Dipesh is a patient in the Médecins Sans Frontières (MSF) field hospital in the Vavuniya region of Sri Lanka,, the closest referral hospital for the 220,000 displaced people living in Manik Farm camp. Since he was wounded over a month ago, Dipesh has been going from one medical structure to another looking for treatment. Anxiety overcomes the 37-year-old man’s face as he awakens after the surgery. “How did it go? What did the surgeon say?” he asks. It’s been one month since he has been unable to walk, and he cannot help his wife and two children as much as he would like.    Dipesh was injured on April 20 while escaping from the Vanni, the now former battle zone in Sri Lanka’s north. With a large, deep wound on his right foot, he continued to walk and managed to cross the frontline. At the first crossing point, the army bandaged his foot and told him to ask for medical care at the main crossing point in Omanthai.  But the Omanthai crossing point was severely crowded, and he was sent straight to a camp without seeing a doctor. Once in the camp, Dipesh asked again to go to the hospital but no authorizations to leave for medical care were given before the registration process was completed. It took four days to be registered and only then was he referred to the hospital in the nearby city of Vavuniya.  A surgeon in Vavuniya hospital cleaned his wound for the first time, almost a week after Dipesh had reached the government-controlled area. But no follow up was possible as the hospital was too crowded and Dipesh had to go back to the camp. That same day, May 2, all the displaced people in his camp were moved to Manik Farm camp.   Once in Manik Farm camp, it took him four days to see a doctor as the clinic in the camp was so crowded. The doctor was obliged to refer Dipesh to another hospital because the wound was too infected. For three weeks, Dipesh went every other day to a hospital in Cheddikulam for a dressing, with a special bus for patient transfer. On May 27, he was referred to the MSF field hospital outside Manik Farm camp, where surgical activity had begun.    “It’s not that bad now, it’s improving,” notes the surgeon after opening Dipesh’s bandage. It’s the second time he proceeds to a wound debridement (removal of infected or dead tissue) for this patient. The wound is far from healed but the infection is under control.  

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