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The areas close to the FDLs, mainly around Muhumalai and Nagarkovil, were particularly volatile, with armed clashes and military confrontations reported almost daily. Fighting and shelling in this area was again reported on 3 November. The curfew remains in place from - hours daily. Agencies are following up and more information is expected to be available soon. It has been reported that Kilinochchi town was shelled and the military operation in Poonakary division continues. It is also reported that there has been displacement of people from Semmankunru and Kiranchchi towards the Tharmapuram and Visuvamadu areas. The RDHS also reported 16 malaria patients have now been identified and treated in Kilinochchi during the month of October while snake bites cases were admitted in the Tharmapuram hospital facility, where two died after failing to respond to treatment. In the meantime, road accidents have increased significantly in areas of dense IDP concentration. In October, accidents were reported including 2 deaths in Tharmapuram. Newly trained staff will be deployed amongst the IDP sites in order to assist those psychologically affected by the conflict. Two malaria cases were identified in the district last week. Thousands of IDPs are without adequate shelter and open defecation is widespread due to the lack of toilet facilities. The RDHS of Kilinochchi has expressed concern at the likelihood of outbreaks of water borne disease unless conditions are improved particularly now with the resumption of seasonal monsoon rains.

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