Background

The official tsunami death toll in Sri Lanka is approximately 30,947 with 5,000 to 6,000 people still missing and around 900,000 displaced persons. The entire coastal area from the north to the southwest was affected. Whilst some villages and towns were worse hit than others, none of the larger towns were completely destroyed. Unlike Indonesia, Sri Lanka was affected by the three tsunami waves, but not by the earthquake which caused most of the destruction in Indonesia. The initial emergency response was carried out by the Sri Lankan authorities and local NGOs.

MSF activity overview in Sri Lanka

Total current international MSF staff: 36

Total relief materials arrived: 513 metric tons, but a significant amount of supplies were bought locally

The first of several teams arrived in Colombo on December 27 and reached Batticaloa and Trincomale three days later. During the 10 to 12 days following their arrival, MSF teams carried out assessments along 200 kilometers of the eastern coast from Pulmodai to Koddaikalar, and covered approximately the same distance between Galle and Poituvil, on the south coast. They visited the most affected areas from Point Pedro to Colombo.

The assessments revealed an uneven destruction of the coastal villages, with those closest to the sea being partially or totally destroyed. The survivors lived in public buildings or with neighbors and family. Livelihoods—boats, fishing nets, fisheries, hotels, restaurants etc—had been destroyed.

Access was often difficult during the first week due to destroyed roads and bridges. The teams found local people to be very active in rebuilding and cleaning up. They discovered no medical emergency, but did treat some specific medical needs.

The Sri Lankan medical system was well organized and remained efficient after the tsunami hit the coast. Vaccination coverage was also relatively high. Respiratory tract infections and diarrhea constituted the most common problems. By mid-January more than 160 non-governmental organizations (NGOs) were present on the ground.

After having provided emergency medical aid through mobile clinics and existing medical facilities as well as distributed relief goods during the first weeks after the tsunami, MSF is now orientating activities towards supporting the most vulnerable people in rebuilding their lives. MSF will be providing psychosocial support in collaboration with the local NGO Shade and the NGO Payasos Sin Fronteras (‘Clowns Without Frontiers') and will help families re-establish their livelihoods and community lives.

MSF operations by location

Jaffna-Point Pedro

Assessments

Evaluations regarding medical needs including psychosocial ones and water and sanitation carried out in the first and third week of January. MSF found no significant unmet needs.

Vanni District

Mental Health

• MSF mainly identified mental health needs and started a psychosocial support programme in around kilinochi and mullativu.
• Other medical services were functioning and basic medical and humanitarian needs were covered by organisations and the authorities.
• Psychosocial support is provided through the local NGO 'Shade', previously established and supported by MSF.
• 50 counsellors are trained.

Distribution of non-food items (NFI)

• 120 metric tons of supplies were flown in and are distributed in and around kilinochi and Mullativu (drugs, 15,000 blankets, 5000 sleeping mats, 500 kitchen sets, 15,000 hygiene sets, 1000 tents, 5000 jerry cans)

Trincomalee area (est. 185,000 displaced)

Assessments

• Assessed the health situation:
  • Health: Respiratory Tract Infections, malaria, no current epidemics
  • Measles coverage for region prior to Tsunami 86%
  • Ministry of Health provides health care free of charge
  • Hospital had one wall damaged so closed wards because patients fear nearness to water. Hospital not overly busy : wards only 50% full, out-patient department 60 patients/day.
  • Plenty of staff and pharmacy well stocked.
• Ongoing assessment of water and sanitation needs: although medical activities ceased on 12 January, medical teams continue to follow up the health situation. Water and sanitation experts are currently doing assessments of non-medical needs.

Kucchavelli (est. 5000 displaced)

Medical Activities

A few hundred consultations were done through mobile clinics. No medical emergency identified, and numerous medical organisations were present.

Rehabilitation

MSF teams cleaned up the newly built hospital partially damaged by the tsunami and rehabilitated the water system. After three days when the medical team was about to begin consultations the Indian Navy arrived with numerous doctors and nurses. Distribution of 700 tents

Batticaloa area (est. over 180,000 displaced)

Assessments

• Accommodation and food
  • Displaced staying public buildings (schools, temples, mosques, churches).
  • High density of population and not enough wat/san infrastructures.
  • People receive food on a daily basis and there are stocks full.
• Health
  • In the first three days after the tsunami, the hospital took care of a great number of wounded, and consultations went up significantly. This was taken care of by the Sri Lanka medical corps. MSF gave a surgery kit to the hospital to replace what had been used.
  • No particular pathology reported, no change in usual morbidity, no increase of consultations in the hospital.
  • In the periphery the situation varies from site to site, however no medical problem has been identified. Mobile clinics or access to health structures are available.
• Distribution of non-food items (NFI)
  • 1500 tents, 1500 hygiene kits and jerry cans, 6000 blankets.

Vakkarai

Assessments

Vakharai town between Batticaloa and Trincomalee districts has been completely destroyed including the brand new hospital. The medical consultations are performed by the health authorities with the help of Malaysian doctors.

Distribution of non-food items (NFI)

1334 families were given family tents, jerrycans, and a hygiene kits. 4 000 blankets were also distributed. Today there are no more families housed in public buildings. 

Koddaikalar

Assessments

Koddaikalar was completely isolated for the first few days. The only bridge linking the island to the mainland had been destroyed as well as about half the buildings. Medical consultations were held by different Sri Lankan doctors as well as MSF until the connection with the mainland was reestablished (the nearest mainland hospital was only 1,5 kilometres away.).

Medical Activities

During the third week of January consultations were carried out in a school housing displaced.

Distribution of non-food items

176 families whose houses had been completely destroyed were given tents, jerry cans, blankets, and hygiene kits

Water and Sanitation

176 families whose houses had been completely destroyed were given tents, jerrycans, blankets, and hygiene kits. Water tanks have been set up (total 18M3 = fulfilling needs for 20,000 people) and water trucking is done daily.

Ampara (est. 38,624 affected families and 87,707 displaced, source: Ministry of Health)

Medical Activities

Mobile clinics and epidemiological surveillance: as MSF arrived earlier than most NGOs in this area, immediate medical needs were found and provided for. Some medical structures were completely or partially destroyed. MSF worked in three medical structures and supported the Ministry of Health in organising 13 mobile clinics and epidemiological surveillance. No outbreaks at the moment.

Temporary MSF hospitals

• Nintavur District Hospital: Temporary structure (tents) already set up. Water and Sanitation works finished.
• Karaitivu Peripheral Unit
• Marathamunai.Peripheral unit Water and sanitation almost finished.
• Set up of an OPD in Tirukkovil
• Saintamarutu District Hospital

Mental Health

MSF in collaboration with the local NGO Shade and the NGO Payasos Sin Fronteras (Clowns Without Borders) will set up psychosocial support programmes for adults and children Distribution of medical equipment

Distribution of non-food items

MSF distributed items to 4,000 families in the area from Nintavur to North Kalmunai.

Shelter

MSF is planning to build 2000 shelters in Tirukovil, and has building plans in Potuvil.

Assessments

Today, numerous organizations are working in health at hospital and primary health care level (mobile clinics) and new ones keep on arriving. Medical attention in camps is guaranteed through government or ngos. Hygiene and sanitation needs are more important than medical ones right now. Regarding medical supplies: there are some specific shortages (mainly antibiotics and some i.v. drugs) but in general drugs are available. Malaria and Dengue control program seem to be working with support of some NGOs. Vector control activities are being carried out (fumigations with malathion) and some organizations are going to distribute mosquito nets.

Hambantota district

Medical Activities

Some medical consultations took place in the first weeks

Shelter

In Tangalla and Rekawa an MSF team is building 120 semi-permanent shelters.

Water and Sanitation

Support in rehabilitating water systems and water trucking.

Support to affected and displaced families including psychosocial support

MSF continues to give support to a number of families and aims to offer a full package including advocacy so that they receive access to land allocated by the government. In this perspective a mental health assessment was done resulting in the decision to open a short-term psychosocial support program. The program targets to assist the population who will resettle into semi-permanent structures.

Matara

Assistance to displaced families

MSF provides assistance in 2 sites where 41 families are relocated in schools.