Every day in the hospital is a busy day for Sivananthan, and today is no different. A 25-year-old electrician from Vavuniya, Sivananthan is one of the Médecins Sans Frontières (MSF) caretakers working in the Ministry of Health Vavuniya General Hospital, in northern Sri Lanka. Today he is working in wards 9 and 10, two of the busiest surgical wards in the hospital. Some missing one leg, others missing both, a few paralysed from the waist down and many with fractures unable to move from their beds, 200 patients fill up these two wards. Wounded in the conflict raging in the northeast of the country between the Liberation Tigers of Tamil Eelam (LTTE) and the Sri Lankan military, many of the patients are alone because their relatives are either dead, have been left behind in the conflict zone or are living in one of the camps for displaced people.

Alongside the Ministry of Health doctors, nurses and two ward attendants, 26 MSF caretakers work in these two wards around the clock. The early hours in the morning are always the busiest: the needs are high and there is little time to waste. Sivananthan started his shift today by changing urine bags and diapers for the elderly patients and those unable to walk. After that he spent time feeding the patients, giving them water, bathing them, combing their hair, helping them walk or transporting them in a wheelchair to the X-ray room or the operating theatre.

“This morning,” he says “I spent a long time with one of the patients: an older man in his fifties, he has a wound in his backside and he is paralysed from his waist down. He arrived at the hospital a month ago with nothing else other than the sarong he was wearing. He has lost all his family, and all he keeps saying to me is:

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