United Nations System
Standing Committee on Nutrition

Nutrition Information in Crisis Situations - Sri Lanka

NICS 6, May 2005

The pace of assistance and reconstruction seems slow in Sri Lanka. Firstly, there is a problem in delivering assistance to the LTTE (Liberation Tigers Tamil Ealam) controlled areas because the LTTE and the government of Sri Lanka have not yet reached an agreement (AFP, 04/05/05). Secondly, the construction of temporary shelters and the rehabilitation of homes has been delayed due to the Government policy of banning building close to the shore line (Reuters foundation, 24/05/05). Many displaced persons are still living in tents (OCHA, 05/05).

The security situation is tense in the eastern provinces with reports of violence (USAID, 30/04/05).

WFP has increased the caseload of beneficiaries of the general food distribution from 750,000 in January to 910,000 from March until June 2005. People have been receiving a full food ration (OCHA, 05/05). Support to fisherman to rebuild their fishing equipment is on-going (OCHA, 24/05/05).

A survey conducted by UNICEF in displaced camps showed a relatively satisfactory situation with regard to water and sanitation, although improvements could be made in some camps (WHO, 11/03/05).

NICS 5, February 2005

Tsunami affected districts, Sri Lanka

Sri Lanka has been ravaged by a civil war for years, with parts of the country controlled by the government and parts by the Tamil Tiger rebel forces, with little possibility of communication between the two sides.

As of early February, there was no agreement between the government and the rebel Tamil Tigers on a joint mechanism to coordinate relief (Xinhua, 02/02/05). It seems that the response to the catastrophe has been slow in Sri Lanka. A government official said that, as of beginning of February, only 30% of the affected population had received aid so far (Xinhua, 02/02/05). Coordination and information flow seemed to be one of the major constraints (DFID, 03/02/05).

The water supply did not seem to be a problem in displaced camps but had not been properly assessed in affected communities (OCHA, 02/02/05). No outbreaks of disease have been reported (WHO, 02/02/05).

WFP reported an anticipated caseload of 845,000 people for February 2005, an increase of 9% in comparison with January (OCHA, 02/02/05). A WFP assessment anticipated that people who earn an income in the service sector, retail trade or tourism sector will be able to sustain themselves from the end of January (WFP, 31/01/05). Others will need public work, micro-credit and food-for-work. There was a fear that food distribution in rice-producing areas might negatively effect local markets (WHO, 02/02/05).

A rapid livelihood assessment conducted in coastal areas of Ampara and Batticaloa districts in January found that repair and reconstruction of housing was thought to be the first priority by the affected population (SC-UK, 18/01/05). Fishermen need the repair or replacement of fishing boats and equipment. Unskilled casual labourers, who form a substantial part of the population, are in need of cash-for-work, in the first instance, while restoring income for the long term will require the support of those who previously employed them, such as masons, carpenters and shopkeepers. Women-headed households will also need support to restart their economic activities and newly widowed-households will need skills-training.

Markets seemed to be well functioning and prices were unchanged from the pre-tsunami levels. The rice harvest was due soon. SC-UK recommended that, then, cash-based interventions would be more appropriate than food aid.

RNIS 24, June 1998

A civil war between government forces and the separatist Liberation Tigers of Tamil Eelam (LTTE) has been on-going in Sri Lanka for the past 14 years. The number of internally displaced is difficult to determine; best estimates suggest that they number around 410,000. Many displaced people are living with relatives or friends, and an estimated 21,000 are living in UNHCR - assisted open relief centres. In addition there are approximately 65,500 people living as refugees in government run camps in India.

The last RNIS report (no 23) included details of a survey carried out in Trincomalee District where wasting was measured at 21%. Adequate access to safe drinking water was determined to be a significant problem in this part of the country. More recently, there have been reports of cholera in the city Trincomalee [PROMED 29/04/98, RNIS 23].

A survey carried out in the Wanni district showed a worrying situation. Wasting and/or oedema was measured at 21.6% with 2.9% severe wasting and/or oedema (see Annex I (16a)). This survey was carried out just before the harvest. Measles immunisation coverage, verified by a card, was only 45.6%; however a further 47% of children were said to be immunised but had no card [OXFAM/SCF 21/12/97].

The main source of income for this population is agriculture. Indications are of a good harvest, despite the high cost of some farm inputs and very heavy rainfall. This is likely to have a positive effect on the levels of wasting seen in the survey. Another source of income is the ration, some of which is consumed and some of which is sold in order to buy other necessary items. The survey noted that ration deliveries were irregular due mainly to transportation difficulties [FAO May 98, OXFAM/SCF 21/12/97].

It was also noted in the survey that sanitary facilities in the region were inadequate. Poor hygienic practices were likely related to high levels of diarrhoea and scabies noted during the survey [OXFAM/SCF 21/12/97].

Overall, these refugees can be considered to be at moderate nutritional risk (category IIb in Table 1), although there are very likely to be pockets of high risk.

On-going interventions: Some of the needs identified in the survey in Wanni may also be relevant to other war-affected populations. Some of these include:

improved sanitation in newly crowded areas, along with some emphasis on improving hygienic practices;
continued distribution of food rations;
improvement of logistics infrastructure to allow ration deliveries.

RNIS 23, March 1998

The civil war in Sri Lanka between the Government and the Liberation Tigers of Tamil Eelam (LTTE) has continued for the past 14 years. Fighting has led to widespread displacement both within Sri Lanka and also to neighbouring India. Many people in Sri Lanka have been displaced several times. There are currently estimated to be 65,000 people living in government-run camps in India and 19,000 in open relief centres in Sri Lanka. There are likely to be many other people affected by the war, but who are not living in open relief centres.

A survey in 7 areas in Trincomalee District (estimated population 350,000) in Sri Lanka was carried out in September 1997. These areas were felt to be most seriously affected by the 14 years of civil war. Wasting was measured at 21.1% and severe wasting was 1.4%. No cases of oedema were noted (see Annex I 15a). It was noted that the 6-29 month age group was more severely affected by malnutrition than the 30-59 month age group. The survey found that food security had been significantly affected by displacement. Many people had lost their property and agricultural capital, including seed stocks, livestock, farming and fishing equipment, tools and sometimes also their houses. Constraints on movement and transport were also affecting food security. Furthermore, there had been three consecutive years of drought. The government systems of food stamps and 'Samurdhi', which aims to provide food aid to the poorest families, were also not functioning and only a low percentage of families receiving help [ACF Sep 97].

Stunting was defined as weight/age <-2sd and was measured at 24% (confidence interval 21.9%-27.6%). This compares with national level data from 1993 when stunting was measured at 23.8%, using the same definition [ACF Sep 97, ACC/SCN, 1997].

The assessment also found that access to safe drinking water in the district was far below the usual standards for the country. The reasons for this are varied, but include the presence of hard rock, salty water in the coastal parts of the district and seasonal variations in the water level aggravated by the drought [ACF Sep 97].

Overall, the affected population in Sri Lanka can be considered to be at moderate nutritional risk (category IIb in Table 1). Although there are likely to be populations at high risk, numbers of people are not currently available.

On-going interventions

The following needs have been identified in Trincomalee District, and may well apply to other war-affected districts:

the distribution of a blend of corn, soya, non-fat dried milk and micro-nutrients to the moderately malnourished should be improved to ensure a receipt of 800 kcals/person/day. Irregularity of distribution has meant that on average ration receipts only amount to 178 kcals per person per day;
continue to encourage exclusive breastfeeding;
seed provision for many households;
construction of wells to support home gardening and rehabilitation of water tanks for paddy cultivation;
evaluate the methods of selection, distribution and monitoring of the government food assistance programme and identify alternative mechanisms for food assistance.

RNIS 22, December 1997

A civil war between government forces and the separatist Liberation Tigers of Tamil Eelam (LTTE) has been ongoing in Sri Lanka for the past 14 years. The security situation is very fluid, but at present, the government controls most of the country. The LTTE controls areas in the Wanni region. The number of people internally displaced by this fighting is difficult to determine with any precision, and best estimates are that they number around 410,000. Many displaced people are living with relatives or friends, and an estimated 21,000 are living in UNHCR-assisted open relief centres. In addition, there are approximately 65,000 people living as refugees in government-run camps in India.

Assistance to the displaced populations is being provided by the government of Sri Lanka as well as international agencies such as UNHCR, although insecurity sometimes hampers aid deliveries. A recent survey in Mulikulam, Mannar district, an open relief centre housing many who fled insecurity in June 1997, showed a worrying situation. Wasting was measured at 24.3% with 7.3% severe wasting. These high levels of wasting were thought to be attributable to many factors, including inadequate water supplies and irregular food distributions. Since the survey, water supplies have improved, and supplementary feeding programmes have been established [MSF-F 19/08/97, UNHCR 27/08/97].

Much of the country's infrastructure has been destroyed in the ongoing conflict. Micro-projects are being implemented in order to address these problems. These projects are designed to minimise the potential for further displacement for socio-economic reasons, and to stabilise populations by recreating community structures. Projects include:

road construction;
water and sanitation systems construction;
school renovations and;
assistance for small businesses.

Overall, the affected population in Sri Lanka is not currently thought to be at heightened risk (category IIc in Table 1). There are likely to be pockets of high risk, such as in Mulikulam, Mannar district, but population breakdowns are not currently available.

Ongoing interventions: Security is the main impediment to improving the timelines of food distributions. However, there is room for improving the monitoring of food distributions. Furthermore, micro-projects should be continued and supported where security allows.

RNIS 21, September 1997

Apart from some notable periods of calm, the conflict in Sri Lanka has been ongoing in the north of the country for the past 14 years. The fighting has led to the displacement of large numbers of people, many of whom have been displaced several times. At least 135,000-210,000 people sought refuge in India, and those who are in government run camps are being assisted by the Government of India.

However, an escalation in fighting in the Jaffna peninsula which began in 1996 led to fresh waves of population displacement. The most recent upsurge in May 1997 is due to a government offensive which aimed at pushing the rebels back towards the peninsula. Although the numbers change rapidly as areas of intense fighting move, it is estimated that approximately 410,000 people are internally displaced. Many are in the rebel controlled Wanni jungle area just north of the peninsula. Most of those displaced within Sri Lanka are living with relatives or friends and while some assistance is needed, little food aid is necessary. There are approximately 150,000 people who live in “welfare centres” which are similar to open refugee camps. These people receive food distributions from either the government or WFP although they are not believed to be fully dependent on these distributions for all their food needs.

Recent reports are that the security situation is stable and calm. There are no new nutritional data on these populations, however there are reports of a cholera outbreak. Anecdotal accounts of the food security situation of the displaced in the Wanni region are often contradictory. One view is that there are far more displaced (as many as 700,000) than the government assessment of 400,000 and that many are not registered for government rations. Furthermore, government food distributions tend to be erratic and are affected by security and logistical factors. Many people are said to be surviving by employing coping strategies that cannot last indefinitely and that an estimated 35-200,000 people may be vulnerable and at risk. [USCR Mar 97, PROMED 20/06/97].

Overall, the affected population is not currently thought to be at heightened nutritional risk (category IIb in Table 1).

Ongoing interventions: In areas where it has responsibilities, the Government should undertake to supply food rations to all displaced people as well as providing adequate amounts of medicines, shelter material, water and sanitation facilities. If the government cannot supply these resources in a timely manner then they should enlist the support of NGOs, which has been offered and let them into areas containing internally displaced populations. For their part, the Liberation Tigers of Tamil Eelam (LTTE) should assume greater responsibility for providing for the needs of those under its control in Wanni region [USCR Mar. 97].

RNIS 20, June 1997

However, an escalation in fighting in the Jaffna peninsula which began in 1996 led to fresh waves of population displacement. The most recent upsurge in May 1997 is due to a government offensive. Although the numbers change rapidly as areas of intense fighting move, it is estimated that approximately 410,000 people are internally displaced. Most of those displaced within. Sri Lanka are living with relatives or friends and while some assistance is needed, little food aid is necessary. There are approximately 150,000 people who live in "welfare centres" which are similar to open refugee camps. These people receive food distributions from either the government or WFP although they are not believed to be fully dependent on these distributions for all their food needs [FAO 09/04/97, WFP 10/02/97].

There has also been about 8,000 new arrivals who have fled to India as a result of renewed fighting. This population joined the existing 92,000 refugees already in India and is the first exodus in recent years. Approximately 56,000 people are housed in camps, while 36,000 people live outside the camps [UNHCR 01/11/96].

A survey carried out in a welfare centre in April 1996 showed 16.4% wasting with 0.6% severe wasting. Oedema was measured at 0.4% (see Annex I (20a)). These results compare with those seen in December 1995 when wasting was measured at 12.6%. It was felt at the time that the ration provided by the government was not adequate and although it was not meant to be a complete ration there is a growing sense that the population was becoming increasingly dependent on this as it's main source of food. In addition, ongoing fighting at that time was leading to a continuous stream of newly arrived displaced people [MSF-H 06/04/96].

In April of 1997, a nutritional survey was carried out in two open relief centres (ORC) in Mannar district in response to a general impression that the nutritional status had deteriorated and due to concerns about the quality and regularity of food distributions. Wasting among this displaced population was measured at 14.6% with 0.8% severe wasting. No cases of oedema were seen (see Annex I (20b)). Anaemia which was suspected to be a problem was seen in 0.8% of the children although assessment of this condition was "rather subjective". These results are comparable to nutritional conditions amongst the local population [MSF-F 07/04/97].

Reports of the return of people from the Wanni district to Jaffna at the end of April have been received. These people cited a lack of medical care, schooling, and insufficient water as reasons for their return. Many areas in the north are reporting stable food prices and adequate availability of food commodities on the markets [CARE 23/04/97. However, an upsurge in fighting in May could disrupt this apparent return to stability.

Overall, these people are not currently thought to be at heightened nutritional risk (category IIc in Table 1).

How could external agencies help? Although levels of wasting are in line with those expected in the local population, they are still somewhat high and efforts to decrease this, including expanding supplementary feeding programmes, and improving the quality and timing of the food distributions, would be useful.

United Nations System Standing Committee on Nutrition