From the memoir: How a doctor worked frantically with medical teams during the Sri Lankan civil war

Just two days before my arrival on October 22, 1987, there had been some serious encounters between the LTTE (Liberation Tigers of Tamil Eelam) and IPKF (Indian Peace Keeping Force). The LTTE allegedly was firing at the advancing IPKF from within the hospital premises. Since the firing did not cease even after the bombardment of the hospital by the IPKF, they rushed into the operation block from where the firing emanated. Seventy persons were killed, including patients, two junior doctors, three nurses, a senior doctor, some LTTE activists and sympathisers. The bodies of the dead were still lying in the OP block which was sealed after sanitisation.

I met the civilian doctors who thanked me for the prompt despatch of supplies which I celebrated by distributing biscuits from my supply. After an easing of tension, I enquired about the incident in the operations theatre. There was a numb silence after which the lady house surgeon Dr Shashi Sabha Ratnam opened up. She said they had been conducting an outpatient clinic when she heard gunfire, screaming and wailing. She locked herself into the toilet, terrified, and stayed there till the next day when the army sanitising team brought her out. The other doctor was opening his file cupboard and was saved as he was not in the line of fire. Dr Ponnambalam, the surviving director of surgery was on his rounds and therefore was spared.

I expressed my regrets at the loss of innocent civilian and professional lives but said that we could not postpone the cremation, however painful it was; as doctors we had a responsibility to prevent any infection by the dead bodies. They agreed and helped in mobilizing a few people in the hospital for the mass cremation. Venugopal arranged for dry timber and petrol. Civilians brought out old mattresses, furniture and other things to consign the bodies to flames in a corner of the hospital compound. We, from the Red Cross, watched it from a distance.

We were now more at ease with each other and could discuss matters openly between us as professionals. Both doctors – Dr Shashi and Dr Ponnambalam – were stranded in the hospital and had not been able to go home due to the curfew. Dr Shashi was staying with her grandparents in Jaffna doing her housemanship and Dr Ponnambalam with an FRCS degree from the UK was a professor at the Jaffna Medical College. They were worried about their families and requested me to do all that I could to get any news about them. Dr Shashi requested a soap cake from my supplies which I gave her gladly along with a T-shirt. The Red Cross team was then moved into accommodation within the hospital. We all slept on the floor. Colonel Venugopal made arrangements for the food to be cooked in a hotel close by.

When the curfew was lifted after a few days, there was complete chaos. The general market close to the hospital was looted. Patients from the hospital too took part and came back with whatever they could lay their hands on for further exchange on a barter basis. I gave some money for cigarettes to Dr Shashi and requested her to get them for me.

The next morning, we visited the camps where people were staying to know what their needs were. I asked Dr Shashi to accompany us as she spoke Tamil. The camps had people above 60 years and children below 16 years. No young men were to be found. The camps were well stocked with food and clothes. The demand was for hypertension and diabetic medicines, sanitary napkins and toiletries. We found signs of looting – shops with shutters broken. Dr Shashi broke down on visiting her house which had been bombed and was informed by the neighbours that both her grandparents were dead and had been cremated by them.

We tried to establish clinics in camps but very few people came and those who did, asked for medicines which were at that time not available in India. Communication was a major issue as we had to find interpreters to translate from Tamil to English for the Delhi team. I asked Dr Venugopal that Tamil-speaking staff and doctors be sent. He was not very sure if the powers that be would agree. Fortunately, Dr Ponnambalam’s family was safe in the camps.

Additional supplies and Red Cross personnel arrived to take care of the distribution. Col Venugopal and I called on the newly appointed town commandant Col Kalhan who had two civil service officers from Tamil Nadu to assist him and Major Narasimhan from Hyderabad with whom I struck up a good relationship.

One day as I was walking in the hospital corridor, a five-year-old boy caught my hand and started walking along with me. His left upper arm was dangling, amputated at the elbow. Although I wanted to speak to him, I could not as I did not speak Tamil. Meanwhile, an elderly gentleman, who I presumed was his grandfather, came running and gathered up the little boy in his arms. I gave them a few biscuits and gestured that they should follow me. Dr Shashi then shared their pathetic story. Both the parents of the boy and his grandfather were labourers from a village close to the hospital and had been caught in the crossfire. The parents died and the boy had lost his arm which was amputated at the hospital. He was attended to by his grandfather. They could not return to the village where there was no food. It was ironic that they were begging from people who were in a better position than they, but who had no food to give them. I gave instructions to the hotel that they be fed and that expenditure be charged to my account.

The Indian Ambassador to Sri Lanka, JM Dixit visited the Jaffna Hospital. There was a doctor from Colombo, who was very ill and in a coma and required skilled neurosurgical care. I requested Col Venugopal to ask if the ambassador could take him back in his aircraft to Colombo. He said he had no objection provided a doctor accompanied the patient. I suggested that Dr Shashi accompany them. She was happy to go to Colombo where her father was. I requested Colonel Venugopal to broach the same with the Ambassador and see if he could make arrangements to shift him to Colombo. Dixit agreed. Dr Shashi jumped at the opportunity and left with him to Colombo and, probably, from there to her mother in the UK.

Days passed but there was no let-up in the fighting. The Red Cross store in Kanakasutharai near Point Pedro, which also had a wireless set, was gutted and an enquiry was ordered. The fighting spread to new areas and a total curfew was imposed across the Northern Peninsula for 21 days with a couple of hours of relaxation. I could not communicate with my family. As Bhowmik was in Chennai, I decided to go and see him. I got a seat on the chopper after a day and flew to Chennai. Although it was good to be back in India, I recall that I used to jump at the slightest noise, be it a door banging close or any other noise, thinking that it was a bomb falling or guns firing. I was able to call my family; all was well at their end.

Bhowmik asked me to stay on for some more time. I raised the issue of the need for Tamil-speaking staff and, after some persuasion, he agreed. We sent a letter of request to the Tamil Nadu government and Colonel Venugopal followed it up. This resulted in a team of thirty-five people being sent, eight of whom were doctors. I returned to Jaffna and divided the team into four groups, keeping most of them in Jaffna and sending the rest to Batticaloa, Vavuniya, Trincomalee and Point Pedro. The team at Vavuniya was threatened, could not find any accommodation and requested to be brought back to Jaffna. I relented and agreed. This infuriated the Commandant Col Kalhan who, allegedly in anger, demanded that I be sent back or punished as an anti-national. Tamil Nadu officers like Subramanyam who were posted as his advisors pacified him.

The Red Cross teams had been sent three vehicles to ensure distribution of supplies and relief in the camps that had been set up. Two drivers from Tamil Nadu were sent, one was locally recruited and could speak a little bit of English and Hindi due to his stint in the Middle East and who worked with us despite threats from the LTTE. It was tragic when I learnt after my return to India that he was killed on duty after he had dropped off a relief team and was returning alone in his vehicle.

I hired a vehicle for my travel. Its owner was also my driver. He was well-experienced, spoke English and shared his bitter experiences of skirmishes with the LTTE. Obviously, everybody was affected by the war.

I visited Batticaloa and Trincomalee once in 10 days. To visit Trinco, I had to travel to Chennai and then take a flight to reach Trincomalee where we were the only guests at the Hotel Sea View overlooking the beach and the bay. I enjoyed the breeze, the beauty of the sea and the tranquillity. I picked up a coral from that hotel and an empty grenade shell in which I used to keep a flower. They stayed with me for a long time till I retired. They were misplaced in shifting. I also got a mango plant and transplanted varieties of mango plant cuttings like Sumuktida in our orchard Panchavati at Mudigonda but could never eat its fruit as we sold the farm later.

I saw many luxury goods like video recorders, clothing, and jewellery on the Army flights. These items were brought into Jaffna without any duty as there was no government customs point and later taken back to India with no duty being collected at military airfields. On another trip, I was asked to brief the Ministry of External Affairs officials and officials of the Cabinet Secretariat.

The Red Cross got many enquiries about the safety and whereabouts of people living in the Jaffna peninsula. We verified and conveyed the information. We also visited the prisoners of the Indian army, enquired about their wellbeing and gave them personal hygiene kits.

Once I was at Nallur Temple Road, cross-checking some information about two persons who were staying in a badly damaged house. The neighbours informed me that both people were dead and they had cremated them. I was numb, walked back to the van and got into the front seat. The driver was getting into his seat when I saw two young boys on a cycle approaching our vehicle. The boy riding pillion had a rolled-up newspaper in his hand. They came to a stop before us and the pillion rider approached my window took out a gun from the newspaper, and gestured for me to step outside.

Meanwhile, four more boys appeared from nowhere and got into the vehicle, searching, pulling and throwing out things. I was nonplussed. I could see that we were observed by many people from their houses. I could not understand anything as they spoke in Tamil, except that we were Red Cross and had no arms.

The boys were young – about thirteen or fourteen years old. I wondered if they had the maturity to make the decision to kill. If they had no guns, I would probably have scolded or slapped the boys. The driver argued with them in Tamil that we meant them no harm. Finally, they seemed convinced and gestured for us to leave. The driver at once started the vehicle and sped away.

I was reluctant to report this to the army but was advised to do so. Along with the report to the Cabinet Secretariat, I requested this not to be publicised in the media to avoid causing my family anguish.

I resumed my routine duties. One day I went to distribute gifts to the prisoners held by the army. My driver was with me carrying the gifts and I was giving them away. There were twenty prisoners. Suddenly, one of them, a boy, turned away his head. I saw it was the same boy who had held a gun to us some days before. I handed over the gift to him. He took it, both of us pretending that we had never seen each other.

I often wondered about the causes of civil strife in Sri Lanka. The Jaffna peninsula was mostly inhabited by Tamils and Keralites, whereas southern Sri Lanka was mostly inhabited by Buddhists who had migrated from north India during Ashoka’s time. While Tamilians in the Jaffna peninsula consisted of one-fifth of the population, the southerners were 80%. The northern areas are not fit for agriculture and people were mostly occupied in the service sector. Education was the industry in the northern areas. Every alternate house was an educational institute. The Tamils who occupied the northern peninsula were well-educated and occupied good positions in the government and private sector. During Bandaranaike’s time, there was a groundswell of protest by the Sinhalese over the Tamil monopoly of government jobs. This led to a reservation in government jobs and professional courses and the Tamils found themselves outplayed by the majority Sinhala community. Owing to the reservation policy, a talented Tamil could not be accommodated in a professional college even if he had good grades. Most educated Tamils, therefore, emigrated to other countries and sent money to their parents and children left behind to study. There were very few young people left in the northern peninsula for decades.

The young uneducated population left behind took to fishing and smuggling and were drawn to the LTTE groups, lured by the call of nationalism and to fight the exploitation of the Tamils. They were buoyed by a sympathetic government and people in Tamil Nadu. Their grandparents and the majority community remained mute spectators to the events that unfolded later.

Excerpted with permission from Beyond The Stethoscope: A Doctor’s Calling, AP Ranga Rao, South Side Books.