In reply: I assure the Deputy High Commissioner of Sri Lanka and the Sri Lanka College of Paediatricians that I did look at “the actual realities” during 6 months of visiting hospitals and participating in tsunami relief in the south of Sri Lanka and teaching paediatrics in the Tamil north. I did see another side of the story that I felt needed telling, though not “at the behest of the LTTE [Liberation Tigers of Tamil Eelam]”. I observed a great disparity between the health facilities in the north and south of the country, and witnessed the stunting and wasting of Tamil women and children.
I did go through a government-approved channel, using lawful means. I was employed by an international organisation that handled my visit and redirected me, after arrival, to teach in the north. Before that, I had never knowingly met a Tamil Tiger. If my organisation did not register me with the Medical Council, it would not have been unusual in that post-tsunami period, when many organisations brought doctors from a range of countries into Sri Lanka.
I do not wish to name my organisation for fear of endangering its workers. Seventeen members of the French-based organisation Action Against Hunger have been murdered and, according to the Sri Lanka Monitoring Mission, “the Security Forces of Sri Lanka are widely and consistently deemed to be responsible”.1
I abhor terrorism as much as most, but the question for Sri Lanka is: “Who is terrorising whom?” The use of terrorism by the LTTE is well publicised. Its use by the state is not, yet its aerial bombing has killed civilians, destroyed facilities and emptied villages, according to church sources.2 Over 250 000 people have been displaced, and “a deliberate policy of extrajudicial killings and abductions of Tamils” has resulted in hundreds of deaths and the disappearance of over 1000 people since early 2006.3 The dead include 23 aid or church workers and 68 children.4 Tamils fear that the underlying intention is genocide. It is hard for me to believe that the government is “protecting [Tamil] civilians” and doing its “utmost to help them”. Has the Sri Lanka College of Paediatricians protested the suffering of Tamil children?
Contrary to the Deputy High Commissioner’s assurances of freedom of the press in Sri Lanka, seven media workers have recently been killed,5 and in 2007 the country earned 156th place in a Worldwide Press Freedom Index, just above Somalia.6
The statement of the College of Paediatricians that there was “no necessity . . . to teach medicine to LTTE cadres, who would, in any case, be inadequately educated and patently incompetent at performing responsible medical duties” is ignorant of “the actual realities”.
These practitioners began medical studies in 1992 based on the curriculum of the University of Jaffna. Since then, theory has been complemented with long periods of clinical responsibilities — from staffing field and civilian hospitals during warfare and peacetime to dealing with cholera and malaria outbreaks, the chronic problem of tuberculosis, the acute needs of tsunami victims and the constant needs of sick children. They function as medical officers of the Department of Health of the de-facto government of the vast north-east region, historically inhabited by the Tamil race, whose needs exceed the capacity of the relatively few government doctors who, I acknowledge, do a great job with limited resources.
They wanted to learn more paediatrics. Should they have been left “inadequately educated”? For me, that would have constituted medical malpractice. Regarding the Hippocratic Oath, I assure the College of Paediatricians that I stayed in Kilinochchi “for the benefit of the sick, remaining free of all intentional injustice”, but I must confess that things I saw and heard in the course of the treatment I have not kept to myself, believing silence to be more “shameful”.
- 1. Senanayake S, Sengupta S. Monitors say troops killed aid workers in Sri Lanka. New York Times 2006; 31 Aug. http://www.nytimes.com/2006/08/31/world/asia/31lanka.html (accessed Feb 2008).
- 2. No fear of Tigers in the east but the people’s future and livelihood questionable — Bishop Swampillai. Asian Tribune 2007; 30 Aug. http://www.asiantribune.com/?q=node/7178/print (accessed Feb 2008).
- 3. International Crisis Group. Sri Lanka’s human rights crisis. Asia Report 2007; 14 Jun. No. 135. http://www.crisisgroup.org/home/index.cfm?id=4896 (accessed Feb 2008).
- 4. Law and Society Trust. Second submission to the Presidential Commission of Inquiry on Human Rights Violations in Sri Lanka: Jan–Aug 2007. 31 October 2007. http://www.lawandsocietytrust.org (accessed Feb 2008).
- 5. Reporters Without Borders. Sri Lanka — annual report 2007. http://www.rsf.org/article.php3?id_article=20798 (accessed Feb 2008).
- 6. Reporters Without Borders. Worldwide Press Freedom Index 2007. http://www.rsf.org/article.php3?id_article=24025 (accessed Mar 2008).
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