Moments When Life Hangs in the Balance
Moments When Life Hangs in the Balance
The Jaffna Peninsula has fallen under enemy occupation.
Hundreds of thousands of people are trapped within what has effectively become an open-air prison, encircled by tens of thousands of soldiers. The region has been carved up by continuous lines of military fortifications and earthen embankments, standing like the walls of a vast prison. Taking cover among the sparse scrublands scattered across barren fields, the mangrove vegetation growing in the marshes, and the dense clusters of young palmyra palms at the edges of open terrain, Tamil Tiger fighters carry out their operations from concealed positions.
A land that once enabled the Tamil people to hold their heads high has become a place where the enemy roams with an air of mocking arrogance. To disrupt the enemy’s sleep and shatter their sense of security, the Tigers launch strikes capable of keeping them in constant unease and uncertainty.
1996
Maveerar Naal (Great Heroes’ Day) was drawing near.
A group of fighters was stationed inside a hostile, enemy-controlled area. For operational reasons, they needed to relocate to a comparatively safer location. At the same time, a plan was devised to destroy several enemy bunkers. To strengthen the assault, another unit would have to infiltrate the area and join the team already inside.
The operation was carefully coordinated. A diversionary attack would be launched from outside the area, drawing the enemy’s attention away from the real objective. While the enemy was distracted, the infiltrating unit would strike from within, attacking the bunkers from the rear. The plan was to eliminate enemy troops, seize weapons, destroy the fortifications, and then withdraw to link up with the unit positioned outside before retreating together.
The strategy, prepared many miles away, had already been communicated in detail to the unit operating inside the enemy-held territory.
At this stage, a fighter-medic named Malaravan joined the infiltrating team. Traveling under the cover of darkness, the group moved through the night and, during daylight hours, concealed themselves within a small patch of scrubland in an open area.
By chance, soldiers entered the vicinity, and the area was subjected to a cursory search. Remaining hidden, the fighters endured without food or water, taking care not to make even the slightest movement that might reveal their presence.
When the right moment finally arrived, they emerged from concealment, crossed the barbed-wire fences and earthen defenses, and successfully linked up with the designated unit.
Now, as planned, the attack had to be carried out—and they would then have to fight their way back out.
They began moving once again toward the enemy bunkers, approaching from the rear as planned. Medic-fighter Malaravan took up a position behind a tree standing beside the barbed-wire fence.
According to the original plan, the rest of his unit was supposed to launch the assault from the front. Unfortunately, the attack commenced before they had arrived at their designated positions.
At that moment, a bullet struck Malaravan’s left shoulder. The impact hurled him several feet backward. He got up and felt the wound with his other hand. Blood was gushing out profusely.
Using his right hand, he checked the pulse in his left arm. Realizing that the injury did not appear to threaten the survival of the limb, he steadied himself. There was no way for him to properly bandage the wound and stop the bleeding on his own. He reported his condition to the commander and then picked up his medical pack and continued moving forward.
Ignoring the bullets that flew like sparks and the fragments from light artillery shells, he pushed his way through the barbed wire, climbed over the earthen embankment, and descended on the other side.
His head was beginning to spin.
He tried to take cover beneath an earthen barrier situated between the enemy bunkers. Something struck against his leg. Reaching down to feel it, he recognized it as an RPG rocket-propelled grenade round.
He quickly concluded that remaining there—or losing consciousness in that position—would be dangerous. Gathering what strength he still possessed, he picked up the RPG round as well and slowly pressed forward, drawing upon every reserve of determination left within him.
Malaravan first made contact with and joined the unit that had originally been assigned to launch the assault. There, he received first aid from another fighter-medic named Amuthan.
By the time the battle came to an end, two fighters had been killed. Eighteen others had sustained injuries ranging from minor to severe. If daylight broke before they could withdraw, many more would likely be destroyed by enemy forces moving in to surround them. For that reason, the unit retreated several miles under the cover of darkness.
The wounded needed to be evacuated to the Vanni for proper treatment. However, such a transfer was impossible for the next few days. It was therefore decided that they would be treated where they were.
The group took shelter in makeshift platforms hidden among mangrove trees in a swampy area, structures that had been prepared for emergencies. Below lay marshland; above, dense mangrove growth rising several feet high. The shelter itself was so cramped that a person could not stand upright, its floor constructed from rusted sheets of metal. Around them lay wounded fighters who had received only basic first aid.
Amuthan and Murali discussed with the injured Malaravan what should be done next.
One fighter had suffered a penetrating abdominal wound. Signs suggested that internal bleeding was continuing. Ideally, he required an emergency laparotomy—surgical opening of the abdomen—but such a procedure was impossible under the conditions they faced. Until he could be transferred to the Vanni, they would have to rely on conservative management and supportive treatment.
Another fighter’s knee had been shattered. To save his life, an amputation above the knee would likely be necessary. Yet they lacked even the most basic equipment needed for such a major operation—there were no instruments for blood typing, no devices to monitor blood pressure, and none of the essential surgical tools required for the procedure. Other medical supplies had been hidden at external locations, and personnel had already been sent to retrieve them.
As for Malaravan, administering anesthesia and treating his own wound properly would take him out of action and prevent him from carrying out his duties. He therefore chose to postpone his own treatment.
The three men—Malaravan, Amuthan, and Murali—decided instead to work together and continue caring for the other wounded fighters, placing their comrades’ survival ahead of their own comfort and safety.
The first priority was to perform the surgery to amputate the shattered leg.
The procedure had to be completed with the absolute minimum blood loss possible. Only then would the wounded fighter have a reasonable chance of survival.
Despite his own injury, Malaravan administered the anesthetic with one hand while the other two medics began the amputation. In the midst of the operation, however, the fighter with the abdominal wound began gasping for breath and crying out in distress.
Observing the situation, Murali went over to examine him. He then took a 50 ml syringe, inserted it into the man’s abdomen, and withdrew some of the blood that had accumulated internally. After repeating the procedure several times, the fighter’s breathing became easier. Murali then returned and resumed assisting Amuthan with the amputation.
Because blood products were unavailable, intravenous fluids were the only means of compensating for blood loss. The surgery continued under these difficult conditions. The blood flowing from the wound appeared unusually thin and lacked its normal clotting characteristics—a dangerous sign.
There was no equipment available to measure blood pressure. Malaravan noted that he could scarcely even detect a pulse.
Amuthan and Murali looked at one another.
There was little to deliberate. They decided to perform a blood transfusion despite being unable to carry out compatibility testing. Blood was drawn from Amuthan and transfused directly into the wounded fighter undergoing surgery. Soon afterward, there were signs of improvement in the patient’s condition.
Meanwhile, the fighter with the abdominal injury again called Murali over and asked him to relieve the blood accumulating inside his abdomen. Murali repeated the procedure, and once again the man felt some relief.
The team then focused on bringing the amputation to a successful conclusion.
At that moment, another wounded fighter, who had suffered a head injury, became severely disoriented. He began running around uncontrollably, pulling at the intravenous lines connected to other patients. The makeshift shelter, precariously built above the swamp, shook as he moved about.
He was immediately given a sedative injection.
Afterward, the amputation was completed successfully.
On the second day, all of the wounded fighters were transported to the Vanni using improvised rafts. In order to ensure that medical support within the area remained available, it was decided that Malaravan would stay behind and continue his duties despite his own injury.
With the demanding field medical mission finally completed, the other medic-fighters returned to their base together with their unit, carrying with them the satisfaction of having brought a desperate and exhausting operation to a successful end.
— Thuyavan
Vibu Magazine, Issue No. 126
Compilation: Tamil Arasan Abdul Kader
Translation by Hari
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