It was in the lobby of an empty hotel on a windswept, rainy Atlantic coast that I had arranged to meet the Tamil doctor. A political refugee from the tropical jungles of northern Sri Lanka, he now lives in a tranquil landscape of pine trees and glaciers. Wrapped in a thick fleece against the damp chill outside, the doctor was extremely nervous about delving back into the past. He had just been through a month of intensive trauma counselling. There were times when he’d contemplated suicide.

On several occasions during our interview he had to break off to visit the bathroom and wash his face, to control the emotions he was reliving. Two years on, the doctor still recounted the war through traumatised flashbacks—the anecdotes exploding in random order in his memory, zigzagging back and forth across the months. He rushed to describe each one quickly before it faded again. Often he seemed to be actually back in the war zone, seeing the scenes of horror flash in front of him, constantly pulling himself back into the present. These snapshots were punctuated by apologetic, high-pitched laughter.

Short, dark and balding, with big eyes peering watchfully from behind a prominent nose, you wouldn’t know he was a hero. He looked like an ordinary forty-seven-year-old man, even a little plump—a far cry from the emaciated figure who escaped at the end of the war.

Though he had many opportunities to flee, he chose to stay till the end in order to save lives, believing he himself would not survive. Pieces of shrapnel narrowly missed him as he operated in makeshift field hospitals. He’s convinced they were deliberately attacked, even though he repeatedly gave the Sri Lankan government details of their positions so they’d be spared. He calculates that his team of doctors, nurses and medics saved at least 20,000 people, but he is tormented by 150 patients he abandoned under a tree on the very last day of the war.

He wants to forget the hands clawing at his sarong, the voices asking to be rescued, as he tore himself away and ran through a hail of bullets to surrender to the Sri Lankan Army.

Now in exile, living in safety with his wife and three daughters on icy, unfamiliar shores, he is still fearful for his extended family back in Sri Lanka.

“Call me Niron: I have to be careful. Any problem caused by me and they will take revenge,” he says, referring to the Sri Lankan authorities. “Recently one friend told me that the police came with my photograph and showed it to him, asking if he’d seen me. That was after I’d left. They were looking for me, but it was too late. At first they were searching for the Tiger leaders; we were the second priority. Now they realise our importance as witnesses.”

He was one of just a few government doctors who stayed on throughout the war to serve their people. Even though the northern jungles had been under rebel administration for years, such was the power of the government bureaucracy that it still deployed doctors and civil servants in these areas. Increasingly desperate, on rare occasions the doctors spoke out about the carnage in telephone interviews with the international media. At the end of the war, the other doctors were captured and forced by the Sri Lankan government to retract everything they’d said. Niron was the one who slipped through the net.

At first Dr Niron worked in proper hospitals, the patients lying onclean sheets in beds, tended by nurses in starched white uniforms. Soon he was setting up makeshift operating theatres in public buildings, homes, tents and then finally in the open, under a tree. By the end, many of the nurses were dead and the doctors were amputating limbs with minimum anaesthetic, using butcher’s knives, as witnessed by Lokeesan. [A volunteer, whose experiences are part of the book]

Niron spent six months working around the clock, taking short naps sitting upright in a chair between operations. The last time he had had a good night’s sleep in a bed was in December 2008. In early January 2009, he was busy at work when he received a message that his own wife had been injured. In the middle of the night he rushed to a nearby clinic, to discover she’d been unconscious for nine hours, with a head injury and fractured arm. Their youngest daughter was by her side, but unhurt. His wife, a teacher, had been speeding on her motorbike, in a panic to reach her children during a shell attack, and crashed into an auto-rickshaw at a junction. Their older girls, aged eight and ten, were left alone at home, wondering what had happened. They only stopped crying when their father eventually appeared, but even that night he didn’t sleep at home, quickly returning to his hospital to be on duty.

Mrs Niron regained consciousness but developed epilepsy. Without the right drugs it was impossible to control. The terrified children wanted their father. Dr Niron felt torn in two directions: his patients needed him, so did his family. With one arm in a sling, it was difficult for Mrs Niron to climb in and out of the bunkers. A few weeks later, she fell on her fracture again.

Dr Niron decided to evacuate his family on a Red Cross ship taking the injured out of the war zone. There was no question in his mind but that he must remain. For the next four months he had no news of his wife and children, and no way of contacting them. After a while, he tried not to think of them. He simply assumed he was going to die.

Now, sitting in an armchair opposite me, Dr Niron abruptly recalls the horrific image of a charred body left on the road outside his hospital. A blackened corpse sat in the driver’s seat of a wrecked tractor, his hands stuck to the steering wheel. For a week all the traffic just went round the tractor as if it were a perfectly normal obstruction.

Passers-by were impervious to the sight of death. “I can’t describe that situation because it was an entirely different world, a place of inhumanity,” he says. “I lived there but now I am afraid to go to such a place as that.”

Towards the end of January 2009 the attacks intensified, the puddles running red with blood. Inside the improvised hospital, desperate mothers fanned their wounded babies with their bare hands in a pathetic attempt to ease their suffering. People would arrive with all the flesh blown off their limbs, the white bones visible like chewed joints of raw human meat.

On the afternoon of 26 January, Dr Niron emerged from hours of surgery, exhausted and spattered with blood. He had a quick chat with a nurse, whose job it was to inspect the incoming patients; the twenty-three-year-old woman had just discovered her own brother among the injured in the admissions tent that morning. After thirty-six hours on duty, she asked Dr Niron for a rest. A few minutes later she walked out into the yard to take a break, just as a shell landed. She was killed right in front of the doctor, who’d been the last person to speak to her.

It was one of 2,000 shells Dr Niron says landed on or around Uddayarkattu hospital in the last ten days of January 2009.During one of the attacks, the Red Cross witnessed the destruction of the admissions room, dispensary, injection room and dressing room as well as damage to wards. This was when the fighting intensified, just as Sri Lankan aircraft dropped leaflets instructing civilians to move to a newly declared “safe zone” inside rebel territory. Dr Niron’s hospital, which was already in the “safe zone”, suddenly faced an influx of patients, as well as people seeking shelter. The problem was that the government had unilaterally decided the location of the “safe zone” and chose to place it very close to the Tigers’ front line, which was not at all safe.

The result, says Dr Niron, was more casualties, not fewer. Later a United Nations official with first-hand experience of the war put it this way: “The intention was not so much to protect civilians as to cause pandemonium behind the Tiger lines. If the government had been really serious about saving lives, it wouldn’t have located the ‘safe zone’ on the front line. It would have been as far away from the fighting as possible.”

Inside the new safe zone, Dr Niron struggled to perform surgery as the shells fell around his hospital. “It is luck that I am still here,” he says, perplexed by his survival. As the vans pulled up outside the hospital, nurses, hardly much older than schoolgirls, ran to unload the injured on to bloodstained trolleys. All the medical staff moved at double speed in the rush to save lives.

When the hospital was attacked, the shells would kill the injured—people who had escaped death once and erroneously believed they’d been rescued by being brought to hospital.

At first the doctors assumed the direct strikes on the hospital buildings were a terrible accident. They made desperate telephone calls. Every time they moved the makeshift hospitals to a new site to escape the bombardment, Dr Niron would paint a large red cross on the roof.

They knew the government had drones flying overhead throughout the daylight hours, providing a live stream of detailed pictures to military headquarters. To be on the safe side, the health service administrators would also send the GPS coordinates to the Red Cross to share with the Sri Lankan Army. They trusted this would protect them. The doctors shared the details of the location of their hospitals on seven occasions. Every single time, the buildings were attacked within a matter of days, if not hours. Eventually they learned their lesson. There were five smaller hospitals, with no red crosses on the roof, whose locations they never passed on to the army or the Red Cross. Not a single one of those five buildings was ever hit. Eventually Dr Niron concluded that the military were deliberately targeting hospitals. “They were attacking purposefully; they wanted to kill as many as possible,” he says gently, his eyes watering at the horror of what he’s saying.

His conclusion is borne out by a United Nations report that also found that civilian hospitals were systematically attacked by the Sri Lankan government during those months. The report said that in early February one of the two remaining hospitals in rebel territory was attacked with multi-barrelled rocket launchers and artillery for five days in a row. According to the UN there were several direct hits within hours, while up to 800 patients were inside. One incoming rocket was captured on video, as a man cowered near an ambulance, the high-pitched, deafening whistling clearly audible as it approached, and then the clattering thud of impact. Inside, men picked up rubble and smashed roof tiles from the hospital verandah. During one of the attacks, international staff from the Red Cross were present, collecting the injured, and they called the army six times to warn them their shells were falling dangerously close the the hospital building, whose coordinates they’d already communicated. The Red Cross had very limited access and this was the last time they went into the war zone by land.

It was rare to have independent witnesses; the Red Cross publicly confirmed that it came under fire from positions held by the Sri Lankan military. The organisation even broke its strict code of silence, predicting in a statement from Geneva that there could be “countless victims and a terrible humanitarian situation”. Nobody heeded their warning. When the fighting ended, the Red Cross said it had seen a lot of wars, but rarely one where civilians had been so badly affected. They called it an “unimaginable humanitarian catastrophe”, but by then it was too late.

Today it’s the constant sound of crying that Dr Niron can’t get out of his head. It wasn’t just his patients. Relatives came to search through  the corpses piling up at the hospitals. Peering under the cloths covering rows of bodies laid out on the ground, they would explode with grief when they found what they’d been looking for. Prostrate mothers howled, beating the earth with their hands and pulling their hair in the dust. Unshaven men sobbed, their hands clasping their heads in utter  incomprehension.

It wasn’t long before Dr Niron and his  colleagues received orders from their employer, the Health Ministry, to quit the war zone. The doctors bravely defied the instruction, continuing to work, now without pay, while bombs crashed around them.

Dr Niron trained his medics to prepare the patients for surgery, cleaning and opening up the wounds. It was like a conveyor belt. He would perform the complex part of the operation, leaving the patient to be stitched up by an assistant while he went on to the next operating table. With only a handful of doctors, it was impossible to treat everyone and many injured were left to die. Post-operative “care” meant being laid out on an old sarong on the dusty, cement floor in a half-built, windowless breezeblock shed.

Everyone suffered from chronic exhaustion, unable to sleep at night because of the explosions that made the earth vibrate and the children scream in fear. They were always hungry. There was no way to harvest crops and the government controlled the flow of food, sending in only a fraction of what was needed, effectively blockading rebel-held territory.

It’s a war crime to cause starvation; after it was all over, the United Nations found there were credible allegations that the government deliberately underestimated population numbers to justify sending less food. American diplomats also commented that the Sri Lankan government wanted to keep civilians hungry enough that they’d have an incentive to abandon the rebels.

One morning in February, a man brought three children to be examined by the doctors. “We checked and they had no heartbeat at all; they were dead. One child had been frothing at the mouth. The man told me the children were starving and in desperation had been eating the root of a fruit bush that is poisonous. All of them were between seven and ten years old; the same age as my own children.”

The doctors reported many cases of children who starved to death. A photograph from early May shows children scavenging in piles of rice husks, hoping to find individual grains to cook.

Dr Niron abruptly recalls the horrific image of a charred body left on the road outside his hospital. A blackened corpse sat in the driver’s seat of a wrecked tractor, his hands stuck to the steering wheel. For a week all the traffic just went round the tractor as if it were a perfectly normal obstruction. Passers-by were impervious to the sight of death

Now, surrounded by supermarkets and cafes, Dr Niron finds it hard to believe he once lived in a place where children died of hunger. He apologises for the fact that he has “very terrible stories” to tell.

It wasn’t just food that was in short supply. In just a few days at the end of January, hundreds of Tamil civilians were killed and more than 1,000 injured. The doctors typed an urgent appeal on official Ministry of Health notepaper—a reminder that they still belonged to the government that was attacking them. The letter, headed “Human Catastrophe & Medical Emergency”, was addressed to the Sri Lankan government, the United Nations, the Red Cross and the international community. It warned that if medical supplies such as anaesthetics, antibiotics, suturing needles and blood bags didn’t arrive within twenty-four hours, many more would die of their wounds. The supplies never came.

As more and more government soldiers perished in the fighting, the military became less keen on sening life-saving drugs into enemy territory.

Dr Niron says the supply of medicine was already inadequate in 2008, but when the war was at its height, in 2009, he received no useful drugs whatsoever. All the government sent him was paracetamol, allergy tablets, vitamins and a local anaesthetic used for dental extraction. He received nothing to treat war wounds. As the United Nations later commented, the denial of medicine by the Sri Lankan government “imposed enormous suffering and unnecessarily cost many lives”. At the time the Americans privately told the Sri Lankan government it was unconscionable to deny medicine to injured civilians, but their words had no effect.

The government argued that it couldn’t send anaesthetics because there was no trained anaesthesiologist in the hospitals in rebel areas. This overlooked the fact that they had sent anaesthetics in the past, and that there were many medics who knew how to administer the injections.

When the doctors openly complained that they hadn’t received a single bottle of intravenous fluid, antibiotic or anaesthetic to do life-saving surgery, they were threatened with disciplinary action for “embarrassing the government”. Increasingly they had to rely on the rebels, who ran a parallel medical service for their front-line fighters.

The Tiger medics gave them some of their precious stocks of essential drugs, blood bags and fuel to operate generators. In the run-up to the war, Dr Niron had run a programme to train 10,000 students in first aid. His foresight paid off. The first-aid training meant members of the public knew how to identify the most critical injuries. They had to choose who would survive the journey—who would live or die. Volunteers then ferried the injured to hospital on the back of motorbikes. On arriving at the hospital patients had their wounds cleaned and splints or tourniquets applied. Blood transfusions were a problem. Before the war, Dr Niron had run a blood-donation campaign, issuing people with cards identifying their blood group and educating villagers who were wary of needles.

Despite malnutrition, people came to the hospitals to give blood they could ill spare, knowing it was a matter of life and death for others. But shortages meant a patient’s own blood was often collected from his bleeding wound into a plastic bag, filtered through a cloth and then retransfused back into his body.

In the final weeks Dr Niron, desperate to save a sixteen-year-old-girl who needed bowel surgery, donated his own blood before operating, despite the fact that he’d lost fifteen kilos in weight and was constantly hungry. “I gave blood twenty-six times over my career,” he says proudly. “Without blood I couldn’t save that girl. She was all alone.”

Over those last few months of the war, the divisional hospitals of Kilinochchi and Mullaitivu kept on relocating to new buildings, until finally they ended up on the beach in Mullivaikkal. Dr Niron was now reduced to working in a bunker, reinforced with layers of sturdy palm-tree trunks and sandbags. One day a bomblet flew into the room and lodged itself in the roof. He believes it belonged to a cluster bomb—a weapon he and others saw several times, though the Sri Lankan government denies having used them. They heard the crack of the initial explosion, followed by a whizzing sound as the bomblets exploded.

Sometimes all the injured were women and children, like the day hundreds of mothers were queuing for rations of milk powder when a drone flew overhead and then not long after a shell exploded on top of them. Many remember that incident as one of unparalleled horror. In the hospital, the doctors struggled to insert needles for the intravenous drips into the tiny veins of injured toddlers: “That day we faced a lot of problems with these young children. We couldn’t find a vein because they were so small the veins would collapse. So we made small incisions and took the vein and put the drip in that way. We had to save them, no? They were tired and hungry and always crying. We couldn’t look after them and it was very difficult to manage them.”

Throughout the war, indeed, a disproportionate number of the serious casualties were children. They didn’t survive because their smaller bodies were less able to withstand the gashes from pieces of burning, jagged shrapnel. The same piece of metal might have caused less havoc with an adult’s larger body.

Soon even bandages started to run out. Volunteers went around collecting old saris to be cut up into strips and boiled. Loudspeakers warned people not to drink the water without boiling it first. “Nobody can imagine; they simply wouldn’t believe our story,” says Dr Niron, “with all those shells and rounds of fire coming in, we still had a publicannouncement system and I have to tell you we didn’t get a single case of a communicable disease right up until the end.”

He’s proud that they managed to prevent an epidemic, despite so many weakened, starving people all living in close proximity, with woefully inadequate numbers of toilets.

As the area controlled by the Tigers shrank, it was hard to cure people so exhausted by continuous attacks, bereavement, hunger and displacement. Hundreds of patients were admitted daily, lying dazed with pain on the golden sand next to dirty drains. Many were sent home immediately after operations, with oral antibiotics to self-administer.

By now anyone with a relatively minor wound simply wouldn’t risk coming to a hospital, knowing it was a target. Early one morning Dr Niron had been expecting his best friend, a psychiatrist called Dr Siva, when someone rushed into the operating room to tell him a person with a stethoscope had been killed outside.

“I went as fast as I could and saw that he’d been killed. It was just ten metres away from where I had been. He was very close to me and always he would come and talk to me if he had any problem... I wondered what a world this was.”

Dr Siva wasn’t the last of his dwindling band of medical colleagues to die. A few weeks later another nurse was killed, and then the hospital’s administrative officer. By the final week of the war, tens of thousands of shattered people were crammed into three square kilometres of beach. Rebels and civilians, the living and the dying were all side by side. The doctors told the UN that many of the injured hadn’t received treatment for days, there were no antibiotics left and half their staff hadn’t reported for work because of heavy shelling. Dr Niron was lying in his tent one night when something exploded above him. As the tent caught fire, he crawled out on all fours. In the dark he put his elbow down on something scorching and then from above a flame dropped on his back, burning the flesh. “It was different from a normal fire. It burned as if in a circle. There was no flammable material in our place, but suddenly there was a blast and then it ignited. It was as if a petrol can was on fire but there wasn’t any petrol there. The area on fire was like a big tree. It was huge. One of my colleagues died—a young assistant called Selvan. He did preventative medicine normally. All the rest of us—all six people—were injured that night.”

The doctor believes the Sri Lankan government was using white phosphorous—and other survivors also report seeing it being used, although international law prohibits its use against civilians in populated areas. Dr Niron still has the black scars on his arm and back, though he says the colour of the burn wound has changed.

“I worked in the surgical department for so many years, but these phosphorous wounds are different from normal burns,” he says. Dr Niron lost all his possessions in that attack, except the sarong in which he’d been sleeping. He had to borrow a shirt from a friend to protect the wound on his back from the buzzing flies. His doctor’s card, his clothes, spectacles, pen—all were destroyed.

Two days later all the doctors held a meeting. The others wanted to leave because there was no medicine, no food and nothing more they could do for their patients. They shared a last supper with the area’s top civil servant, who had remained behind to try to administer the civilian population. Someone found a bit of white flour and they made a kind  of pancake with no oil, milk or eggs. In the morning Dr Niron’s colleagues left. Later he found out that they had been arrested by the army, interrogated for months and then forced to retract everything they’d said during the war.

They appeared at a press conference to declare that they’d lied about the civilian casualties and in reality very few people had died. After the war, a United Nations report confirmed what most knew: that the doctors had been put under pressure by the government. Secret US Embassy cables made public by WikiLeaks revealed that the doctors had been “heavily coached for the press conference, given specific lines to say, and even practiced with several members of the local media beforehand”.

The US Embassy worried that the doctors were at risk of abduction or extrajudicial killing. Later the government accused all the doctors of being Tigers.

The last makeshift hospital on the beach ceased to function on May 15. Dr Niron tried to set up his remaining equipment in a tiny building nearby, hoping he could do some emergency surgery. He was forced to move the next day, burying three bodies under the soft, blisteringly hot sand before he left. The patients who were still alive were laid out under a big, overarching mango tree—scores of emaciated people, bandaged in rags.

Peering out from his bunker, Dr Niron thought he’d spotted a fallen fruit from the palmyrah trees that dominate this part of Sri Lanka. Starving, he told his assistant to run and fetch it quickly so they could share it. The young man came back, having found not a dark, round coconut but a small baby’s head, severed from its body.

“I have terrible memories of that whole coast,” he says, “bodies without heads and babies missing both legs.”

On the last morning of the war, 17 May, rebel territory had been reduced to a tiny dot of land about 150 metres in radius. Tiger fighters were nowhere to be seen; they’d either been killed or had switched to civilian clothes to try and escape. All around there was gunfire. Dr Niron and his assistant knew there was nothing more they could do. They had to cross to the army side if they wanted to stay alive, but even that wasn’t guaranteed. Would they be safe if they made a run for it? How would the army treat them if they surrendered?

Despite malnutrition, people came to the hospitals to give blood they could ill spare, knowing it was a matter of life and death for others. But shortages meant a patient’s own blood was often collected from his bleeding wound into a plastic bag, filtered through a cloth and then retransfused back into his body

“I left around 150 patients there under a big tree,” he repeats. “It was the worst thing I did in my career.”

Fleeing on that final morning, Dr Niron felt the injured and dying tug at his clothes, calling out his name, pleading for help.

They ran, bent double to avoid the shooting. Most people had already left. The only protection against the bullets was other human beings—a small group of about a dozen people also taking their chances. They tried to take cover behind anyone else moving. Every time they halted for a few seconds, the doctor would ask his assistant if he was injured and check his body for bullet wounds. It was like playing Russian roulette.

“We had a fifty:fifty chance of coming out alive,” he said. Around them corpses were strewn—people like themselves, who’d been hit that morning. Some of the elderly wouldn’t leave the dead behind.

“I told them to go,” said Dr Niron. “The firing was so intense that they stood no chance if they stayed.” The shots seemed to come from all directions.

Dr Niron remembers the first soldier he saw very clearly. He wore a helmet and ammunition belt and was peering down his rifle at them from inside the forked branches of a tree. That meant they were already in government-controlled territory. The doctor and his companions had their hands up in the air. “Go!” barked the soldier in broken Tamil, “but don’t look back.” Shocked to see the army at such close quarters after so many months, Dr Niron couldn’t help wondering what was happening to all those left behind.

They moved through a scorched landscape of beheaded, blackened palm trees towards a long earthen bridge across the lagoon. Dr Niron noticed the corpse of a soldier lying near a tree stump. He was a big man, covered in ants. It looked as if he’d been dead for a couple of days, but nobody had been able to move him. Bullets whizzed over their heads as they hurried across the bridge.

Once across the water, in seeming safety, civilians had to line up in a queue for checking. Dr Niron was separated from his colleague, the medical assistant, who has disappeared without trace after treating more than 100,000 patients in the last three years of the war. It torments the exiled Dr Niron that he couldn’t save even one of his loyal helpers. “They were with me in my tragedy days,” he says, trying to explain the emotional bond.

What happened next is a blur. Dr Niron remembers how painful it was to be body-searched because the soldiers touched his burn injuries, where the shirt had stuck to the raw wound on his back. It’s the thirst he remembers next; his mouth was parched with anxiety.

Sweating in the sweltering midday heat, he thought he would faint. Spotting a Tamil man with a gallon container of water, he asked him for a sip.

“He didn’t know me and he wouldn’t give it. At that moment I reflected how I had given blood twenty-six times for my patients and now I couldn’t get one drop of water. I didn’t tell him who I was, but I begged him to give me water and he refused.”

The only consolation was that his companions didn’t turn him in to the authorities. “Other Tamils in that place knew me very well—I had always helped them—but they kept silent and didn’t tell the authorities who I was, which was lucky... Later on I found out they were looking for me. I was a wanted man there.”

The army did register his name, but it was a common one and they didn’t realise who he was. Transported to the Zone 4 refugee camp well inside government territory, Dr Niron was assigned to a tent with sixteen other people. There was so little space that he spread a few pieces of paper on the ground and slept in the open. It was only here that he finally got a drink of water.

All Tamils leaving the war zone were detained in the camp, irrespective of their age, profession or political persuasion. Priests, doctors, United Nations employees, foreign-passport holders—it made no difference. Paying bribes was the only way out at that stage. Dr Niron didn’t have a penny, but he had a network of medical colleagues. One by one they came to his rescue.

When he stepped into the clinic in the refugee camp, Dr Niron was immediately recognised by the doctor on duty. “He saved my life,” he says of his colleague. The doctor quickly wrote out a slip of paper ordering urgent treatment for chest pain. Dr Niron was put into an ambulance with other patients being transferred under armed guard to the district hospital.

The hospital was watched by the police and army to prevent Tamil refugees escaping. The doctor on duty there also recognised Dr Niron. He quickly hid him in a side room, being careful not to register him as a patient and leave a paper trail. Then he dressed Dr Niron in his own jeans and T-shirt so he’d look like a  member of staff. They waited till night and then got into the official staff van that dropped doctors home at the end of their shift. Together they drove out of the hospital compound, past the police sentry post at the entrance, without being questioned. “Most of the doctors were Tamils and they wanted to save us. Not only me—a lot of other people too. They took risks,” says Niron.

That night Dr Niron remembers stopping at a soft-drink stall, before even looking for his wife and children.

“I was very excited to drink Coca-Cola because I hadn’t had it for months.” His friend bought him a huge bottle and he knocked it all back in twenty minutes. After several phone calls, Dr Niron tracked down his family. For four months Mrs Niron had been praying her husband would emerge alive, but he had lost so much weight, she didn’t recognise him on the doorstep.

He laughs about it, saying if she didn’t know him, how could the authorities spot him? They probably missed him because he’d grown a beard and moustache and looked so bedraggled. He  arrived at one o’clock in the morning, but all the children woke up and were running up and down, laughing in excitement.

He was so hungry that his wife cooked him a meal in the middle of the night; he still remembers exactly what she cooked him and how it felt to have a proper food again after months of near-starvation. For the next fifty-five days, Dr Niron hid with his family in one tiny room. Money was tight because the government had stopped his salary. They sold his wife’s gold jewellery to get him a passport and friends smuggled him through the military checkpoints to the capital and helped him survive.

He flew to Singapore, went overland to Malaysia, then spent four desperate months in Thailand and finally arrived in Europe. It took ten more months and the generosity of many other doctors to get his wife and children out of Sri Lanka.

Today the only possession Dr Niron has left from his old life is his wedding ring, which he sent out of the war zone with his wife. It’s taken him two years just to be able to snatch some sleep at night. Not a man to remain idle, he spends the dark hours writing poetry in Tamil. In his first year of exile, he published a collection of his poems under a pseudonym in Sri Lanka.

Dr Niron doesn’t want to draw attention to himself for the sake of his relatives still in Sri Lanka. For years his father worked as a doctor in rebel areas and even now some of the people whom Dr Niron saved have discreetly been to thank his parents.

“People will do anything for me,” he says. “I have a lot of goodwill there.”

Soft-spoken and self-effacing, Dr Niron is a witness to the crimes of the Tigers as well as those of the army. Living in rebel territory, he saw the Tamil Tigers forcibly recruit one person from every family to fight from 2007 onwards. In the final months he says younger and younger children went to the front line, including the teenage children of top rebel leaders.

The death toll is still uncertain, but Dr Niron is in a good position to make an estimate. It was his job to pass the names of the injured to the rebel radio station so they could broadcast the information to the families.

At every makeshift hospital the medics kept records of how many people they had treated, but the documents were captured by the Sri Lankan Army. From March 2009 onwards Dr Niron says they treated 300 injured people a day, but in January and February the numbers were also high. This does not include the dead.

“On some roads there were lots of bodies and nobody counted them. Some gravely wounded people who later died never made it to hospital,” he says.

There were no funerals and no marking of the graves; many were hastily buried in bunkers and under the sand. By the last few weeks, when the casualties were at their highest, movement was so restricted that it was impossible to collect any information at all. Dr Niron believes one person in every two was injured in the final weeks, himself included.

He first calculated the 2009 death toll as at least 27,000 in five months. Today, as he hears that more and more people he once knew are dead, he’s revising that estimate upwards.


Attacks on Hospitals

Source: Human Rights Watch

15 december 2008           Mullaitivu General Hospital: shelling

19 december 2008           Mullaitivu General Hospital: five shells hit hospital

20 december 2008           Mullaitivu General Hospital: shells hit hospital grounds

22 december 2008           Kilinochchi General Hospital: aerial bombing near hosptial

25 december 2008           Kilinochchi General Hospital: shells hit hospitalgrounds

30 december 2008           Kilinochchi General Hospital: shells hit hospital

8 january 2009   Tharmapuram Hospital: shells hit seventy-five metres away

19 january 2009 Valipunam Hospital: shells land in hospital yard

21 january 2009 Valipunam Hospital: shell hits hospital

22 january 2009                 Valipunam Hospital: shells hit hospital compound

26 january 2009 Uddayarkattu Hospital: shells hit hospital

31 january 2009 PTK Hospital: shrapnel from shells hits hospital

1 february 2009 PTK Hospital: three attacks – shrapnel and shells

2 february 2009 PTK Hospital: shell hits hospital

3 february 2009 PTK Hospital: two attacks on hospital

5 february 2009 Ponnampalam Memorial Hospital: shelling

9 february 2009 Puttumatalan Hospital: shell hits near by, causing damage to wall

10 february 2009              Puttumatalan Hospital: shelling

16 march 2009   Puttumatalan Hospital: RPG hits inside the

23 march 2009   Puttumatalan Hospital: RPG in front of building and two shells nearby

9 april 2009          Puttumatalan Hospital: several shell attacks

20 april 2009       Puttumatalan Hospital: heavy shelling and gunfire, hundreds injured

21 april 2009       Valayanmadam Hospital: aerial attack

23 april 2009       Mullivaikkal Hospital: three shells hit hospital

28 april 2009       Mullivaikkal Primary Health: heavy shelling and aerial attacks

29 april 2009       Mullivaikkal Hospital: shelling

30 april 2009       Mullivaikkal Hospital: shelling

2 may 2009          Mullivaikkal Hospital: two shell attacks


Source: International Committee of the Red Cross

24 january 2009 Uddayarkattu Hospital: hit by two shells, five dead, twenty-seven injured

7 february 2009 PTK Hospital: video shows attack, date not confirmed

12 may 2009       Mullivaikkal Hospital: shell attack killed admin officer and others

13 may 2009       Mullivaikkal Hospital: video shows attack, datenot confirmed


Looking at the cruise ships in the icy harbour, I ask Dr Niron if he thinks he will ever see Sri Lanka again. “If it was secure I would go back,” he says, “but not to the places where the fighting took place.” He tells me about a headless torso he saw: “The head was on the junction,” he says, and then adds with a nervous giggle, “It was a place where our landmarks were bits of exploded bodies. It was a horrible place to live. I can never, ever go back to those areas.”

Home is now a Hanseatic trading port, with shops full of toy trolls and chunky knitwear for the tourists en route to the glaciers. Dr Niron spends his days learning the language of his adopted country, twisting his tongue around the unfamiliar, guttural sounds. He is a faceless refugee, conspicuous only for his dark skin. None of his new friends know who he really is. He finds it easier that way.

“I can’t concentrate on anything. I am not normal. I can’t plan ahead. It’s very difficult. If someone says, ‘You can work next year,’ my mind goes all blank. If I tell the truth, in my heart of hearts, I don’t want to work as a doctor any more. I can do any job, but not that one.”

He is now a surgeon who cannot stand the sight of blood.

Astonishingly, Dr Niron feels he failed as a doctor. There was one woman he met on the last morning whom he cannot forget. She was kneeling by the side of her husband, whose legs had been blown off.

Dr Niron asked his assistant if they could carry the man out, but there was gunfire everywhere and they couldn’t. “Please rescue him, please rescue him!” the woman begged several times, refusing to give up on her husband.

This doctor who did so much still feels he should have done more. We argue for some time over what else he could have done. “I did my job, I agree with you,” he says eventually, “but if I meet that lady again, what will she think of me?”


An excerpt from Still Counting the Dead, Survivors of 
Sri Lanka’s Hidden War by Frances Harrison. Published 
by Portobello Books.