Provision of Healthcare Services/ Mobile Medical Initiatives
Centre for Health Care (CHC): $45,000
Status: Ongoing
Centre for Health Care (CHC) is a non-profit health care organization registered with the Sri Lankan Ministry of Social Services in 1995. The organization has focused primarily on the North and East regions of Sri Lanka bringing a wide spectrum of healthcare services to populations affected by the tsunami and by the longstanding conflict. In response to the tsunami, CHC opened offices in the city of Batticaloa, a densely populated district that suffered extensive damage. The CHC Batticaloa employs 15 community health workers and relies on its strong partnership with the Batticaloa Teaching Hospital to supply doctors and nurses (paid a minimal additional salary by CHC) to conduct mobile clinic activities in Batticaloa District.
CHC Batticaloa operates multiple mobile clinics at different sites per week and is seeking to grow its outreach work. In 2005, 9,242 patients were treated through 127 mobile clinics. Services provided include basic first aid and treatment of common illnesses, preventative health and prenatal services, pediatric clinics, eye clinics, and dental clinics. Direct Relief funding will ensure that CHC will be able to maintain and expand mobile medical services to reach some o the neediest, most isolated communities in Batticaloa District. Support will cover the procurement of a mobile medical van, basic medicines to be used in the mobile clinics for 12 months, a mobile dental unit and local dentist’s salary, and intraocular lenses for 300 patients.
Foundation of Goodness-Rainbow Clinic: $70,000
Status: Ongoing
Foundation of Goodness is a registered Sri Lankan non-profit organization that has been active in Seenigama and surrounding villages since 1999. Foundation of Goodness has worked for over seven years to fulfill its mission to empower economically and socially disadvantaged communities to enable the creation of a better and more equitable society. Following the Indian Ocean tsunami in December 2004, Foundation of Goodness grew rapidly to meet the varied needs of the tsunami-affected population. The Foundation has focused on constructing and renovating homes, providing livelihood opportunities to rural communities, empowering youth through education and athletics programs, training individuals in computer, English, and handicraft skills, and providing healthcare services to thousands of displaced residents.
Foundation of Goodness will use Direct Relief funding to support the operation of The Rainbow Clinic, which provides care to thousands of residents in Hikkaduwa and Seenigama affected by the tsunami. Funding will support the formation of a laboratory stocked with supplies and reagents, and will cover the cost of expanding the clinic’s medical team for a period of 12 months. Investing in a laboratory and increased staffing will enhance the Rainbow Clinic’s existing assets and allow it to expand to meet the healthcare needs of their community.
Foundation for Social Welfare: $16,942
Project Status: Completed
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 Reconstruction of Healthcare Infrastructure).
Guardian Foundation: $100,000
Project Status: Completed
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. In the town of Nintavur, a community with a population of 50,000, the Guardian Foundation has undertaken a project with Direct Relief's support to construct a primary health care clinic that will provide critically needed services to the approximately 15,000 residents of Nintavur displaced by the tsunami.
To improve post-tsunami medical services in the Ampara district, Guardian Foundation operates mobile medical clinics to help those who still lack access or transportation to basic health services. Through the generosity of GlaxoSmithKline, Direct Relief provided funding to increase the frequency and capacity of these mobile clinics that reach the entire affected Ampara coastline from Kalmunai to Pothuvil. Each mobile clinic is now staffed by two medical officers, two public health nurses, two midwives, and an administrative assistant. The clinics see between 100 and 150 patients per day and offer health education as well as curative and preventative health services.
International Relief & Development: $500,000
Project Status: Completed
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 Sri Lankan NGOs for grant funding.
This is the second grant of its kind to IRD since tsunami response began. The program was extremely successful; IRD identified, funded, and monitored eight local NGOs conducting health -related activities such as health care delivery, water and sanitation, vector control, and reproductive health. Direct Relief is was integrally involved in the review and selection process and develops strong working relationships with organizations identified through this program. IRD provide s d 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, v ector control, and reproductive health and family planning in tsunami-affected areas. Due to the program’s success, Direct Relief re-funded the program for an additional $250,000 in November 2005 so that 12 more small grant projects could be chosen and supported.
Sarvodaya: $135,555
Project Status: Completed
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 By September 2005, preliminary construction of health posts had begun in Galle District , and Matara District . , Trincomalee District, and Batticaloa District. In April 2006, health posts had been established in the targeted Southern Districts and steady progress was being made to establish posts in the Eastern Districts of Ampara, Batticaloa, and Trincomalee. 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.
Foundation of Goodness: $11,540
Project Status: Complete
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.
Jaffna Diocese of the Church of South India: $11,150
Project Status: Complete
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.
St. John’s Ambulance Brigade, Sri Lanka: $196,180
Project Status: Complete
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. In April 2006, St. John’s Ambulance Brigade completed procurement of Direct Relief-sponsored ambulances as well as the training of 20 first aid specialists and 16 EMTs.
Mutual Assistance International: $30,000
Project Status: Complete
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.
Shilpa Children's Trust and Friends of Tibetan Women's Association: $60,000
Project Status: Ongoing
Shilpa Children's Trust (SCT) channels support to over 300 children in the poorest district in Sri Lanka, Hambantota. In this area, five-thousand people were killed in the tsunami and many lost family members including one or both parents. Access to healthcare services and nutritional foods is limited and mental, dental, and nutrition problems have taken a desolate toll on the girls. Psychological problems are also common and must be addressed to prevent long-term mental illness.
With funding from Direct Relief, Shilpa Children's Trust provides medical and dental services, nutritional supplements, and education that benefit the tsunami-affected children. In addition to these health and educational services, Friends of Tibetan Women's Association has partnered with SCT to coordinate an art therapy program which will help the girls to express their fear, depression, and emotion post-tsunami. Some of this art will be on display in the United States to promote awareness about the tsunami's devastation and create a deeper understanding about the tragedy and recovery process of the victims.
Reconstruction of Healthcare Infrastructure
American Refugee Committee: $148,390
Project Status: Completed
Since 1979, the American Refugee Committee (ARC), a U.S.-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. In April 2006, construction on the rural clinics was complete and the repair of the Kuchchaveli hospital was nearly finished.
Foundation for Social Welfare: $73,535
Project Status: Complete
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 clinics destroyed by the tsunami. 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. Construction was completed on the clinic in May 2006, and the Ministry of Health is providing equipment for the new facility.
Guardian Foundation: $209,785
Project Status: Completed
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. In the town of Nintavur, a community with a population of 50,000, the Guardian Foundation has undertaken a project with Direct Relief's support to construct a primary health care clinic that will provide critically needed services to the approximately 15,000 residents of Nintavur displaced by the tsunami. The District Hospital located in Nintavur was damaged beyond use by the disaster and patients now travel approximately 7 kilometers to the increasingly congested Kalmunai Base Hospital for services including primary health services. Local government authorities have planned for the relocation of tsunami evacuees in Nintavur, further emphasizing the need for nearby quality healthcare facilities. With support from Direct Relief, Guardian Foundation has begun construction on a one-story health clinic that will meet basic curative and preventative service needs of the Nintavur population.
Through the generosity of GlaxoSmithKilne, Direct Relief was again able to support Guardian Foundation in construction of a second health facility in Nintavur. This two room clinic focuses its services on primary and preventative health as well as maternal and child health which include immunizations, prenatal checkups, family planning services, nutritional supplements, treatment of minor illnesses, and health education activities. The grant also supports yearly salaries for doctors, nurses, and midwives working in the facility as well as provide basic equipment to furnish the waiting room, exam rooms, and nurses' offices.
Global Action: $66,916
Project Status: Completed
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 it 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. The first phase of construction, which included one-story with exam rooms and a small women’s and small men’s ward, was completed in February 2006. An extension of the project to complete a second story on the clinic was awarded in March 2006.
Hambantota Base Hospital: $109,252
Project Status: Complete
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. Most recently, Direct Relief provided two infusion pumps and one multi-parameter monitor for use in the Children’s Ward. This will help improve the monitoring and intravenous infusion capabilities for this important wing of the hospital
McLeod Hospital: $166,680
Project Status: Ongoing
McLeod Hospital, located seven kilometers outside of Sri Lanka’s northernmost city of Jaffna, was established in 1894; during the early decades of operation, it built a reputation for excellence in maternal health care and was patronized by Jaffna’s Muslim and Hindu populations. The hospital remained in operation during the 20 year civil war, during which very heavy fighting occurred in and around the Jaffna Peninsula. The hospital’s catchment area includes villages comprised of approximately 4,000 families including Inuvil, Urumparai, Chunnakam, Udavil, Kokavil, Kopay, and Marathnamadam as well as residents of the city of Jaffna. In order to fulfil the hospital’s mission of serving the poor, all services are offered on a sliding scale basis or free of charge.
In response to the tsunami, which killed approximately 2,700 people in Jaffna, McLeod Hospital provided immediate relief including medical aid, food, clothing, and spectacles for the elderly. In the months after the disaster, the hospital provided fishing boats, nets, and motors in several areas to rehabilitate livelihoods, and assisted with new home construction and resettlement along the Jaffna peninsula. Since January 2005, McLeod Hospital has conducted twice weekly mobile medical camps in nine tsunami-affected villages. Direct Relief provided two grants to McLeod Hospital to help rebuild and improve the hospital facility, including renovating the damaged outpatient ward and operating theater, and to expand their mobile medical camps to a number of coastal villages south of Jaffna.
Preventative Health & Mental Health Care
Batticaloa Befrienders: $47,850
Project Status: Ongoing
Batticaloa Befrienders is a Sri Lankan community-based organization founded in 1993. Its mission is to improve the lives of children who have been uprooted as a result of Sri Lanka’s bloody civil conflict and have been living in displaced persons camps for years with no clear plan for resettlement. War-induced trauma and multiple years of displacement have resulted in serious mental health issues for many displaced families. When the tsunami struck Batticaloa District in December 2004, Batticaloa Befrienders expanded its program work to include children affected by the disaster with the goal of mitigating the damaging mental health effects of refugee camp life in children.
With funding from Direct Relief, Batticaloa Befrienders will conduct programs in four tsunami displaced persons camps and five conflict displaced persons camps to support 550 children as they deal with trauma, loss of family members and friends, and abrupt changes in living situations. As part of the psychosocial program, Batticaloa Befrienders will monitor the health of all children in the program and will pay for all transport, clinic fees, and necessary medicine should children require a physician’s attention. Batticaloa Befrienders will also serve nutritious meals to 550 children daily.
Safe Bottle Lamp Foundation: $18,260
Project Status: Completed
The Safe Bottle Lamp Foundation is a local Sri Lankan nonprofit organization identified for Direct Relief support through the IRD Small Grants Program. Their mission is to improve community health by preventing accidents and injuries from use of kerosene lamps. Since only 70% of homes in Sri Lanka have electricity, many Sri Lankans rely on kerosene lamps. Tsunami-affected individuals living in temporary shelter displaced persons camps or partially damaged homes are more apt than usual to use kerosene as a means of lighting, and as such are at risk for accidents and injuries. Safe Bottle Lamp Foundation has designed a safe version of the kerosene lamps over a decade ago, which is endorsed by the World Health Organization, the International Society for Burn Injuries (ISBI), and the Sri Lanka Medical Association. The organization’s mission is to provide these safe lamps to Sri Lankans without electricity. In response to the tsunami, Safe Bottle Lamp Foundation has undertaken an ambitious plan to replace 600,000 unsafe kerosene lamps in temporary shelter displaced persons camps with their safe version. Direct Relief funding is supporting this important preventative health measure.
Tropical and Environmental Disease & Associates (TEDHA): $70,000
Status: Completed
Tropical & Environmental Disease & Health Associates (TEDHA) is a Sri Lankan based organization that was formed to address national environmental health concerns. TEDHA is comprised of environmental health specialists, an epidemiologist, a social scientist, parasitologist and public health inspectors. In response to the tsunami, TEDHA initiated a program to address the prevention of water and vector-borne diseases in Thotagamuwa-Hikkaduwa. TEDHA has expanded its prevention work in Hikkaduwa and initiated a vector-borne disease prevention program in Hambantota District, working closely with the Hambantota Ministry of Health office. Direct Relief has supported TEDHA’s work distributing insecticide-treated mosquito nets in tsunami relief camps and affected neighborhoods in Thotagamuwa-Hikkaduwa area.
This Direct Relief funding will support the establishment of education and awareness programs in the Hikkaduwa area to prevent the spread of communicable diseases and improve the psychological health of tsunami-affected residents of displaced persons camps. TEDHA will hold clinics for screenings and workshops for prevention education to target common health problems among the displaced including psychological stress, alcoholism and drug use, and sexually transmitted diseases. In addition, seminars and workshops will be conducted to address topics such as hygiene and waste disposal and best practices for water and sanitation in temporary living shelters and newly constructed homes.
International Medical Corps: $769,264
Project Status: Complete
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 seven 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.
EMACE Foundation of Sri Lanka: $14,849
Project Status: Complete
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.
World Federation of Occupational Therapists: $34,990
Project Status: Complete
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. The five day training program took place in December 2005 and resulted in plans for local-regional-national-and global networking and support arrangements through the development of a Draft National Action Plan.
Family Planning Association of Sri Lanka: $10,110
Project Status: Complete
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
TEDHA: $125,360
Project Status: Completed
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 received training on use of the nets and on measures to effectively prevent disease. Bed nets are retreated as needed will be retreated as needed b by TEDHA’s community health volunteers who will regularly monitor net use. In January 2006, TEDHA initiated a program with Direct Relief support to provide 50,000 calendars with dengue prevention messages to public schools in tsunami-affected areas. This educational initiative was supplemented by a skit aimed at disseminating information to prevent the spread of vector borne diseases in Moratuwa, Hikkaduwa, Matara, and Hambantota. The skits continue through the spring of 2006.
Institute for Development of Community Strengths: $21,208
Project Status: Completed
Institute for Development of Community Strengths (IDCS) is a Sri Lankan nonprofit organization established in 1990 to implement social services in Galle, Matara, and Hambantota Districts from the provision of water and sanitation solutions to micro-credit programs to nutrition education. With support from Direct Relief through the IRD Small Grants Program, IDCS has undertaken an aggressive health education campaign targeting mothers in tsunami affected villages with training to prevent the spread of vector-borne and water-borne diseases. IDCS will conduct training sessions to educate 500 mothers on clean drinking water practices, combating mosquito breeding sites to reduce the occurrence of dengue fever, and increasing awareness on hygiene.
Water & Sanitation
Guardian Foundation: $212,199
Project Status: Completed
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, and Pothuvil, 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 in Nintavur and 50 wells in Pothuvil, 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 in Nintavur and 200 toilets in Pothuvil 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 . All well and toilet construction in Nintavur was completed in March 2006, while project completion in Pothuvil is set for June 2006. , completing nearly all by December 2005.
Project Sri Lanka: $68,917
Project Status: Completed
The southern Sri Lankan city of Galle was severely damaged by the tsunami. Approximately 4,200 people lost their lives and many more lost homes, personal possessions, and livelihoods. Project Sri Lanka is a local Sri Lankan nonprofit organization working in Galle and other affected districts with the mission of improving the lives of selected tsunami affected communities in the areas of health and education. With support from Direct Relief, through the IRD Small Grants Program, Project Sri Lanka will construct 20 toilets at the Anula Devi Balika Maha Vidyalaya girl’s school that was severely damaged by the tsunami. The toilets will allow for proper sanitation at the facility thereby assisting in the prevention of water-borne diseases among the school’s tsunami-affected students.
Muslim Women's Research & Action Forum: $183,400
Project Status: Ongoing
The Muslim Women’s Research and Action Forum (MWRAF) was established in 1978 as a women’s organization focused on empowering Muslim women socially and legally, improving the health of communities, including physical, social, psychological, and economic viability in the ethnically mixed eastern districts of Sri Lanka.
In response to the tsunami, MWRAF immediately engaged its extensive community network in the Ampara District, the district that lost approximately 12,000 people. MWRAF formed a partnership network of 52 community based organization (CBOs) called the “Network for Sustainable Community Development” in the Eastern Province to manage tsunami relief as effectively as possible. From January 2005 to April 2005, MWRAF focused on settlement of displaced persons in relief camps and the provision of curative medical services for displaced populations. Since the initial emergency phase, MWRAF has completed numerous long-term response programs including the restoration of livelihoods, provision of psychosocial counseling, and construction of facilities such as a preschool and daycare center, a school, a women’s community center, and a community health center. Direct Relief’s grant funds to MWRAF were made in support of a three part project, which includes the construction of collector wells, environmental rehabilitation, and health camps located along the coast of Sri Lanka’s eastern Ampara District. In March 2006, construction of wells begun in Kalmunai and Sorikalmunai.
Thadaham Rural People’s Organization: $13,172
Project Status: Completed
Thadaham Rural People’s Organization is a Sri Lankan community-based organization working in 36 villages in the tsunami affected Batticaloa District. Tsunami relief programs have focused on combating the outbreak of infectious diseases in tsunami relief camps and affected villages, specifically dengue and diarrheal disease. Areas affected by the tsunami suffered the contamination of wells with salt water and debris. Even more than a year after the disaster, many coastal villages lack steady access to safe drinking water. With support from Direct Relief, through the IRD Small Grants Program, Thadaham Rural People’s Organization is constructing 125 tube wells to benefit tsunami affected villages in Batticaloa District.
Community Development Organization: $29,934
Project Status: Completed
Community Development Organization is a Sri Lankan nonprofit organization active in the northern district of Puttalam where thousands of families displaced from the civil conflict reside. With experience working with displaced persons, Community Development Organization initiated programs to bring water and sanitation solutions to residents of tsunami-affected villages many of which are located side-by-side to the conflict-affected communities in which Community Development Organization had active programs. With support from Direct Relief, through the IRD Small Grants Program, Community Development Organization is constructing 100 toilets and 20 wells to improve access to clean drinking water and proper waste disposal facilities that will prevent the outbreak of water-borne disease. Community Development Organization will also work with local Ministry of Health officials to increase awareness on behaviors to prevent the spread of these diseases in affected areas.
Y.M.C.A. Batticaloa: $32,019
Project Status: Completed
The eastern coastal district of Batticaloa was badly affected by the tsunami with over 3,000 deaths and thousands of people displaced. Many affected people remain in temporary shelter relief camps, even more than a year after the disaster. Y.M.C.A. Batticaloa has been active in Batticaloa for decades and responded immediately to the tsunami with temporary housing assistance, water and sanitation improvements, and psychological support for affected residents of Batticaloa. Through the IRD Small Grants Program, Direct Relief has provided a grant to support the construction of 40 toilets and 30 wells for families that have lost their access to a reliable supply of drinking water and sanitation facilities. Y.M.C.A. Batticaloa will compliment the construction activities with awareness training on preventing water-borne diseases, such as diarrhea and cholera, in temporary living conditions.
Child Rehabilitation Center: $21,828
Project Status: Completed
Child Rehabilitation Center is a Sri Lankan rehabilitation and development organization active in health and education work in the eastern district of Ampara. Child Rehabilitation Center has focused its tsunami relief work on assistance to the many temporary shelter relief camps located along the coast of the severely affected district. With support from Direct Relief, through the IRD Small Grants Program, Child Rehabilitation Center will construct 50 toilets in tsunami relief camps to benefit approximately 693 displaced people. Proper sanitation facilities curb the occurrence of water-borne diseases from diarrhea to cholera.
Youth Assembly Sri Lanka: $19,047
Project Status: Completed
With grant funding from Direct Relief through the IRD Small Grants Program, Youth Assembly Sri Lanka will target 116 villages along the coast of Ampara District, the eastern district in Sri Lanka with the highest number of tsunami deaths (approximately 12,000) and infrastructure damage. With the goal of preventing diarrheal diseases among tsunami affected people, Youth Assembly Sri Lanka has begun constructing 20 toilets to alleviate the lack of sanitation facilities in temporary shelter camps and partially damaged (but still inhabited) homes in Kalmunai, Karaitihvu, Nintavur, Thrikkovil, and Akkaraipattu.
Community Trust Fund: $58,524
Project Status: Complete
Community Trust Fund (CTF) is a Sri Lankan humanitarian organization headquartered in Puttalam with programs across the north and east of the country. In response to the tsunami, CTF initiated water and sanitation improvements in Ampara and Trincomalee Districts. With a two part grant from Direct Relief, through the IRD Small Grants Program, CTF distributed fiber water tanks to 30 displaced persons camps and other strategic sites in the Ampara District and 20 throughout the Trincomalee District in the first phase of the grant. In February 2006, Direct Relief re-funded CTF to construct 60 toilets in the city of Mutur in the Trincomalee District. A lack of access to clean drinking water and proper sanitation facilities has plagued many relief camps in the east and north, and CTF has acted swiftly to help address this critical need. 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.
Technical Assistance & Equipment Provision
Ampara General Hospital: $195,750
Project Status: Completed
The Ampara district of Sri Lanka, located on the east coast of the island, was the worst affected district in Sri Lanka with an estimated 12,000 casualties and major infrastructure damage. Already plagued by sporadic violence, ethnic tensions, and underdevelopment from the 20 year civil war, the tsunami only added to the hardships of the population.
Ampara General Hospital is the main public tertiary facility in the eastern Ampara District, serving a population of approximately 600,000. On the day of the tsunami, thousands of Ampara General Hospital took the lead in the relief effort. Thousands of dead bodies were brought to the hospital, which acted as an improvised morgue and place for families to congregate to search for their missing relatives. The facility was the main reference point for the scores of medical teams arriving to assist the medical response along Sri Lanka’s affected eastern coastline. In the year since the tsunami, Ampara General Hospital has acted as the main anchor facility for a region in recovery. It serves as the main tertiary facility for a region from Pothuvil in the south to the edge of Batticaloa District in the north. The hospital has absorbed an increased patient load as many damaged or destroyed coastal hospitals have yet to be rebuilt.
In an effort to improve diagnostic capabilities at the hospital, Direct Relief funded the purchase of a CT scan for the facility in June 2005. In December 2005, Direct Relief provided funding to the hospital to cover the costs of purchasing a variety of medical equipment items. ICU beds, vital signs monitors, infusion pumps, ventilators, defibrillators, suction machines, and other essential equipment was procured to expand and improve the hospital’s intensive care unit. In addition, the purchase of a color doppler ultra sound scanner, to be used during outreach visits to IDP camps, was funded in May of 2006.
Hambantota Base Hospital: $100,202
Project Status: Complete
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. In April 2006, the high pressure sterilizer and operating microscope were delivered and installed in Hambantota Base Hospital.
I-Freed: $169,000
Project Status: Complete
Of the nearly 40,000 tsunami-related deaths in Sri Lanka, the greatest number of casualties, over 10,000 approximately 12,000, 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 procured 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.
Jaffna Teaching Hospital: $188,500
Project Status: Ongoing
Jaffna Teaching Hospital is a 1,200-bed major public health referral facility and teaching hospital in Sri Lanka’s northern urban center of Jaffna. The hospital is the only functioning tertiary facility in the Northern Province and, as such, serves a catchment area of over 750,000 people. Jaffna Teaching Hospital responded to the tsunami by introducing mobile medical clinics along the coast, especially in displaced persons camps, and absorbing an increased patient load in the main facility.
In anticipation of a long-term increase in patient load and a continued need to improve its capability to deliver services to the Jaffna District and beyond, Direct Relief provided funding to Jaffna Teaching Hospital to upgrade their neonatal ward. New medical equipment will help to ensure that high quality intensive care is available for babies born in the tsunami affected region and will increase the services available for the long-term to a high need, conflict affected population.
Kuchchaveli Ministry of Health Division, Trincomalee District: $10,100
Project Status: Completed
The Trincomalee District is located in the northeastern area of Sri Lanka and it is one of the most affected centers of violence and ethnic tensions in the country. The region is home to many displaced persons suffering from the conflict between government forces and the Liberation Tigers of Tamil Eelam (LTTE) and was incredibly hard-hit by the 2004 tsunami. The Kuchchaveli Ministry of Health responded to the disaster by implementing temporary shelter camps, promoting hygiene by providing safe drinking water in the camps and affected neighborhoods, distributing food items to displaced persons, and supporting psychological support programs within the camps. The Kuchchaveli MOH also operates Mother and Child Health clinics in the relief camps that aid in preventative health such as immunizations for children under 5 and prenatal care.
Because the MCH clinics did not have adequate diagnostic tools for potential pregnancy complications, 90% of tsunami affected expectant mothers could not receive ultrasounds which can provide a visual of the uterus and unborn baby to diagnose pre-birth health. In September 2006, Direct Relief provided a portable ultrasound scanner machine that will benefit approximately 4,000 mothers in the area through mobile medical clinics.
Real Medicine Foundation/Tangalle District Hospital: $70,000
Project Status: Completed
The Real Medicine Foundation provides support to people living in disaster, post-war, and poverty stricken areas. The organization was founded in 2005, inspired by lessons learned after months of tsunami relief efforts in Sri Lanka. Currently, the organization has branches in the United States, Asia, Africa, and Europe.
Following the tsunami, the Real Medicine Foundation partnered with the BTR Tangalle District Hospital Trust to renovate the Tangalle District Hospital and guarantee the facility’s long-term sustainability and high standards of healthcare, preventative medicine, and nutritional, psychological, and psycho-trauma counseling. To assist the final steps of the reconstruction and renovation of Tangalle District Hospital, Direct Relief provided a High-Pressure Sterilizer to the Operating Theater Suite that will help accommodate the sterilization needs of the 150-bed health facility.
Shelter
Galle Medical Association: $80,000
Project Status: Complete
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.
Habitat for Humanity: $10,000
Project Status: Complete
Habitat for Humanity International, a non-profit, nondenominational Christian organization, builds affordable housing for low-income people throughout the world. Since its conception in 1976, over 175,000 houses in 100 countries have been built through Habitat’s intricate network of local affiliates. After the devastation of the 2005 tsunami, Habitat’s many affiliates set out to help in rebuilding damaged and destroyed homes, in particular, the 25,000 lost in Sri Lanka.
The Lexington, Kentucky branch of Habitat for Humanity sent a team of 11 workers to Sri Lanka to help rebuild homes in Galle, a city where over 130 of 745 Habitat homes were destroyed. The team also assessed the adequacy of functioning healthcare facilities and the need to reconstruct hospitals, clinics, and long-term residence facilities in the area. In March 2005, Direct Relief provided a grant to Habitat for Humanity to conduct a housing and medical infrastructure assessment in the Southern Province.