Facilitate Health Services for affected people in Batticaloa.

Background

The district of Batticaloa occupies the Central Part of the Eastern Province. Major portion of the population is engaged in Agriculture while the fishing occupies the second place in the social structure. Other occupations are Industrial activities, Business and Employment in Government, Corporation and private establishments. There are about 20 % of population are live under poverty line in this district which is highest in Sri Lanka. Post war areas of Batticaloa are extremely poor due to disadvantaged social and economic circumstances. Disadvantaged families are those in financial strain, those with less parenting support (I.e. single parent), families with a lower level of education, Lower Health Care, Lower parenting skills, individuals with mental illness, those that lack social support or formal or informal community networks.

After war and Tsunami many of the people become most vulnerable, they affected psychically and mentally. Especially mentally and psychically handicapped people have been identified, the reasons are the lack of counseling programme, lack of mobile clinics at the village level, lack of proper treatment,  lack of family health officers, lack of nutrition food consumption and lack of health care experts and poor equipment and tools for service.

The state hospitals in Batticaloa are not having capacity to provide the quality services to the poor people and other middle glass and rich people are only able to access the services from private health service providers in this district.   The available Hospitals are listed down here.

Problem Statement

There are about 12 divisional secretaries (DS) division are functioning in Batticaloa District and most of the DSs effected by the civil war, flood and tsunami consequently most of them become as poor. Affecting health are the high prevalence of mental illness, lack of physicians, lack of transportation, and inability to purchase medicine. There are two areas divided informally in this district respectively very difficult areas (Eravurpattu, Koralaipattu North, Koralaipattu South, Manmunai South West, Manmunai West and Porativupattu) and Other eight areas are located mostly in coastal areas. The coastal area people comparatively are able to access the available services than others. There is another problem is Batticaloa hospitals have adequate equipment, tools and specialist in other areas than the dental and vision to treat the patients.

The identifies Issues

Shortage of Health Personnel

·         In the Batticaloa Districts, there is a severe shortage of health personnel specially Consultants, Medical Officers, Para Medical and other category of staffs. The shortage of Human Resources in Health Sector is acute in the East which is likely to be a major obstacle to rapidly recover the Health System. It is also major factor in determining the effectiveness of delivering essential Health Services to the East population. Implementation of Health Programme also impeded due to lack of staff.

S.No.	Health Officer	Cadre	Position
1	Specialists	08	-
2	Paramedical Staff	516	499

• ·      Inadequate Training to staff in Modern Techniques.
• ·    Increase in the incidence (ARI) and Diarrhoeal  Diseases due to inadequate shelter, damage / disruption to water and sanitation systems and in-sanitary conditions of the welfare centres where the displaced are crowded in.  
• ·       The worsening of the maternal and child health status
• ·       Disability services – the marginalized of the marginalized?
• ·     Health promotion often takes LOW PRIORITY in resource poor settings, reduced to IEC - promoting appropriate healthy living and behavior patterns is very poor.
• ·         Poor medicines, equipment and laboratory and .other supplies. (HEALTH AND HUMAN RIGHTS issue when governments block supply … but what to do?)
• ·         Poor sanitary and hygiene facilities/ programs for the IDPs and camps
• ·         Poor health accessibility and Lack of Improvement of health care services at village level in the very difficult areas.
• ·         Lack of necessary medical equipment to improve of health centers services
• ·         Lack of Improvement/construction of infrastructure facilities of hospitals and MOH office.
• ·         Lack of construction of sanitation facilities because 43 % of household are struggling to access the improved sanitation facilities within premises.
• ·         Lack of water sources because 47 % of household are struggling to access improved water source within 250m travelling distance.
• ·         Increase the school dropout among the poor families.
• ·         Child labour and exploitation is prevalent.

The target group

The target group for this service selected whole disadvantaged families including single mother household, single father households and parentless families and poor families from the most difficult areas from Porativu Pattu Divisional Secretariats where 12549 families are living. These people are suffering without employment opportunities and 80% of them are engaging in labour work in paddy field but it is gradually reducing by introducing machineries instead of manual harvesting and other work. Most of them are living far away from the urban and suburban in this districts and most of the health services are providing from urban and suburban so the poor people are staying in these areas are suffering to access the quality health services.

We plan to target 1200 patients from the above targeted group by giving priority base of their requirements.

Stakeholders

We concerned the key stakeholders to do this programmer with collaboration of, Ministry of Health, Department of Health, Local Community Based Organizations, Police, District Secretariat, Divisional Secretariats, Local NGOs and Volunteers.

Key Outcome

• ·         There is about 1200 people get maximum benefits
• ·        Provide quality health service for theses target group through mobile programme
• ·         Reduce the number of dropout of School Students
• ·         Increase the efficiency of labour force by providing the health care services

Reference:

·         http://www.ep.gov.lk/Documents/POI-2008/MiniHealth.pdf

·         Kolitha, Wickramage, World Health Organization, Sri Lanka.

University of NSW, School of Public Health and Community medicine, Sydney, Australia

Author

Dr.Thulitha W

S.Thanigaseelan