PHR Calls for Inquiry into Detention of Doctors and War Crimes in Sri Lanka

Cambridge, Mass – 05/20/2009

Physicians for Human Rights (PHR) believes that the detention of three Sri Lankan doctors is an attempt to suppress reports about the humanitarian crisis, civilian casualties, and attacks on hospitals during the recent routing of Tamil separatist forces in Sri Lanka.

“In the context of indiscriminate attacks on civilians and the sealing off of the conflict zone, PHR is calling for an international Commission of Inquiry to investigate possible war crimes in Sri Lanka by all parties,” stated Frank Donaghue, PHR’s CEO.

Doctors in Detention for Following Professional Ethics

The Sri Lankan Army (SLA) detained the doctors on 16 May 2009, and a government official stated on 18 May that government forces handed them over to police. They are reportedly being charged with “spreading false information” and are in police custody, reportedly at the Terrorist Investigation Division in Colombo. PHR fears Sri Lankan security forces will use excessive force or torture in retaliation against them for providing detailed information about government shelling and civilian casualties in the conflict zone to outside media. The Sri Lankan Prevention of Terrorism Act grants security forces broad arrest and detention prerogatives.

“Physicians for Human Rights is deeply concerned about the arrest and detention under illegitimate charges of our three Sri Lankan colleagues.  We have no information on the three men’s conditions of confinement, but we fear for their health and safety,” stated Mr. Donaghue.

PHR calls on the Sri Lankan government to release the doctors immediately and to respect their rights to legal counsel and to receive medical care as well as family visits.  The International Committee of the Red Cross (ICRC) should also be given immediate access to the doctors.  

As the conflict zone became increasingly inaccessible to the outside world, the doctors provided first-hand accounts of shelling and civilian casualties and described the condition of their patients.  Reliable sources indicated to PHR that the government is likely detaining them in retaliation for adhering to their ethical obligation to protect the lives of their patients in all circumstances. These are serious violations of medical neutrality.

“Doctors have an ethical duty to prevent and limit suffering of patients in their care and a duty to practice medicine in a neutral way without fear or favor. When there is evidence of any attack on a hospital or medical facility, it is appropriate for physicians to speak out in keeping with their ethical commitments. An embarrassed government has no right to detain doctors for practicing neutral medicine and for providing factual reports about the humanitarian and health situation on the ground,” stated Donaghue.

The three government physicians, who were last seen on 15 May 2009 at the Omanthai crossing point in northern Sri Lanka, are:

  • Thangamutha Sathiyamoorthy, MD, Regional Director of Health Services in Kilinochchi.
  • V. Shanmugarajah, MD, Medical Superintendent at Mullivaaykkaal field hospital.
  • Thurairaja Varatharajah, MD, Regional Director of Health Services in Mullaitivu, who apparently sustained bullet wounds to his shoulder.  SLA forces reportedly airlifted him from the Omanthai crossing point to Anuradhapura hospital.

Violations Against Civilians Require Investigation

More than 7,000 civilians alone have been killed during renewed intense fighting since January 2009, according to the United Nations.  PHR sources estimate that number now exceeds 8,000. Without a functioning hospital anymore to provide emergency care for the remaining wounded, that figure will likely increase significantly.

Both government and LTTE forces have committed egregious violations of human rights and humanitarian law.  PHR received eyewitness accounts that government forces used heavy weapons (mortars, artillery) and indiscriminately bombed civilian populations.  High-resolution satellite imagery analyzed by the American Association for the Advancement of Science (AAAS) illustrates shell-impact craters throughout the conflict zone, which corroborates these testimonies.

During hostilities, the population density of the estimated 150,000 IDPs held hostage in the conflict zone was so great (approximately five times more densely populated than Manhattan) that bombing even near these human settlements, as well as substantiated reports of targeting and destroying field hospitals, constitutes a grave breach of international humanitarian law (IHL).

LTTE forces reportedly used civilian populations as “human shields” and prevented them from leaving to seek refuge.  These actions also constitute serious IHL violations.  Sources in the “no-fire zone” reported to PHR that LTTE forces had shot, wounded, or killed some Tamil civilians trying to flee.  PHR also received reports of systematic forced conscription of child soldiers as young as 12 years into the LTTE, which commonly demanded that two or more persons from each Tamil family join their ranks.  The recruitment of child soldiers under the age of 15 is prohibited under IHL.

Physicians for Human Rights calls on the United Nations to convene a special session of the Human Rights Council (HRC) and for the HRC to establish a Commission of Inquiry to investigate possible war crimes and crimes against humanity in Sri Lanka. 

Immediate Concern for the Safety and Wellbeing of IDPs: Access and Transparency Required

PHR remains alarmed by the tens of thousands of civilians who are unaccounted for and who still lack access to humanitarian emergency relief in the conflict zone.  Given reports of indiscriminate attacks on the civilian population in northeastern Sri Lanka, PHR calls on the Sri Lankan government to ensure the protection and freedom of movement of all civilians and medical personnel.

The protracted armed conflict has forcibly uprooted nearly half a million IDPs, or roughly one-quarter of the country’s Tamil population.  Women and children comprise an estimated 80% of Sri Lanka’s IDP population.  According to the UN, the government is accommodating 230,000 registered Tamil civilians in 41 heavily militarized camps as of 18 May 2009.  An additional 50,000 await screening and transport to camps.  A total of 80,000 IDPs fled the conflict zone immediately following the end of hostilities on 17 May 2009.

International aid workers have no access to some IDP camps, and sources report to PHR that most camps lack sufficient shelter, clean water, food stocks, medical supplies, and adequate hygiene. The Sri Lankan government must immediately allow unhindered access to all IDP populations for humanitarian personnel to provide emergency relief as well as to conduct a thorough needs assessment.

As populations move in the aftermath of the recent intensive campaign by the SLA, the government must initiate a transparent IDP screening process, which ICRC or UN observers should be allowed to oversee.  The government must unequivocally guarantee security and protection of all IDPs, including women and unaccompanied children, who are at risk of targeted sexual violence.  Government authorities need also to plan now for the early and safe return of all IDPs to their places of origin while adhering to established UN guidelines.

Civilian Casualties and Disease Require Emergency Health Response

Fighting between the 150,000-strong SLA government forces and the 7,000-strong LTTE armed forces has led to a significant number of wounded.  The UN reported some 16,700 casualties between January and April 2009.  Intense fighting during May 2009 only augments this figure.  Sources in the region whom PHR interviewed reported treating maimed victims needing amputation of limbs and other war-related wounds.

Reliable sources in the conflict zone reported “more than 50% of the health staff are not reporting to duty because their residences are under attack.”  PHR also received reports of severe over-crowding at the make-shift field hospitals, a critical lack of medical supplies (anesthetics), medicine (antibiotics), and potable water, which prevent medical staff from adequately treating most casualties.

PHR received several reports of outbreaks of Chickenpox, Hepatitis A, and Typhoid in a number of IDP camps in government-controlled areas. Food insecurity among civilian IDPs is also of concern as food intake is reportedly well below daily nutritional requirements.  One source opined that one out of four displaced children is malnourished.

The Government of Sri Lanka must ensure that all IDP camps meet internationally accepted standards including safe and equitable access to sufficient clean water, sanitation, hygiene, health services, shelter, and food. Further, the Government must demilitarize all IDP camps and transfer camp administration to civilian control.

Background

The armed conflict in Sri Lanka, an island country off the southern coast of India, has pitted Sinhalese government forces against the LTTE for 26 years.  Tamil-Sinhalese ethnic tensions have existed, however, since at least 1948 when nationalist Sinhalese communities won Sri Lanka independence from British colonial rule.  Disagreements over post-independence power-sharing erupted between the minority Hindu Tamils and majority Buddhist Sinhalese while drafting the country’s first constitution.  Sinhala replaced English as the official language of Sri Lanka in 1956.  Although later amended, this act had its intended effect and forced most Tamils from civil service positions as they did not speak the majority language.  Several state-sponsored colonization schemes concurrently fueled tensions as the government encouraged Sinhalese settlement in Tamil-populated northeastern Sri Lanka.  Government-imposed cultural and educational restrictions on the Tamil minority in the 1970s further exacerbated relations between the two ethnic groups resulting in a rise in Tamil militancy.  Armed LTTE forces ambushed and killed 15 government soldiers on 23 July 1983, and riotous mobs of Sinhalese civilians across the country retaliated by beating, raping, burning, and killing some 1,000 Tamils and destroying thousands of Tamil homes.  The events of “Black July” marked the beginning of the armed conflict.