Tamils - a Trans State Nation..

"To us all towns are one, all men our kin.
Life's good comes not from others' gift, nor ill
Man's pains and pains' relief are from within.
Thus have we seen in visions of the wise !."
- Tamil Poem in Purananuru, circa 500 B.C 

Tsunami Disaster & Tamil Eelam

Tsunami & Sri Lanka: Emerging Realities

Brian Senewiratne

10 January 2005

"..Even in the face of a national disaster, ethnic and political considerations are never too far away in Sri Lankan thinking, in particular in the minds of the Sinhalese politicians of all parties. The best example of this is a recent statement by President Chandrika Kumaratunga that the Tamil Tigers had lost too many cadres in the tsunami disaster to resume the armed struggle. This is an outrageous comment from a national leader whose country has been decimated. Faced with a national crisis from an unavoidable natural disaster, all that the President could do was to focus on what ‘benefit’ it could be towards settling her political problems...

In a disaster such as this, there is rarely any difficulty in raising money or goods. Such is the generosity of ordinary people across the world. The problem is its delivery to the affected people. If this is left in the hands of the Government, Sri Lankan or any other, it will not go where it is most needed. The entire effort of raising the aid will then be nothing but a betrayal of the trust of people who have given so generously to alleviate the suffering of the less fortunate. The damage done is many layered and unless at least some of these are addressed the aid may well be wasted. There are people in positions of power who have an agenda and a hidden agenda and it is our business to identify and address these. This is a lot harder than colleting aid but infinitely more useful. "

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Over the past two decades a deep ethno-religious split has occurred between the Tamil minority and the majority Sinhalese-dominated Government (for the record, I am a Sinhalese). In the face of continuing discrimination in the use of their language(Tamil), education, employment and the developmental neglect of the area they live in (north, northeast and east), the Tamils (12.5% of the population) have been asking for a federal or separate state. With peaceful non-violent Tamil protests being met by Government-sponsored violence, in 1972 the Tamil Tigers embarked on an armed conflict to establish a separate Tamil state in the North and East. After 30 years of one of the most destructive conflicts in Asia, in February 2002 a ceasefire was negotiated between the Tamil Tigers and the former Sri Lankan government under Prime Minister Ranil Wickremasinghe. Since then, the guns have been silenced but the basic problems underlying the conflict have not been resolved.

In late 2003, President Chandrika Kumaratunga, from the other side of the Sinhalese political divide, using her sweeping executive powers, sabotaged Prime Minister Wickremasinghe’s parliamentary tenure, precipitating yet another General Election, four years ahead of schedule. Following the election, her party formed Government in December 2003. The new government, with extreme anti-Tamil ‘Marxists’ (read ethno-religious chauvinists) in its fold, has been dragging its feet in political negotiations with the Tamil Tigers, putting the ‘Peace’ under threat. A resumption of the fighting, a possibility pre-tsunami, would have seriously damaged Kumaratunga’s political career and even more so the massive foreign aid package of US$4.5 billion, negotiated by the Wickremasinghe government, and promised on condition the peace process would go forward (which it was not).

As a result of the 20-year war in northern Sri Lanka, the Northeast came under Tamil Tiger control. With a complete absence of government administration in this devastated area, the Tamil Tigers have, over the years, established a quasi-separate state with its own army, police, law courts, administration, infrastructure, and rehabilitation and reconstruction programs. The writ of the Sri Lankan Government does not even run in this area.

The tsunami hit the south coast (which is under the Sri Lankan government) and, causing even more devastation, the northeast (which is under the Tamil Tigers).

Political thinking and actions.

Even in the face of a national disaster, ethnic and political considerations are never too far away in Sri Lankan thinking, in particular in the minds of the Sinhalese politicians of all parties. The best example of this is a recent statement by President Chandrika Kumaratunga that the Tamil Tigers had lost too many cadres in the tsunami disaster to resume the armed struggle. This is an outrageous comment from a national leader whose country has been decimated. Faced with a national crisis from an unavoidable natural disaster, all that the President could do was to focus on what ‘benefit’ it could be towards settling her political problems. There can be no better example of the narrow-mindedness of Sri Lankan politicians even when faced with a major humanitarian disaster, with nearly 40,000 killed (probably more), many thousands whose lives have been shattered, two million rendered homeless, and extensive damage to two thirds of the coastline and those who live and work in this area. The President’s insensitive and irresponsible comment should not only be condemned, but should be noted by the international community since it has a direct bearing on aid, its delivery, and even its use and abuse in Sri Lanka.

The actions of the Sri Lankan Government, match this thinking. For five crucial days after the tsunami struck, the entire Government focus was on tourist resorts in the South, which was what the world saw and where the foreign aid went. Not a scrap of foreign aid arriving in Colombo was sent to the Tamil northeast and east, which suffered some of the greatest destruction. Aid that this devastated area so desperately needed came from the expatriate Tamil community, mainly via the Tamil Rehabilitation Organisation (see below), international NGOs and church groups, and civilians, both local and foreign. With increasing international concerns about what the Sri Lankan government was not doing, the Government belatedly sent some aid, although grossly inadequate in relation to the destruction, a situation which continues to this day.

The result of this neglect of the Tamil areas is a serious increase in preventable deaths and disability of the people in this area (mainly Tamils). A single quote from an Australian volunteer doctor, David Young, operating in this area, illustrates this. “Too many of the people will be left crippled, not because the injuries are that bad, but because the treatment they are receiving is woefully inadequate”. Doctors, both local, expatriate and foreign, working in the East and Northeast, are amputating limbs simply because they do not have the basic screws, plates and pins needed to fix broken bones.This is just one example. There are many more that have resulted in unnessary suffering, permanent disability and even death.

The Sri Lankan Government is guilty of criminal negligence, which has nasty ethnic overtones. It is up to the international community and foreign governments, and Sri Lankan civil society to do something about this and see that the donated money and goods go where they are most needed. This may not be ‘diplomatically easy’ but we are here talking of the lives and future of thousands of poor people (as we were in Rwanda, Ethiopia and innumerable other places) and diplomatic protocol has no place. To do otherwise is blatant hypocrisy that has devastating humanitarian consequences.

News

For many years, news out of Sri Lanka has been either Sri Lankan government propaganda or Tamil Tiger propaganda. Today, with international media roaming around the country, it is unnecessary to rely on either of these sources since independent reporters are there to report the situation as it is. The picture that emerges from these and other reports from international journalists forms the basis of this article.

The ground realities

1 The Sri Lankan Government

The Sri Lankan Government, in striking contrast to the Thai government, seems to have been completely unable to handle the situation. The infrastructure, organization and competence which are so necessary to handle a disaster of this magnitude, simply does not seem to exist. One wonders what the Disaster Management Unit of the Presidential Secretariat under President Kumaratunga, no less, was doing. The result of this disorganization was that aid even to the South, which is so readily accessible, faced problems in its delivery.

As for the East and Northeast, there is not only the inability to do so but also a highly questionable resolve to do so. For example, 24 hours after the wave struck, the Government summoned a meeting of all Parliamentary parties to discuss the management of the disaster. In the two-hour conference, the situation in the northeast, that had borne the brunt of the damage, was discussed for less than five minutes. A factually correct comment came from an MP from the area “They simply are not bothered about the plight of our (Tamil) people.” With 4% of the time spent in discussing an area which took nearly 60% of the damage and from 50% of the casualties came (of the 30,000 dead, 9,500 are confirmed dead from the North and another 10,000 missing), the comment is entirely justified. It should open the eyes of aid-givers that about 4% of their aid will reach this area if its delivery is left in the hands of the Sri Lankan government.

The Sri Lankan President, emerging at last from her holiday, breezed into Colombo and immediately set about marginalizing what her own Prime Minister, Mahinda Rajapakse, had been commendably doing with the Opposition Leader, Ranil Wickremasinghe. Rajapakse was told that there was enough to be done in his home town in the South and that he should not be running around the rest of the country!. The crude message was to go home and stay there. The reason for this extraordinary request was that any build-up of the Prime Minister’s profile had to be prevented. Not even a tsunami was sufficient to prevent the internal squabbles of the governing party. Such is the pettiness of Sri Lankan politicians.

The President, falsely claiming that nothing was done in her absence, went on to duplicate what the Prime Minister had done, setting up a ‘task force’ to rebuild the nation, handle rescue and relief , and maintain order. The Tamil Tigers (wisely) declined to be part of this since it is likely to turn out to be no more than yet another obstacle for potential aid-givers to negotiate on a road already cluttered with bureaucratic obstacles and even roadblocks.

The Tamil Tigers

As has been mentioned, some of the most serious damage is in the area controlled by the Tamil Tigers. They have a crucial role to play in the delivery of aid to this area and the east. The Tamil Rehabilitation Organisation (TRO), widely described as a “Front for the Tigers” is a major body that has been in operation for over 19 years and has extensive experience and expertise to translate ‘relief effort’ to ‘effective relief’. With district offices and sub-offices in all 18 districts in the Tamil area, an office in Colombo, and employing some 3500 paid staff, the TRO has been partners with several international NGOs and UN agencies in major reconstruction and rehabilitation programs in the Northeast over a long period of time. The question at issue is not whether it is, or is not, a ‘Tamil Tiger Front’ but whether it can deliver. The answer seems to be ‘Yes, it can’. If the alternative is the lethargic, disorganized, incompetent and disinterested Sri Lankan Government, then the TRO is on an entirely different plane. You will find the TRO details on http://www.tsunami-trocsc.com , www.troonline.org  , www.trousa.org .

If the TRO can deliver, it makes sense to let it do so. Recognizing this, even the Sri Lankan Government permitted the TRO to engage in rehabilitation and reconstructive work in both the Tamil Tiger controlled area as well as the Sri Lankan military controlled area in the northeast. However, whatever the Government says, its Armed Forces and Police have ideas of their own – to obstruct the work done by the TRO in the East, an area where the devastation was particularly severe. In an unbelievable act, bordering on treason, the Sri Lankan Army and the ‘Secial Task Force’ of the Police, has just moved into the refugee camps in the East and have taken them over from the TRO. It is difficult to believe that the Executive President, the Minister of Defense, the Minister of Reconstruction and Rehabilitation, the Head of the Disaster Management Unit of the Presidential Secretariat, and the Commander-in-Chief of the Armed Forces, who all happen to be one person, Chandrika Kumaratunga, was unable to prevent or reverse this.

The NGOs and Church groups.

A number of NGOs (World Vision, Red Cross, OxFam, Care Australia, UNICEF and Caritas) are doing an outstanding job in raising money and delivering what they can where they can. The Executive Director of World Vision (Australia) the dynamic Rev.Tim Costello, brother of the Australian ‘Prime Minister in Waiting’ who incidentally has been waiting a long time!), has just returned after visiting both the South and the Northeast of Sri Lanka. The Australian public has raised an amazing $15 million dollars in a single day supporting a cricket match for World Vision.

By naming the large NGOs, I am in no way trying to down play the outstanding contributions of small groups, especially small Church groups, and even individuals Details of each by typing out the name of the NGO on the google search engine.

An important point is that ANY of these Organisations would be a safer bet than the Sri Lankan Government until such time, if ever, that it gets its act together.

Foreign Governments

Foreign governments, big and small from across the world, have been commendably generous. India was, as expected, first off the block, flying in six helicopters to rescue victims, following this up with huge amounts of medical supplies, food and other relief supplies. Later two entire field hospitals with over 70 medical personnel and medical supplies arrived.

Dragging its feet was what the US was doing. With international eyebrows raised, when it finally decide to act, it was to play geopolitical games. Some 1,500 American troops have landed, supposedly to help and are busy establishing camps. Warships, probably three, are anchored off the Sri Lankan coast. What are they doing other than irritating India? Predictably, India has ‘expressed concern’ adopting a “I don’t want that boy to be in my backyard’ attitude.

Let me digress to deal with US aid. If the US really wanted to help Sri Lanka, it could pressure American companies operating in Colombo to pay even a little more than the $1/day they are paying impoverished Sri Lankans to sew denim jeans which are sold at $100 each. Sending 1500 troops and even three ships is not an alternative. The tsunami will not wash away the injustice and misery of slave labour in sweatshops.

The Australian public has been magnificent, perhaps more so than any other people. The collections for a country with only 20 million people have been unbelievable. It feels good to be an Australian. As I write, some of Australia’s best musicians are performing at the massive Sydney Opera House to a packed audience, the proceeds to go to the tsunami victims. “Cricket Australia’ with Asian cricket groups organized a match, raising over $15 million in a single day. The Australian Government, however, has behaved in an extraordinary way. At a major international donor meeting in Jakarta, Indonesia, on 6 January 2005, Prime Minister John Howard pledged A$ 1 billion for Indonesian Aceh. Aceh has been ravaged and no one will begrudge the funds, but so has Sri Lanka, Phuket and South India. There are a fair few Sri Lankans, Indians and Thai who live in Australia and pay their taxes. Howard’s generosity with their money, by-passing the desperate needs of countries which were once home to these people, is nothing but a slap in the face to a significant number of Australian citizens. That Aceh is a mineral-rich area (like oil-rich East Timor in which Australia also got involved) and the others (Sri Lanka, Thailand, South India) have no exploitable minerals or oil, I gather, had nothing to do with this highly questionable decision. If Howard wants to play geopolitical games and enter into ‘sweetheart deals’ with Indonesia to mend fences broken by Australia’s East Timor intervention, he should have chosen a more appropriate venue.

As for the United Nations, an incredible situation has arisen. UN Secretary General, Kofi Annan has just visited Sri Lanka. He toured the South, flew over Trincomalee in the East but avoided any contact (even from the air!) with the devastated Tamil Northeast. When asked whether he will be visiting the Northeast, his amazing response to Reuters news agency was “I am here on a humanitarian mission. I would like to visit all areas, but as you know, I am here as a guest of the government and they set the itinerary”. Clearly ‘the itinerary (read ‘interest’) of the Sri Lankan government does not extend to the Tamil areas (even aerially!).

The Sri Lankan newspaper the ‘Sunday Times’, not known to be critical of the Government, spilt the beans.

“Moves by senior UN officials based in Sri Lanka to schedule a visit by UN Secretary General Kofi Annan to inspect tsunami damaged area under control of the LTTE (Tamil Tigers) were stymied by the Government yesterday, fearing the visit would disturb the ‘south’.” Now we know where the Government stands, not that there were any doubts. UN officials privately vented their frustrations to Reuter “It is a relief visit, not a political one. The Secretary General wanted to go, but it didn’t happen” Well, if it ‘didn’t happen’ it is for the UN Chief to ‘make it happen’.

Can this be raised at the UN? It can but is unlikely. Sri Lanka’s UN Representative is, and has always been, a Sinhala representative voicing Sinhalese concerns, not Tamil ones. If the Tamils have a problem (which they have and have had for years) to expect the ‘Sri Lankan’ representative to voice it is completely unrealistic. The Tamils will have to get the Representative of some other country to do so, and that’s unlikely to happen however serious the problem. This is the reality of the UN, in effect a “Trade Union of Nations”, and a non-performing one at that. If the UN and its Secretary General cannot do the right thing, to expect this body to help the Tamil areas is quite unrealistic. All we can do is to cry “Shame” and say it loud and clear.

Amid the din of Sri Lankan Government voices shouting themselves hoarse about how much they are doing for the Tamil areas, one could hear the unmistakable clear shrill of Sinhala ethnic chauvinism and anti-Tamil discrimination that has devastated that country long before the tsunami.

Sri Lanka’s continuing war-stance

This is a problem that the international community and Sri Lankan civil society will have to take up with Sri Lankan government. Just four weeks ago the ruling United People’s Alliance Party and the main Opposition, the United National Party, supported by the Muslim party and the political party of the Buddhist clergy (incredibly some Buddhist monks in parliament), in a rare show of unity, voted to ‘beef-up’ the Armed Forces, allocating more than Rs 56.2 billion (US$ 536 million) for 2005. This is a 8% increase over the allocation in 2004.

In a recent publication “Sri Lanka’s military: The Search For A Mission”, Brian Blodgett, a career US Army officer and an Adjunct Professor in the American Military University, pointed out some ‘hard-to-stomach’ and even ‘harder-to-justify’ facts. While ‘Peace’ negotiations are in progress, the Sri Lankan Air Force bought 10 Mi-35 (a special export version of the Mi-24) helicopter gunships and 10 military transport planes. The Army doubled its artillery from 97 to 187. Armoured Personnel Carriers increased 70% from 158 to 204. The air force personnel nearly doubled from 10,000 airmen to 19,000, the army from 95,000 to 118,000 soldiers, and the navy from 18,000 to 20,000 sailors. These are indisputable signs that Sri Lanka is preparing for war, to inflict willful damage and destruction on its people, as if a natural disaster is not enough.

It is time that foreign governments, the international community, Sri Lankan civil society, the Churches, and NGO’s, started asking some hard questions since the tsunami notwithstanding, there is no indication that this outrageous military expenditure will be scaled down. What the international assistance, in particular monetary assistance, might do is to free-up even more funds for the Government to ‘beef up’ the Armed Forces even more to wage an even more destructive war which will cost even more lives of both the Tamils and the Sinhalese, especially the rural poor. Unless we get the situation clarified, our well-intentioned efforts might result in even greater destruction.

There is talk of debt-cancellation for tsunami-affected countries. The World Bank President James D Wolfensohn, is to visit Sri Lanka to “have a first-hand view of the destruction”. He should also have “a first-hand view” of the recent Sri Lankan budget and get the Government to justify the unconscionable allocation to ‘Defense”. The government response, as always when faced with hard questions, will be that this is ‘an internal affair of Sri Lanka’. The response to this should be ‘So is the devastation caused by the tsunami”.

If foreign debt is to be written off a guarantee will have to be written in that the money saved will be used for the development of infrastructure in all parts of the country, in particular, the war/tsunami damaged areas. This will, of course, have to be closely monitored, and if there is no co-operation, the debt repayments should recommence.

The long term

The devastation has been on a scale that it will take years to restore. The fear is that the wave of enthusiasm will come and go, like the tsunami itself. “To maintain the rage”, as former Australian Prime Minister Gough Whitlam asked the Australian public to do when he was undemocratically dismissed by Governor General John Kerr, may be difficult to do in the present crisis, as it was then. The question of long term aid is dealt with below.

Another fear is that Sri Lankan politicians seeing manna descending from heaven, will think up bigger and better ways to squander the money or use it for purposes for which it was not intended. This is the problem with pouring money into outstretched but unaccountable hands. One cannot lose sight of the fact that Sri Lanka and Indonesia are two of the most corrupt governments in South Asia. The tsunami will not wash away entrenched corruption. It might enhance it.

Sri Lanka and Indonesia are also two of the most repressive regimes in the area. The serious fear is that these repressive regimes will ‘use’ the destruction caused by the tsunami to crush the entirely justifiable separatist movements in both these countries. Should this happen, the damage done will be far greater than what the tsunami has done.

The situation in Aceh is very clear. Jakarta has ‘ruled’ the mineral-rich Aceh province down the barrel of a gun. The death of 100,000 Indonesians in that area is not going to change that. Indonesia’s army chief, General Rayamizard Ryacudu, admitted that a third of all soldiers deployed to the Aceh region were not there to provide aid but to secure control of the area. This is the regime into whose hands the Australian Prime Minister John Howard had just slipped in A$1 billion of Australian taxpayer’s money. The Sri Lankan Armed Forces’ agenda in the Tamil areas of Sri lanka is no different from that of their counterparts in Indonesia.

In Sri Lanka (and I guess in Aceh), the initial hope was that the warring parties in these on-going conflicts (the Tamil Tigers with the Sri Lankan Government, the Free Aceh movement with the Indonesian Government) would be ‘blown together’ by the tsunami. The Sri Lankan President shaking the hands of two Tamil Tigers seems to have mesmerized people. The reality is was that this was no more than politicians providing photo opportunities for foreign media. The reality was best put by Trond Furuhovde, leader of the Nordic ‘Peace’ mission to Sri Lanka who said “We should be careful not to draw conclusions too far. The disaster has done a lot of things to the country but has done nothing at all in (resolving) the conflict.”

Unrealistic optimism betrays a complete lack of understanding of what underlies these conflicts. The scales are now beginning to fall from the eyes of these optimists. All reports now agree that these expectations are far from reality. In fact, the opposite may well be the final result as the Tamils in the northeast see incontrovertible evidence of step-motherly treatment, or no treatment at all, at the hands of the Sinhala regime in Colombo.

What has occurred, post-tsunami, is a different kind of a ‘war’ with words, claims, and some inappropriate actions. What is definite is that neither the tsunami nor fighting is going to bring the elusive peace to Sri Lanka (and probably Aceh). Any attempt by either side to capitalize on any weakness, perceived or real, caused by this natural disaster will have no currency.

The Tamils of Sri Lanka have developed a deep distrust (not without reason) in the Sinhala-majority governments because of repeated violence suffered by them at the hands of Government-sponsored Sinhalese hoodlums and the Sinhala Armed Forces and Police. What the tsunami might have done is to give the Sri Lankan government the opportunity to establish its good faith among the Tamil people, especially in the Northeast, North and East, so that there would be a substantial increase in faith at any subsequent Peace talks. Regrettably, the Government seems to have failed to grasp this golden opportunity, the same tragic mistake made by a succession of Sinhala-dominated governments over the past 50 years for which the country has paid dearly.

What is amazing is that countries seem to learn nothing from the experience of others, or even from their own blunders. George W Bush learnt nothing from Vietnam and insists on repeating it in Iraq. Indonesia learnt nothing from East Timor and insists on repeating it in Aceh. Sri Lanka has learnt nothing from the Indonesian experience in East Timor and insists on repeating it in Sri Lanka. Ethnic conflicts based on the way people have been treated cannot be settled by military might or by a tsunami. To expect otherwise is to be naive and distance oneself from reality and history.

Long-term aid

To be realistic, Sri Lanka nor any of the other countries affected by the tsunami are going to get long-term aid. The current media attention and the funds it generates will be history in 4-8 weeks, 12 if we are lucky.

If long-term aid is not forthcoming, what are the alternative? The alternative, which may be as unrealistic as hoping for long-term aid, is to insist that Sri Lanka and numerous other countries hit by the tsunami (and others that have been spared), be paid a reasonable price for their produce and a reasonable wage for those who work in these countries. I have already alluded to the American companies paying a $1/day for $100 denim jeans. The list is endless. Tea pluckers in what were British-owned tea estates, and now increasingly, Indian-owned (but with Sri Lankan fronts to camouflage their true owners), pay less than $2/day for an 8-hour stint, picking tea at 6000 feet in freezing conditions, on treacherous slopes with no proper attire and no sanitation. The area is infested with leeches, snakes and hookworm. They (almost all are women) carry tea baskets on their backs which weigh more than their body weight. How do I know? I weighed them and their baskets in a research project that I did some years ago. That is the human cost of a cup of tea.

If thousands of fisherman in the North who have earned their living and have supplied fish to the rest of the country and for export, are prevented from fishing off the North and Eastern coasts of Sri Lanka because the Sri Lankan Navy claims that this is a “security risk”, there will be widespread poverty in the entire North and Eastern sea front. If hundreds of thousands of Tamil peasants in the North of Sri Lanka are prevented from cultivating their land because Sri Lankan army has declared that these prime agricultural lands are “security zones”, there will be widespread poverty. There will be widespread anger which sometimes manifests itself in outrageous acts of terror. Hundreds of thousands who are not capable of such acts suffer in silence.

If foreign aid comes with conditions which, if implemented, will make the poor poorer (as aid from the IMF and World Bank always do), then the country will be better off without this aid. If garments made by a tailor in Bangladesh or Sri Lanka are taxed twenty times more than those made in Paris or London, there will be suffering far greater than that inflicted by the tsunami.

No amount of ‘impulsive’ aid post-tsunami or post-some other disaster is an answer. What we are seeing is global injustice on a massive scale. The answer is global justice and this will not be delivered by aid, however impressive. The answer may well be in the actions of groups such as the World Social Forum (WSF) a small but outstanding group who are prepared to take on those who are responsible for this outrage. That is where our support should be directed if we are to have any long-term impact.

Current needs

The most urgent need is for people and organizations that are able to rebuild and reconstruct the damaged area without ripping off the country. Given the extent of the damage, it is a monumental task. It will be even more difficult given the incompetence, inefficiency, corruption, and bureaucratic road-block creating ability of the Sri Lankan government.

As for the Northeast, an added problem is its relative inaccessibility with roads completely destroyed by 20 years of war, a tsunami and the current floods from the onslaught of the north-east monsoon. If that is not enough, there is the major problem of overcoming the hidden agenda of the Sri Lankan government to keep this area in a devastated state if at all possible. There is not the slightest doubt that the organization most capable of doing the job is the TRO. There is also not the slightest doubt that the work of the TRO will be obstructed by the Government and/or its Armed Forces and Police. As I have alluded to, this is already happening. The challenge facing the international community is to confront the Sri Lankan government and expose that which is being concealed.

From the medical point of view, the needs are physical and mental rehabilitation, and the prevention of the spread of infectious diseases.

Physical problems are the treating of serious infections such as cholera and typhoid, and also tetanus which will become widespread given open wounds, contamination and the absence of vaccination. There are the problems of the physical rehabilitation of those who have lost their limbs or have suffered paralytic injuries.

There are serious problems with the rehabilitation of children who from a significant percentage of those who were injured or were orphaned.

Crowding people into refuge camps, which is inevitable in a disaster of this magnitude, invites communicable diseases such as cholera, typhoid and measles (currently at epidemic levels in Aceh). Measles in children in this scenario has a terrible mortality.

There is a major need for trauma councilors and doctors competent to deal with the psychological effects of major trauma, the mental effects of which are complex. There is the expected initial sadness and reaction to loss. That is normal human sadness for which trauma counseling is appropriate and adequate. Unfortunately, in some people this is followed by a definite psychiatric problem which manifests itself as a sleep disorder, a mood disorder with anxiety, depression and irritability, a loss of interest, difficulty in concentration and impairment of memory, fatigue, headaches, a variety of aches and pains, a drop off in performance, an inability to function and to cope. This is the syndrome of major depression for which no amount of counseling will be adequate. It is a biochemical disturbance for which chemical i.e drug therapy is necessary. If it is not properly treated, it can last years, with a complete functional breakdown, often ending in suicide. The human cost of unrecognized or poorly managed depression is horrendous. I doubt if all this is widely appreciated by lay people and even by many doctors.

In summary

In a disaster such as this, there is rarely any difficulty in raising money or goods. Such is the generosity of ordinary people across the world. The problem is its delivery to the affected people. If this is left in the hands of the Government, Sri Lankan or any other, it will not go where it is most needed. The entire effort of raising the aid will then be nothing but a betrayal of the trust of people who have given so generously to alleviate the suffering of the less fortunate. The damage done is many layered and unless at least some of these are addressed the aid may well be wasted. There are people in positions of power who have an agenda and a hidden agenda and it is our business to identify and address these. This is a lot harder than colleting aid but infinitely more useful.