Aid agencies in northern Sri Lanka, where over 100,000 people have recently fled a tiny war zone, say they're overwhelmed by the exodus and ill-equipped for the next one.
Tens of thousands of civilians remain trapped in the battle ground on the northeast coast where government troops are fighting Tamil Tiger separatists in the final days of a war that has lasted a quarter of a century.
But as troops move to wipe out the Liberation Tigers of Tamil Eelam, aid workers say they will face major hurdles in providing basic assistance to thousands more traumatised, wounded and malnourished survivors expected to stream into camps for the displaced in the coming days or weeks.
"There were big problems in the huge outflow of people that came out last week," said Gordon Weiss, a U.N. spokesman in Colombo. "There were more than 100,000 coming in the space of a few days and that obviously overwhelmed the already stretched resources of the camps and hospitals."
The U.N. refugee agency said on Tuesday that conditions in the overcrowded camps had "reached breaking point, placing severe strains on the humanitarian services available".
Around 170,000 people are in government-controlled camps which they are not allowed to leave. Of these 150,000 are in the town of Vavuniya, to the southwest of the war zone.
Aid agencies are pressing the government to identify new sites for camps where resources are more available. They also want the government to come up with a clear plan on how it will resettle people as soon as possible Â? something they feel may encourage donors to fund immediate relief needs.
CAMP PRESSURES
A key concern in the camps is the provision of water and sanitation facilities such as pit latrines, say aid workers.
"All the immediate water needs are being met by trucking in water bowsers," said David White, Oxfam's deputy country director. "We are looking at setting up piping systems from nearby rivers and purification units but this will take a lot of time."
White said areas such as Mannar district - where the government has housed civilians displaced earlier in the war - have sufficient water sites which would make them good locations for new camps. But he believed there was a reluctance to do this.
Already stretched medical services have also been burdened by the huge influx of civilians from the war zone Â? many suffering from injuries, including 150 wounded in mine explosions.
Many civilians are also seriously malnourished and anaemic, say relief workers. Around 25 percent of under-fives are acutely malnourished and U.N. workers say there is a desperate need to establish therapeutic feeding centres in the camps.
Aid agencies also want the authorities to ease pressure in the shelters by allowing civilians who do not pose a security risk to return home, including unaccompanied children, the elderly and the wounded.
Many local aid workers Â? 13 of whom are working for the United Nations - should also be released, relief groups say, adding that it would be helpful to have their expertise.
The government has so far only released 1,200 mostly elderly civilians. It says camp dwellers present a serious security risk and has restricted their communications as well as their movement.
In February, a suspected Tamil Tiger suicide bomber blew herself up at a refugee reception centre, killing at least 28 people and wounding 90.
FUNDING DOUBTS
Aid agencies are now launching multi-million dollar emergency appeals to help them provide for the displaced and prepare for new arrivals from the war zone.
Tents, food and non-food items are being flown in, but charities remain concerned about funding.
"All the agencies are trying to scale up their response for the next exodus, but we all need funding and this is one of the biggest reasons behind our constraints," said the country director of one international aid group.
The United Nations has raised just 30 percent of the funds it needed for a $155 million appeal made in February and is planning to launch an emergency appeal on Monday.
Some aid workers feel there is fatigue among donors over Asia's longest running conflict. Others believe donors are nervous about committing resources - possibly concerned about government plans to keep civilians in the camps for two or three years.
"The international community has expressed concern over a plan that would keep a huge population inside areas for that period of time," said Zola Dowell, head of the U.N. Office for the Coordination of Humanitarian Affairs.
"It would mean we would be asked to pour resources into supporting the government in maintaining these kind of structures as opposed to providing help for people to go back home."
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