In addition to providing critically needed
medicines, supplies and equipment, comprising full courses of treatment
to 4 million Tsunami affected individuals, Direct Relief also is providing
cash grants to in-country health facilities in order to improve water and
sanitation, repair damaged health care facilities, constructed new community
health centers, and funded the purchase of mobile medical units. Our grants
have also paid for nearly 200,000 insecticide treated bed nets to prevent
malaria.
SRI LANKA
Provision of Healthcare Services/ Mobile Medical Initiatives
Sri Lanka, Foundation of Goodness: $11,540
Seenigama, Sri Lanka, an enclave near Hikkaduwa, was hit hard by the tsunami. Rebuilding work is progressing steadily, due in large part to the Foundation of Goodness. The Foundation, identified for partnership with Direct Relief through the IRD Health Grants Program, operated in Seenigama prior to the tsunami and was able to utilize strong community ties to mobilize relief efforts when the disaster struck. Under normal circumstances, the Foundation operates a maternity child health clinic, pediatric clinic, provides free English and computer lessons, and supports micro-enterprise programs These activities have been expanded in response to the tsunami; and, in addition, the Foundation has rebuilt more than 10 new homes for tsunami survivors in the area, all on land that was previously owned by the residents.
The Foundation of Goodness clinic, called the Rainbow Clinic, has experienced a swell in patient load at their clinics as a result of the tsunami. A shortage of physicians in the areas resulted in the Foundation having to bring in additional physicians from Colombo. To assist their efforts to provide medical services, Direct Relief purchased a vehicle to be used to transport physicians from Colombo who are serving two to three times per week in the maternity child health and pediatric clinics. This assistance has allowed specialized care to reach a large catchment of affected individuals in the Seenigama and Hikkaduwa areas.
Sri Lanka, Foundation for Social Welfare: $16,942
In support of the Moratuwa Ministry of Health oral health program, designed to address the needs of displaced families living in the city's 13 relief camps, Direct Relief provided funding to purchase two new dental chairs to be housed in Moratuwa's public health clinics offering dental services. Outreach programs in relief camps, also funded by Direct Relief, will provide basic exams and screen patients for referral to the clinics and provide supplies -- toothbrushes and toothpaste donated in a Direct Relief shipment -- as well as oral health education to displaced persons. The outreach component of the oral health program is managed by the Foundation for Social Welfare, a Sri Lankan nonprofit organization based in Moratuwa, with which Direct Relief is also working to construct a maternal and child health clinic in Moratuwa (see construction section).
Sri Lanka, Jaffna Diocese of the Church of South India: $11,150
Identified by the Direct Relief-funded IRD Health Grants Program, the Direct Relief grant recipient, Jaffna Diocese of the Church of South India, began a mobile medical clinic program prior to the tsunami to relieve the medical needs of isolated fishing villages in the Jaffna district of Sri Lanka. The first clinic was set up in the village of Chilipurum, a "leprosy colony" consisting of 99 families. The tsunami affected most of the areas in which the mobile clinic had operated, making the medical relief services even more vital. As a result, JDCSI expanded the mobile initiative into the Chavakachcheri, Varani, and Kudathanai areas of the Northern Province. JDCSI estimates that as many as 750 families are without services in the areas targeted for expansion of the mobile programs. In addition to the mobile program, Direct Relief is funding JDCSI to establish a permanent clinic in Kudathanai.
Sri Lanka, St. John's Ambulance Brigade, Sri Lanka: $196,180
St. John's Ambulance Brigade, Sri Lanka is a nearly 100 year old, predominantly volunteer-operated affiliate of the International Order of St. John. The organization, based in Colombo, provides emergency services including ambulance services, as well as first aid, CPR, and EMT trainings to Sri Lankans in districts across the country through satellite centers. St. John's was actively involved in search and rescue work during the tsunami, offering immediate response along the coastal belt. In addition, the organization assisted with the establishment of displaced persons camps and attended to the medical needs of survivors.
In support of St. John's emergency relief work across Sri Lanka, Direct Relief procured five new ambulances (one of which was funded by the U.S. Priory of the Order of St. John to assist the Sri Lankan affiliate), outfitted the vehicles with equipment, and provided assistance for EMT training of volunteers. The new ambulances have been dispatched in the greater Colombo area and in Jaffna, the northernmost city in Sri Lanka. In addition to supporting ongoing relief activities, which include first-aid trainings for healthcare workers and volunteers working in mobile medical camps, the Direct Relief-procured ambulances increase emergency response capabilities available in Sri Lanka.
Sri Lanka, Mutual Assistance International: $30,000
Mutual Assistance International (MAI) is a Sri Lankan nongovernmental organization dedicated to the provision of social services within the country. With a mission of "mobilizing communities and resources to assist the disadvantaged to get on their feet to lead a happy life," MAI quickly applied this principle to post-tsunami relief and social rehabilitation.
With a grant from Direct Relief through the IRD Health Grants Program, MAI is implementing services to compliment existing Ministry of Health programs. As a component of the Ministry's National School Health Program, Medical Officers of Health and their teams visit the 9,826 government schools on an annual basis. During these visits, children are screened for visual and other medical problems. If a problem is detected, the children are referred to medical institutions for special care. Parents typically must cover the costs of traveling long distances to specialized facilities, as well as bear the costs of treatment and spectacles for vision correction. The majority of poor parents cannot afford the necessary treatment. In tsunami-affected areas, parents' inability to provide medical aid for their children is magnified.
With funding from Direct Relief, a MAI representative, along with the Public Health Inspector (PHI), visits schools prior to the School Medical Inspection to screen for visual defects. Children with visual problems are referred to the closest eye clinic. MAI is also able to provide financial assistance to parents so that they can address the visual needs of their children.
Sri Lanka, Sarvodaya: $ 135,555
Sarvodaya Shramadana Sangamaya is the oldest and largest Sri Lankan nonprofit, non-political, social service organization. Established in 1958, the organization currently has a presence in 15,000 villages across the country and conducts programs aimed at improving the economic, social, political, and spiritual lives of Sri Lankans. Sarvodaya's response to the tsunami was rapid. Drawing on its strong community ties across the country, Sarvodaya provided food, clothing, and medical services to thousands of affected people and assisted in the establishment and operation of relief camps. Sarvodaya continues to be active in all of the major areas of long-term disaster relief including the construction of permanent housing, livelihoods rehabilitation, and reconstruction of community-level medical infrastructure.
To assist their efforts, Direct Relief air freighted a shipment of medicines, supplies, and personal care products to Sarvodaya to be distributed by physicians in displaced persons camps. Additionally, Direct Relief provided a grant to establish community health and disaster preparedness programs in tsunami-affected villages. Sarvodaya will establish 30 local primary healthcare centers in 15 tsunami-affected districts, and will procure a mobile unit to reach more isolated areas. As of September 2005, preliminary construction of health posts had begun in Galle District, Matara District, Trincomalee District, and Batticaloa District. Health posts provide basic first aid and primary care services as well as preventative health programs including nutrition counseling. In addition, Direct Relief provided 5,000 insecticide-treated mosquito nets, with a value of $30,457, to Sarvodaya to assist in their (separate) vector control programs in relief camps.
Sri Lanka, International Relief & Development, $250,000
International Relief and Development (IRD) is a Virginia-based non-profit corporation with a demonstrated capability in providing rapid response assistance to people in disaster-affected countries in the areas of water and sanitation, malaria, infectious disease, reproductive health, nutrition, community-based primary health care, and health education and promotion. IRD has established a reputation for working closely with local civic, professional and social organizations and with appropriate governmental agencies to establish programs in which the beneficiaries are active participants. Direct Relief has provided IRD with $250,000 to conduct a Health Grants Management Program through which IRD identifies, reviews, and selects appropriate local tsunami relief-focused Indonesian NGOs for grant funding. This is the second grant of its kind to IRD since tsunami response began. Direct Relief is integrally involved in the review and selection process and develops strong working relationships with organizations identified through this program. IRD provides program oversight through monthly reporting, site visits, capacity-building workshops, and frequent coordination meetings. Grant recipients are engaged in health-related activities such as healthcare delivery, water and sanitation, vector control, and reproductive health and family planning in tsunami-affected areas.
Reconstruction of Healthcare Infrastructure
Sri Lanka, American Refugee Committee: $148,390
Since 1979, the American Refugee Committee (ARC), a US-based NGO, has been providing a wide range of medical services and training to refugee and displaced persons in Asia, Africa, and Eastern Europe. In response to the tsunami, ARC began working with local partners in the affected eastern district of Trincomalee, Sri Lanka to meet the medical needs of residents of relief camps displaced by the disaster.
Since the initial relief stages, ARC has focused relief work in Kuchchaveli, a coastal city in the northeast of the island country. Already affected by twenty years of civil war, nearly half of the area's population was displaced by the tsunami (14,600 out of 31,400). Kuchchaveli's public health facilities were partially damaged, and a great need existed for rehabilitation of existing infrastructure and expansion of healthcare services to meet the increased needs of the displaced populations. With a grant from Direct Relief, ARC will manage the repair and reconstruction of a 46-bed hospital in Kuchchaveli and two four-bed rural clinics in Nilaveli and Pulmoddai, as well as establish five temporary medical outposts to serve displaced persons camps. Medical posts will operate weekly and provide primary care services with a special emphasis on pre- and post-natal care.
Sri Lanka, Foundation for Social Welfare: $73,535
As a Sri Lankan nonprofit social service organization based in Moratuwa, the Foundation for Social Welfare (FSW) has been active in tsunami relief activities along the southwestern coastal belt of the country. Initially specializing in the provision of medical equipment for public health facilities, FSW was approached by the Ministry of Health and the Moratuwa Municipal Council to replace one of the maternal & child healthcare clinic destroyed by the tsumani. With funding from Direct Relief FSW has begun the construction of a two-story public health clinic in Murawatte that will offer maternal health care, child health care, malnutrition prevention, health promotion activities for youth and adults, chronic disease screening, mental health care, indigenous medicine clinic, dental clinic, and a library and reading room. Direct Relief has also provided medicines, supplies, and equipment to the 15 undamaged public maternal & child health clinics in Moratuwa operating over capacity since the tsunami.
Sri Lanka, Global Action: $33,250
With assistance from Direct Relief, Global Action is constructing a two-story clinic and dispensary to upgrade an existing clinic in Koralawella, Moratuwa. The existing small clinic is facing an increased burden since peripheral health centers were destroyed by the tsunami and is in a unique position to be able to expand services to Moratuwa's tsunami-affected populations. The clinic will expand capacity to provide basic primary care services and treat acute and chronic illnesses for an estimated 530 patients per day.
Sri Lanka, BECT Foundation: $13,250
BECT Foundation, a non-profit Sri Lankan organization, was established to address animal rights but expanded its mission and activities in order to respond to the tsunami. BECT Foundation is overseeing construction of a village to house 50 relocated families in the Hambantota District, one of the poorest in Sri Lanka. Hambantota lost over 5,000 residents in the tsunami, and homes and infrastructure were severely damaged. The new village of relocated families is nearly completed in the small village of Ruvingama. The village will include common facilities, including a community center, a market, and a health clinic and dispensary constructed and equipped using funds from a Direct Relief grant. A physician will be present at the clinic three days per week providing basic primary care services.
Preventative Health & Mental Health care
Sri Lanka, International Medical Corps: $769,264
International Medical Corps (IMC) is a global humanitarian nonprofit in operation since 1984. Based in Los Angeles, the organization works in 21 countries to implement healthcare-focused development programs. In February of 2005, Direct Relief provided a grant to IMC Sri Lanka to implement a variety of projects in Ampara District including the coordination of mobile medical camps, the procurement of six mobile medical units for outreach programs, psychosocial training of Medical Officers of Health, and livelihood support programs. This district, located on Sri Lanka's east coast, suffered the greatest number of casualties -- over 10,000 -- approximately one fourth of the total deaths in Sri Lanka.
IMC psychiatrists have teamed up with the local Ministry of Health's Medical Officers of Health on designing methods for identifying and treating individuals suffering from post traumatic stress syndrome and other mental health problems. The Medical Officers of Health, in turn, train their districts' Public Health Inspectors, Public Health Nurses, and Public Health Midwives in identification of at risk individuals who are then referred back to the Medical Officer of Health for treatment. Initial trainings had been completed, and trained identifiers are present at the Ministry of Health medical camps that continue to operate along the coastal region.
Sri Lanka, EMACE Foundation of Sri Lanka: $14,849
Since 1993, EMACE has worked within the Western Province of Sri Lanka to reduce the level of HIV/AIDS incidence among women. The organization has focused on impoverished coastal areas that have been especially impacted by war and the loss of family structure. Program work was expanded in response to the tsunami as women and children in displaced persons camps are especially vulnerable to HIV/AIDS and other sexually transmitted infections. This is caused, in part, by the convergence of wide-spread communities in a single small area, a lack of contraceptives and regular medical check-ups, increased sexual violence, coercion and rape, and the lower status of women, which leads to abuse of reproductive and human rights. With a Direct Relief grant, EMACE has created an educational program that will decrease the existing information gap within four major displaced persons camps in Jaffna, Batticaloa, Matara, and Moratuwa.
Sri Lanka, World Federation of Occupational Therapists: $34,990
The World Federation of Occupational Therapists (WFOT), launched in 1952, is a United Nations recognized NGO with 62 member countries. The WFOT works to encourage the practice and use of OT worldwide by promoting occupational and community based services, improving access to health and other services for people with disabilities, and through capacity building efforts designed to strengthen providers' ability to assess and deliver quality care.
Worldwide there an estimated 600 million people with disabilities. The majority of these individuals live in developing countries, and are often denied access to dignified and meaningful participation in daily life. Yet, there are few OTs available with even fewer working in regional centers and none working in more remote coastal-rural communities. The small population of OTs and their unfamiliarity or connection with disaster response coordination has limited them with regard to responding in emergency situations. To put some of the OT numbers in context, there are 400 OTs in Indonesia, 54 in Sri Lanka, and 300 in Thailand. Just one of those OTs works in Banda Aceh, Indonesia (at the main hospital). Two other OTs from Jakarta did visit Banda Aceh as part a response team. In Sri Lanka, OTs were part of the initial assessment and are working on formalizing response efforts. In Thailand, a senior OT is leading a mental health recovery program. Much of this information was drawn from a situational assessment the WFOT conducted in March 2005 to assess the national OT capacity to respond to the tsunami. Overall they noted a critical need to improve linkages with wider disaster coordination mechanisms and to strengthen capacity for communities to cope with disabilities and loss. With a grant from Direct Relief, WFOT is sponsoring a training program in Sri Lanka to educate public health workers in OT methods and provide a forum for OTs in the tsunami affected countries of Indonesia, Thailand, and Sri Lanka to coordinate a response to the ongoing needs of communities in which there are now a great number of individuals living with disabilities.
Sri Lanka, Family Planning Association of Sri Lanka: $10,110
The Family Planning Association of Sri Lanka (FPASL) is a private, nongovernmental institution in operation in Sri Lanka for over 50 years. FPASL provides reproductive health services including counseling for youth and adults on reproductive and sexual health issues, provides testing and treatment for sexually transmitted diseases, and distributes educational material on reproductive health.
The tsunami significantly weakened the Sri Lankan health system by destroying and damaging many hospitals and primary care clinics, as well as displacing many health professionals. The social construction of communities was also changed significantly. Displaced persons in relief camps and other temporary living arrangements are especially vulnerable to sexual abuse, rape, causal sex, and the consequent unwanted pregnancies and sexually transmitted infections. Apart from the need for treatment of acute and chronic illnesses, sexual and reproductive health is known to be a common concern in refugee settings. With financial support from Direct Relief, FPASL has expanded their education and treatment programs to encompass more displaced persons camps along Sri Lanka's southern and eastern coasts.
Vector-Borne Disease Control
Sri Lanka, TEDHA: $94,160
The Tropical and Environmental Diseases and Health Association (TEDHA) was founded in Hikkaduwa, Sri Lanka to address environmental concerns in the country. Comprised of environmental health specialists, an epidemiologist, parasitologists, and public health inspectors, the organization has worked closely with the Ministry of Health on a national malaria control program. Following the tsunami, TEDHA initiated voluntary tsunami relief health activities in Thotagamuwa-Hikkaduwa, including a vector control assessment of the area. This assessment confirmed a strong need for vector control measures in the area, especially in relief camps.
With a grant from Direct Relief, TEDHA has implemented vector borne disease prevention programs in Hikkaduwa and Hambantota, both located on the southern coast of Sri Lanka, and both devastated by the tsunami. Hikkaduwa was severely affected by the tsunami, suffering approximately half of the Galle District's nearly 5,000 deaths. Hambantota District sustained over 5,000 causalities making it one of the worst affected districts. For survivors, a lack of housing, an unsafe water supply, limited nutritional supply, and poor hygiene conditions contribute to an increased risk of communicable diseases such as diarrhea, dengue, malaria, filariasis, and Japanese encephalitis.
In Hikkaduwa and Hambantota, TEDHA has distributed 18,000 insecticide treated mosquito nets, procured by Direct Relief, to families residing in displaced persons camps and affected neighborhoods. Recipients receive training on use of the nets and on measures to effectively prevent disease. Bed nets will be retreated as needed by TEDHA's community health volunteers who will regularly monitor net use.
Water & Sanitation
Sri Lanka, Community Trust Fund: $30,000
Community Trust Fund (CTF) is a Sri Lankan humanitarian organization headquartered in Puttalam with several field offices across the country identified by the IRD Health Grants Program. In response to the tsunami, CTF initiated water and sanitation improvements in Ampara and Trincomalee Districts. With a grant from Direct Relief, CTF distributed fiber water tanks to 30 displaced persons camps and other strategic sites in the Ampara District and 20 throughout the Trincomalee District. A lack of access to clean drinking water has plagued many relief camps in the east and north, and CTF has acted swiftly to help address this critical need. In addition, CTF has constructed two toilets in each site selected for distribution of water tanks. By providing access to drinking water and improving sanitary conditions by constructing toilets, CTF's activities help curb the outbreak of disease in over crowded and poorly equipped relief camps in two of the worst affected districts of Sri Lanka.
Sri Lanka, Guardian Foundation: $121,957
Guardian Foundation is a Sri Lankan country-wide, private, nonprofit organization, established in 1995, with the mission of providing rehabilitation services to populations displaced by Sri Lanka's twenty-year civil conflict. Using their expertise, the Guardian Foundation was able to focus efforts on displaced tsunami-affected populations in the geographical region worst hit by the disaster, the coastal regions of the Ampara District. Working in Kalmunai and Nintavur, the Guardian Foundation has received funding from Direct Relief to implement water and sanitation improvements in displaced persons camps and affected neighborhoods.
Guardian Foundation is working to complete 125 wells, each strategically positioned for use by several families. These wells will replace water supply methods destroyed by the tsunami and/or will replace wells contaminated by salt water, debris, or human bodies which were deposited by the waves. In addition, Guardian Foundation is constructing 125 toilets for families whose homes were partially destroyed by the tsunami but who have been able to rebuild. These water and sanitation improvements will help curb the spread of disease by improving hygiene and access to clean water. Guardian Foundation has made tremendous progress in construction of wells and toilets, completing nearly all by December 2005.
Sri Lanka, Project Sri Lanka: $36,625
Project Sri Lanka is a private, nonprofit, Sri Lankan organization dedicated to tsunami relief and reconstruction efforts. It consists of a group of professionals representing various disciplines, including medicine, marketing, manufacturing, and engineering. Identified for partnership by the IRD Health Grants Program, Project Sri Lanka is working in the southern district of Galle to help rebuild infrastructure.
Located in Magelle, Galle District, Anula Devi Balika Maha Vidyalaya is a prestigious school for women with a student body of over 1,700 between the ages of 6 and 17. With a strong scholarship program, a large segment of the student body is drawn from rural middle class families and some of the lowest-income urban families in Galle District. The school's campus was destroyed in the tsunami. The reconstruction plans include a new, relocated middle and high school campus that will continue to develop female leaders. With a grant from Direct Relief, Project Sri Lanka is providing 20 toilets and drinking water facilities to service student and faculty needs.
Technical Assistance & Equipment Provision
Sri Lanka, I-Freed: $169,000
Of the nearly 40,000 tsunami-related deaths in Sri Lanka, the greatest number of casualties, over 10,000, occurred in the Ampara District, on the eastern coast of the country. The Ampara General Hospital, the main referral hospital for the district, is renowned for being one of the best government hospitals in the country. Five public hospitals were destroyed by the tsunami in the eastern province, and the Ampara General Hospital absorbed the added patient load in addition to the influx of tsunami-related illnesses and injuries.
Through the U.S.-based organization I-FREED, established in 1992 and comprised mostly of volunteer Sri Lankan expatriates, Direct Relief provided a grant to I-Freed for the procurement of a Toshiba CAT Scan machine for the Ampara General Hospital. The CAT Scan machine will be the first in the Ampara district and will offer an advanced level of health services as yet not available to the most severely tsunami-affected population. Before the tsunami, there were no CT scanners in the entire Eastern Province and patients with head injuries or undiagnosed pain were transported three to four hours over mountainous road to reach one of the country's eight CT scanners. The Sri Lankan Ministry of Health committed to expanding the hospital's radiology department by constructing a building to house the imaging equipment, allotting approximately US $ 20,000 to the project. Construction on the building is nearly complete, at which point the CT scan will be used to treat an increased patient load from severely affected towns.
Sri Lanka, Hambantota Base Hospital: $100,202
The Hambantota Base Hospital is a public health facility providing medical care to the entire Hambantota district. With a population of over 550,000, Hambantota is the poorest district in Sri Lanka. The Base Hospital functions as the main public health provider for the region offering primary care, out-patient services, and secondary and tertiary care free of charge to patients. Severely affected by the tsunami, Hambantota District lost over 5,000 residents in the disaster. The Base Hospital, already strained to accommodate high patient loads, was overwhelmed by the influx of tsunami-related cases.
In an effort to increase the Base Hospital's ability to provide long-term quality care, Direct Relief provided funding to procure a high pressure sterilizer, to replace the one in use which only functioned 50 percent of the time, and an operating microscope. These additions to the hospital will assist in day-to-day surgeries and care for patients.
Shelter
Sri Lanka, Galle Medical Association: $80,000
The Karapitiya Teaching Hospital is a multi-specialty referral hospital serving the Galle District. In the Galle District, one of the worst tsunami-affected districts in the country, approximately 24,000 families were affected by the tsunami. Many of the homes of Karapitiya Teaching Hospital staff members were damaged or destroyed, creating both physical and financial hardship.
In response to the hardships incurred by hospital staff, several specialist physicians at the hospital established the Galle Medical Association with the goal of helping affected hospital employees. Direct Relief provided a grant (in two segments) to the Galle Medical Association, which, in turn, issued small grants to individual healthcare workers to repair or rebuild their homes. As a result of their efforts, over 100 staff members have received funds for the repair or reconstruction of their homes and have been able to return from displaced persons camps and resume work in the hospital. Additionally, the Karapitiya Teaching Hospital has received material aid as part of multiple Direct Relief shipments to the Ministry of Health.