COLOMBO, 30 June 2009 (IRIN) - Health experts warn that the arrival of monsoon rains in July could increase the risk of waterborne diseases for tens of thousands of internally displaced persons (IDPs) in camps in northern Sri Lanka.

More than 280,000 people who fled fighting between government forces and the now defeated Liberation Tigers of Tamil Eelam (LTTE) are staying in some 35 government camps in four northern districts - Vavuniya, Mannar, Jaffna and Trincomalee.

The majority, 220,000, are living at the Menik Farm camp, a sprawling site of over 700ha outside Vavuniya town.

"With such a large number of people concentrated together, there is always the risk of waterborne disease with the rains," Laurent Sury, head of mission for Médecins Sans Frontières, told IRIN in Colombo.

MSF runs a field hospital in Vavuniya District where more than 23 of the IDP camps are located, housing 260,000 IDPs.

"There are around 115 patients at the MSF hospital now," Sury said.

The monsoon rains last about four months, and even though the World Health Organization (WHO) says no large disease outbreaks have been reported, the risk factors for malaria and diarrhoea have increased.

WHO said the Ministry of Health had taken precautions to deal with a possible malaria outbreak, with proper surveillance mechanisms at all camps.

Until 19 June, only 29 cases of malaria had been reported, but health officials initiated a high alert when two cases were reported on 18 June from zone 4 in Menik Farm.

Field staff have been deployed to all hospitals and healthcare units assisting IDPs by the Regional Malaria Office for the Vavuniya District from 8 June.

"This is an alarming situation considering the very small number of malaria cases reported from the entire country in the recent past," the WHO update said. "An active surveillance for malaria is ... [ongoing]."

Until 18 June, 1,060 cases of dysentery and more than 5,000 cases of diarrhoea had been reported from the camps, it said.

"There is a serious threat of waterborne diseases because of so many people living so close together," one humanitarian official said, highlighting the risk posed by improper disposal of solid waste and rubbish in the camps.

According to OCHA on 27 June, the greatest needs were specialist doctors.

"IDP health workers, paid by the government of Sri Lanka, are working in the IDP sites. Thirty-seven new doctors are expected to be appointed at the Vavuniya District within a week. However, a shortage of specialists remain," the UN Office for the Coordination of Humanitarian Affairs (OCHA) confirmed.

Chickenpox update

According to the latest communicable Disease Weekly Update released on 25 June, surveillance within the camps by the Ministry of Health staff was being strengthened. The greatest disease outbreak reported so far was chickenpox, with more than 12,000 cases, but those numbers had since been decreasing, the UN reported.

The number of new cases reported is steadily declining and admissions to hospitals are 40–50 patients per day, OCHA confirmed on 19 June.

"In Vavuniya, the number of Hepatitis A cases is also declining. A total of 2,139 cases were reported as at 12 June," the report added.

Medical officers working with the displaced suspect that most of the chickenpox patients contracted the disease before they arrived in camps.

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