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2. Affected PHM areas
Out of thirty PHM areas seven were partially or totally
affected. Madiha, Polhena,
Pamburana, Totamuna, Kadaweediya, Kotuwegoda and Eliyakanda were affected.Polhena,
Totamuna were most damaged.
NilwalaRiver flows through the city of Matara and meets sea at Thotamuna. As the impact of the tidal wave was much
absorbed by the river, it overflowed causing floods on either side.
Buildings Affected
Deputy Provincial Director’s (of Health Services)
office, which was located in fort about 10 – 20 meters from sea was
destroyed, with its vehicles, equipments and documents.
General Hospital Matara,
located close to the NilwalaRiver was flooded to some extent.
Regional drugs stores which was situated at paramulla about 200 meters away from the sea, was damaged
completely with its vehicles, vaccines, refrigerators and drugs.
Matara MOH office was not affected as
it is located away from sea.
Staff Affected
Two public health inspectors (PHI) and 4 public health
midwives (PHM) were affected in the disaster. PHI motor bicycles and houses
and property were damaged. PHM Polhena was much
affected and her parents died, her house was fully damaged and property was
lost. PHM Pamburana too had her house and property damaged.PHM Kadaweediya had sea
water floods without major damage to buildings. Thotamuna
PHM’s office was destroyed with equipments and
documents.
Paramulla clinic which was held in a
Municipal Council owned building was under water but not destroyed.
Affected Population
Population
of the MOH area 106416
Population
affected 14978
Number
of Deaths
375
Number
Disappeared 96
Table 1.
Affected population by PHM area
|
Number
|
Area
|
Total
population of P.H.M Area
|
Affected
population
|
|
1
2
3
4
5
6
7
|
Kotuwegoda
Eliyakanda
Totamuna
Polhena
Pamburana
Walgama South
Kadaweediya
|
4065
2276
3201
3562
2813
4707
3556
|
3475
976
2148
2583
1546
3580
670
|
|
|
|
24180
|
14978
|
By the evening of 26th there were seventeen
refugee camps in temples and schools. People have run away from sea and found
shelter in a secured place. Number of camps was reduced to twelve the next
day. 
3. Management during the acute stage
As the Deputy Provincial Director of Health Service’s
(DPDHS) office was destroyed and none functioning, a temporary coordinating centre was established in general Hospital, Matara. An official from Ministry of Health Colombo,
Director General Hospital Matara, Regional
Epidemiologist, MOH of affected areas , and other officials met twice daily
in this centre to discuss and plan day to day
activities. A meeting was held in the morning to plan and a meeting in the
evening to review. Officials from the presidential secretariat, WHO, UNICEF
and Nongovernmental Organizations participated in these meetings and gave
their fullest possible support. This organized agenda facilitated proper
functioning and adequate health care in all camps and affected areas. This
temporary centre functioned as the coordinating
center until, the DPDHS office was temporary started at the chest clinic Matara.
Population in Refugee Camps –MOH
area Matara
|
Refugee
Camp
|
Population
|
|
1. Rahula college
2. Sariputra school
3. Weeraba Piriwena(temple)
4. Wewahamanduwa school
5. Madiha Weeratungaramaya(temple)
6. Walgama Sri Vijayathilakaramaya
7. Ilam Vidyalaya
8. NilwalaPrimary school
9. Kadaweediya Mosque
10. Madiha Dammawansikarama(temple)
11. St ThomasGirlsSchool
12. KitulewelaTemple
|
2300
400
200
800
300
180
118
80
200
50
50
91
|
4. Management of Refugee
Camps
RahulaCollege which is located in the centre of the town was the largest camp and there were
2300 occupants initially.
Health authorities were faced with the problem of
maintaining sanitation and prevention of out breaks of communicable diseases.
A public health Inspector was appointed to each camp to stay in the camp. PHM
visited the camps daily. Public Health Nursing Sister worked in the Rahula camp. Other officials at MOH office visited camps
regularly.
 Temporary latrines were built in adequate
number with the support of government and non government organizations.
Daily cleaning of latrines arranged.
Safe drinking water was provided by the water
board –chlorination levels were regularly monitored.
Garbage disposal was regular with the support
of municipal council. Lidded bins were provided.
Tropical Chloride of Lime
(TCL), Fly killing insecticides were provided to PHI to maintain
satisfactory level of sanitation.
Cooking area was supervised by PHI and food
brought from out side too was checked by PHI.
Mothers, women, babies were cared by PHM or
PHNS.
Weaning food (“poshana
Bath”) was prepared in camps by
PHM
During the first week there were many organized groups
visited the camps with food, clothing or other necessary items for refugees.
By the 2nd week, donors and well wishers had to come through the
divisional secretariat. Officials from government and soldiers from army and
police were kept in all camps to provide security and to prevent unnecessary
crowds getting into camps.
Treating Patients in Camps
Teams of doctors were arriving from other areas of Sri Lanka and overseas to serve in refugee
camps. They were always directed to the coordinating centre
and from there were sent to camps according to the needs.
A Medical centre was
established in RahulaCollege where Medical students served
round the clock. Doctors from General Hospital Matara
and DistrictHospital. Kamburupitiya
visited camps regularly.
Pharmacists served in Rahula
camp through out this period.
Situations of Drugs
Although
the regional drug stores were destroyed, Hospital drug stores functioned as
the main drug stores for the first two weeks.
There
were donations of drugs from all over the world. Ministry of Health sent all
essential drugs to MOH offices during the initial period.
We were
not short of drugs at all. Whatever was not available, we were able to
purchase with available funds.
A
nebulizer was kept at the Rahula camp.
We were
able to get down the ambulance from General Hospital Matara
to refugee camps when necessary.
5. Diseases Surveillance in Camps
PHI visited daily to every room or tent in the
camp to identify patients with communicable diseases.
Grama Niladhari and Other officials in the camp were made aware
to report about patients.
PHI kept daily records of patients seen by
doctors.
Notification forms were provided to doctors
working in camps to notify any communicable disease to camp
PHI, thereby the MOH.
Regular notifications from General
Hospital, Matara
informed us about patients admitting from camps.
Prevention of Possible Outbreaks
We were
anticipating spread of enteric diseases mainly.
Health education by PHI through public
addressing system in camps daily played a major role.
Handouts on primary health care were
distributed among indwellers.
Posters printed and written on Bristol
boards were exhibited in many places of the camp.
Provision of safe drinking water- Either
boiled cooled or bottled water. Unlabeled bottled water was checked for
microorganisms by the laboratory at water board free of charge before
distribution among people.
Cleaning of latrine regularly and provision of
baby commodes, advice on safe disposal of excreta of children.
Fly breeding was minimized by provision of
lidded bins and spraying of fly
killing insecticides with early disposal of garbage.
Breast feeding was promoted whenever possible
and distribution of bottles and formula were discouraged and minimized.
Patients with infectious diseases were
admitted to Hospital earliest possible. Hospital ambulance service was helpful.
Fogging of camps once in two weeks to reduce
mosquito density.
Diseases reported in refugee
camps during first three weeks.
|
Disease
|
Number
|
|
Respiratory
tract infections
Wounds
Acute
gastro enteritis
Bacillary
dysentery
Mumps
Herpes
Zoster
Tetanus
Conjunctivitis
|
48
175
32
03
02
03
01
03
|
Vaccination in Camps
Tetanus toxoid was given to
patients with minor and major wounds. Oral Typhoid vaccine brought by a
Korean health care team was taken by us and given to food handlers in camps
(with the approval of Regional Epidemiologist) Routine vaccination was not
carried out in camps; mothers and children were sent to the closest Maternal
and Child Health Clinic for vaccination. Hepatitis A vaccination was given in
one camp by the Korean team.
Mothers and Women
We had five maternal deaths due to Tsunami in our MOH
area. One was a doctor in General Hospital Matara.
There were twenty pregnant mothers in camps initially.
Women who needed to continue with family planning were
supplied with the necessary items.
Psychological Support
Psychiatrists and other counselors arrived at camps
within the initial period. They were able to communicate with people and be
supportive just after the disaster. Many were suffering from grief reaction.
Few people with suicidal ideas had been identified and the necessary support
was given by the psychiatrists.
|
Disease
|
Number
|
|
Depression
Schizophrenia
Delusional
Disorder
Phobia
|
40
02
01
25
|
Health Care of Affected Areas
After the first few days, cleaning up of the affected
area was started, security forces, local authorities from other areas,
foreign missions helped in cleaning up.
Some of displaced people gradually started visiting
their homes and tried to clean up houses which were intact. We had to cover
up affected areas for health care provision as same as in refugee camps.
Mobile clinics for wound dressing and
vaccination with Tetanus toxoid.
Doctors conducted mobile field clinics for
patients in affected areas.
Disinfectants were distributed to clean houses
Latrines which were filled up were emptied.
Wells were emptied and chlorinated.
Spraying of larvicidal
chemicals and fogging for mosquito control.
Disease surveillance by the area PHI, PHM and
doctors conducting mobile clinics.
Funds and Donations
Funds from WHO and donations of drugs and equipment were
useful to provide a satisfactory service initially to the displaced
population. Funds enabled us to have adequate transport facilities and
communication facilities which established a successful team work.
6. Secondary Stage
Three
week after the disaster, the number of initially displaced population in
camps was reduced, to 1200.As the schools needed to reopen; people were relocated
in six semi permanent camps. They will be in these camps until they get their
own houses.
These
camps were built by NGOs and maintained by the government.
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