A Tragic Misdiagnosis: The Continued Suffering of Civilians Amongst Victory Celebrations in Sri Lanka

"We are in fear, not just for my life, but for all the civilians and patients and staff." It was just 24 hours later that an injured Dr. Varatharajah, and several other government physicians who had remained to serve patients in the "No Fire Zone" in North Eastern Sri Lanka, were taken into military custody. Perhaps he was relieved. Though his fate in government hands will be no less than that of other dissenters ("traitors"), he would no longer have to count the bodies of those he couldn't save, find the right words to convey his desperation via satellite phone, or protect a panicked mob of patients as shells fell on the only remaining hospital in the conflict zone.

Today they have said that the three-decade-long civil war between the Government of Sri Lanka and the Liberation Tigers of Tamil Eelam (LTTE) fighting for a separate state is over. After months of intense fighting leaving thousands dead and hundreds of thousands displaced, we cannot afford to be relieved. The words of the President and the Ministry of Defense should be understood in the context of the actions behind them which will impact any possibility of a sustainable peace. Actions like the neglect of a reported 20,000 injured civilians remaining in bunkers, patients who the physicians were forced to leave behind. Without the immediate mobilization of medical teams and complete access granted to the ICRC, the cost of waiting for the "dust to settle" will be paid in thousands of lives.

Relief may be one among a complicated array of emotions, but amongst most grassroots advocates and activists today there is a pervading sense of defeat -- one that has no connection to military advances or conquests. There is a disillusionment with the United Nations and other international institutions who have been paralyzed by their decision to prioritize protocol and politics over their founding principles. There is a disappointment in a new U.S. administration whose "nuanced perspective" on terrorism somehow missed a massive humanitarian crisis unfolding under the guise of a "War on Terror". The emptiness behind the words of our collective commitment ( "responsibility to protect", "never again") has become even more obvious in comparison with a few physicians whose selfless actions embodied the words of the Hippocratic oath.

When a physician loses a patient they often lie awake at night wondering what they may have missed, whether the diagnosis was correct, but in the end knowing they did the best they could. In Sri Lanka, though the symptoms presented themselves years ago (briefings were held, reports were written) the International Community did not begin to think (or care about) a cure until it was too late . Though it is likely they have not slept in weeks, these government physicians should know that they did everything they could. The same cannot be said for key actors in the International Community.

The Secretary General may visit the island this weekend, a strategically-timed visit for maximum benefit (measured in perceptions of UN strength and relevance rather than in lives saved). UN Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator John Holmes yesterday claimed that the UN is aware of issues of overcrowding in the camps, large numbers of refugees being "detained" indefinitely, lack of access to medical care and the deplorable conditions of the internment camps. If we have learned nothing else in the past few months it is that awareness does not always translate into action... still, in the coming days and weeks it is essential that it does.

The conflict is over, but the crisis continues. In the past 72 hours, access to the detained physicians has been denied until later this week. If they could be reached, they would have pleaded for the supplies and personnel to, at the very least, temporarily stop the bleeding. And perhaps that is what the declaration of the end of this war has done. But the abuses of the past few months have left deep wounds that empty promises alone cannot heal.