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 with the assistance of the Navy 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 (LTTE) in the Vanni Pocket in the Mullaithivu District in northern Sri Lanka has forced tens of thousands to flee.
More than 36,000 have fled the fighting since January to safer areas behind government lines, but thousands remain trapped. The ICRC estimates that up to 150,000 persons are still in the Vanni Pocket.
Interactive map showing sea route
"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.
Photo: Sri Lankan Navy
|An injured civilian who had fled the combat zone in the Vanni pocket is carried ashore by Sri Lankan Navy personnel|
The Sri Lankan government said the Tamil Tigers had stopped civilians from moving to safe government-controlled areas.
"After over 30,000 had got away in the space of a week, with the churches among others providing admirable leadership, they were intimidated and targeted by suicide bombing and gunfire and forced into a tiny area," Mahinda Samarasinghe, Minister for Human Rights and Disaster Management, said during a speech at the 10th session of the UN Human Rights Council in Geneva on 2 March.
He said government troops had taken precautions to avoid hitting civilian areas.
"Our troops, who carry handbooks as part of their standard kit on how to conduct themselves in accordance with these norms and standards [of international humanitarian law], know that even a few deaths of civilians are deaths too many, and that is why currently we are holding back our strength even at the cost of increased casualties to our forces."