Enduring War and Health Inequality in Sri Lanka

This evidence-based report by the Tamil Information Centre (TIC) analyses, from a human rights and public health perspective, the impact of the violent conflict in Sri Lanka on health, the health system, and relief and reconstruction. In particular it examines the deteriorating health of the population in the conflict zones of the northern and eastern Provinces.

This report aims to inform a wide audience about the health situation in North-East Sri Lanka, and seeks to improve the health conditions through greater awareness and subsequent action. It is the fruit of an extensive literature review and discussions with health professionals and health workers in Sri Lanka and elsewhere. It cites and analyses data derived from the reports of international and nongovernmental agencies

The effects of war are often measured by death and injuries due to weaponry, and the grim total in Sri Lanka is likely to be at least a quarter of a million deaths and hundreds of thousands of trauma-related injuries. Less attention is usually paid to deaths and illnesses arising from the indirect effects of conflict, but as this report suggests, the longer-term impact on the population of the North-East is likely to be equally dramatic. Health has been harmed by conflict-related damage to health-sustaining infrastructure and the health system, as well as by the corrosive effects of conflict-related factors such as poverty, unemployment, disrupted education and low morale.

'Enduring War and Health Inequality in Sri Lanka' highlights the failure of all sides in the conflict to protect health, or to facilitate the rebuilding of the health system. It describes the devastating direct and indirect impacts of the conflict particularly for those living in the North-East but also for Sri Lanka as a whole. Conflict, criminality, social inequality, lack of democratic processes, political instability and decrepit essential infrastructure combine to damage health and arrest the development of a decentralised, primary care-based health system. Immediate action is needed: the need to find alternatives to violence and to resolve political differences peacefully, not least so that ordinary people can rebuild their shattered lives, could not be more urgent.