of 
accompanying technical personnel to install the hospitals."  This 
language indicated that the deployment of U.S. medical personnel 
still had to be negotiated and clarified with the Sri Lankan 
Ministries of Health and Defense.  When the Charge raised this issue 
with the Minister of Foreign Affairs and the Presidential 
Secretariat, he was assured that there was no issue with 
non-uniformed military personnel, but we would receive nothing 
further in writing. 
 
4.  Simultaneous to these discussions, USG officials had undertaken 
to assess existing medical needs as the situation in the North 
evolved.  Through field assessments and conversations with health 
actors, the USG learned that MOH capacity had improved significantly 
vastly in terms of staff and facilities: Doctors and nurses from all 
over the country were sent to the North, IDPs now have access to 14 
hospitals, the MOH has set up a 10,000 square foot dome hospital in 
the most populated zone of IDP camps in Vavuniya, and several 
hospitals and clinics have been augmented with wards and beds.  The 
USG further understood that the long-negotiated Norwegian Red Cross 
and Medecins Sans Frontieres (MSF, or Doctors Without Borders) 
France field hospitals and staff were being allowed into the 
country, in both Mannar and Cheddikulum respectively, and that MSF 
Holland staff and equipment were being allowed in to augment 
hospitals. Beds were therefore being increased, as were equipment, 
staff, and surgical capacity.  These two field hospitals were in 
addition to field hospitals, with military medical support 
personnel, provided by the governments of India and France. 
 
The Agreement 
 
5.  On May 10, USG officials met with MOH officials, including 
Minister de Silva and Secretary Kahandaliyanage.  During the 
meeting, MOH officials said that the realities and consequent needs 
on the ground had changed, and that they would prefer that the USG 
 
provide a long term hospital focused on obstetrics and pediatrics. 
The USG officials responded that providing such a hospital would 
probably not be possible at this time and suggested that the USG 
continue to provide assistance in upgrading the water, sanitation 
and hygiene (WASH) conditions at the camps.  Minister de Silva 
responded that improving the WASH conditions could solve "90 percent 
of our problems," and agreed with the recommendation.  The USG 
representatives further advised that they would be willing to 
consider the provision of the $1.6 million in-kind request for 
medicines and medical supplies made by the MOH earlier.  (Note: 
USPACOM has identified $1.6 million worth of excess medical goods 
that they could provide).  The MOH officials agreed with this, 
saying that they would be willing and able to waive any taxes 
associated with bringing the goods into Sri Lanka. 
 
6.  On May 11, USAID sent a letter to the MOH summarizing p the 
meeting and reaffirming our commitment to assist the MOH and GSL in 
humanitarian assistance efforts.  We further stated that 
understanding the direct correlation between water, sanitation and 
hygiene with health, we would continue to focus our assistance in 
these sectors to mitigate disease outbreak. 
 
MOORE