Civilians stand behind the barbed-wire perimeter fence of the Manik Farm refugee camp near Vavuniya, Sri Lanka. (Photograph: David Gray / Reuters)
The photo probably best describes the human crisis which so dominated 2009.
The Guardian explains, in detail, in "Blocking of Aid Worsened 2009 Humanitarian Crises, Group Says - Trapped civilians in Sri Lanka, Pakistan and Sudan cut off from aid deliberately, says Médecins sans Frontières":
"The withholding of government aid to trapped civilians in Sri Lanka, Pakistan and Sudan contributed to the worst humanitarian emergencies of 2009, a medical group said today.
Médecins sans Frontières (MSF) also pointed to a fall in funding for the treatment of diseases such as sleeping sickness and HIV/Aids as part of its annual list of worst humanitarian crises for the past year.
"There is no question that civilians are increasingly victimised in conflicts and further cut off from lifesaving assistance, often deliberately," said Christophe Fournier, the MSF international council president. "In places like Sri Lanka and Yemen, where armed conflicts raged in 2009, aid groups were either blocked from accessing those in need or forced out because they too came under fire. This unacceptable dynamic is becoming the norm."
In Sri Lanka, tens of thousands of civilians were trapped with no aid and limited medical care as government forces battled Tamil Tiger rebels in the spring with aid organisations banned from entering the conflict zone. In some conflicts, hospitals themselves came under fire. In what MSF described as a glaring case of abuse of humanitarian action for military gain, civilians who gathered with their children at MSF vaccination sites in North Kivu, in the Democratic Republic of the Congo (DRC) came under attack by government forces."