The humanitarian situation in the Vanni is said to be dire, as a lack of food and clean water lead to illness and death by starvation.
Dr. T. Sathiyamoorthy, the Regional Director of Health Services (RDHS) of Kilinochchi district, said that only 109.71MT of food had been received for the month of February 2009 through the ships with the help of the ICRC.
The real requirement per month, according to the RDHS is 4950 MT.
"Consequently people are threatened with starvation unless the food condition is urgently rectified," the doctor said in his situation report adding: "Particularly children, women, elders and those who are seriously ill become vulnerable to the onslaught of starvation."
"Only a few people could be satisfied with this amount of food received. Even to receive this, people wait in winding queues in the scorching son."
"In fact, 13 people have died of starvation in the latter part of February alone."
The water facilities in the 'safety zone' have been naturally limited because of the landscape. The sudden increase in the population had made the situation worse. The available open wells and the water provided by the bowsers are not enough at all to provide sufficient water to the people, the report said. People wait in long queues for a long time even to collect a few pots of water provided at 10 places.
Due to the non availability of materials to construct toilets, open defecation has become common among the majority of the people, reports said.
The report by the Kilinochchi RDHS, citing the Government Agent's statement on 28 February 2009, said around 330,000 persons from about 81,000 families were living in and around the 'safety zone' and more than 90 percent of the people are living under substandard tarpaulin shelters.
The International Committee of the Red Cross (ICRC) organised the eighth sea evacuation of sick and wounded civilians and their dependents from combat areas on 4 March, but officials warned the situation was dire.
Since the first evacuation on 10 February from Putumattalan in Mullaithivu District, more than 2,700 sick and wounded civilians have been moved by ferry to safer areas for medical care, Sarasi Wijeratne, ICRC spokesperson, told IRIN.
"Concerning the civilian population trapped by the continuing fighting in the Vanni region, it is definitely one of the most disastrous situations I have come across," Jacques de Maio, ICRC's head of operations for South Asia, said in a statement on 4 March.
"They are exposed to shelling and exchanges of gunfire. People are dying. There is no functioning hospital or other medical facility in the area," De Maio said.
"The facilities that did exist have been shelled and are mostly destroyed."
Wijeratne said one of the ICRC's local staff had been killed inside the combat zone on 4 March.
The ICRC established the ferry service in February when evacuation overland was halted because of security fears.
The ferry service has also been used by World Food Programme (WFP) to transport food into the combat areas.
Heavy fighting between government forces and the Liberation Tigers of Tamil Eelam in the Vanni in the Mullaithivu District in northern Sri Lanka has forced tens of thousands to flee.
The ICRC estimates that up to 150,000 persons are still in the Vanni.
"Civilians are literally trapped in the combat zone. In the ongoing military confrontation, civilians and other non-combatants are dying in the line of fire and cannot receive life-saving assistance," De Maio said.
Morven Murchison, the ICRC health coordinator, said more and more people were moving into Putumattalan to escape the fighting.
"Because there is not enough drinking water in the Putumattalan area, they end up moving back inland in search of water," she said in a web post on 26 February.
"The lack of clean water is a major humanitarian concern," she told IRIN.
"The population at the coast has increased tremendously over recent weeks and the wells in Putumattalan cannot provide enough water for everyone to drink, wash and cook."
"The risk of an outbreak [of disease] is very high given most people's living conditions, the lack of water and the lack of proper sanitation," she said.
"There are no proper latrines or pits in the area where most displaced people are. There are reports of an increase in the number of cases of communicable diseases, including diarrhoea and respiratory infections," Murchison said. "We are very concerned about the possibility of a serious outbreak of disease."
De Maio said the ICRC had been unable to transport sufficient medical supplies into the combat areas.
