In an earlier editorial in this journal, Madhiwalla and Roy give a sombre account of the destruction of the Ponnampalam Memorial hospital in Puthukkudiyiruppu by the Sri Lankan air force in February 2009. Although they state in their editorial that the international medical community was silent during the intense final months of the conflict in Sri Lanka, this is not entirely accurate. The British Medical Association, in whose ethics department I work, was paying close attention to the conflict. Members of the Association called on us to intervene. We wrote to the British and Sri Lankan governments expressing grave concern about the humanitarian crisis and urging them to intervene to protect the civilian population and to respect medical neutrality. We were in correspondence with the World Medical Association (WMA). The WMA also issued statements regarding medical neutrality during the conflict .