No longer a need to walk five hours to the nearest health centre
by Francis Mead
The water in the lagoon lies flat and still. Beyond a small strip of sand, the sea too is calm. It’s a hot afternoon. A fan whirs inside the new health centre. Around fifteen mothers tend to the small children they’ve brought with them. Some of the children squirm and cry. Others are quietly curious. A midwife, in a white dress with a maroon collar, is on her feet.
“From the moment of conception you have to provide food for two people,” the midwife says, looking across the room. “What kind of food can you feed babies after 4 months?”
Visvathasa has brought her one-year-old son Arunsor because she’s worried about his eating. “He weighs eight kilos,” she says, “He’s not very interested in solid food - he wants to continue breastfeeding.” She’s come to get advice from the midwives.
Before the tsunami, the village of Koddakallar in Batticaloa Province, had a small building where mothers could go for health care. It was swept away by the waves. “There was no room, no furniture to sit on. It was so crowded,” says Visvathasa. Her house was mostly destroyed by the tsunami, but it’s since been repaired and she has returned home.
The new health centre, built with UNICEF support, has a large open area where mothers and midwives can gather, as well as an ample store-room and a separate space where women and children can be examined. Not everything is in place yet – weighing machines are on their way. In the meantime one mother has brought her own scales. Water can also be a problem in the dry season when the water tank runs low. In fact all the mothers say that safe water is in short supply throughout the area. Since the tsunami, water from the wells has become salty and they have to use chlorine to clean it.
The health centre in Koddakallar is one of twelve that have recently been constructed with UNICEF funding – six in areas affected by the tsunami, and six in locations that have suffered because of Sri Lanka’s ongoing conflict.
Before the building of their new clinic, the villagers of Iralakulam had to walk four or five hours to get to the nearest hospital. If it was closed, they would simply have to walk back without getting any medical care. As a result, it wasn’t uncommon for people to die for lack of treatment.
Located in a remote area controlled by the LTTE, about 40 km inland from the town of Batticaloa, the village is deeply marked by poverty and has long been neglected. Most of the villagers do not know their date of birth, nor do they have birth certificates or identity cards. Very few are able to read or understand forms. People travel by bike or on foot, and when the Santhanamadu Aru River rises in the rainy season, they cross toward the nearest town by boat. The houses have no toilets. “People defecate in the fields and in the surrounding areas, so when the monsoon comes micro-organisms spread to the drinking water – which then causes diarrhoeal diseases,” says the Deputy Provincial Director of Health Services, Dr S. Sathurmugam.
Despite the challenges, UNICEF was able to consult with the villagers and establish that a major priority for them was to have health care within reach of their homes. Now doctors, midwives and nurses from the Sri Lankan Ministry of Health visit the new centre on a rotational basis. Midwives tend to be listened to, and are well-known in their communities. On the first day of the clinic in Iralakulam, 57 pregnant mothers came for help and advice.
The aim is that the new health centres will not only be part of a broader effort to create a better environment for children to thrive in, but they will also help draw people together in their own communities. The clinics will form part of a hub, where people might come for classes, to meet socially, or for business. For example, the UN Development Programme has built two community centres next to the new clinics and, in the conflict-affected villages, other agencies are developing projects to rebuild homes and reintegrate former combatants.
Building the health centres has not been easy. Shortages of cement, and tin-sheet, and difficulties in getting materials through military check-points, have held back construction. But for mothers like Srikanth in Koddakallar, it has made a difference. Her little boy, Krishanth, is doing well. “The worst he’s had is a little fever,” she says. “It’s good to be able to get medicine from a clinic that’s close by. This is new and it has electricity,” she says.