Health Assessment to Landslide Affected Areas in Badulla 5 November 2014, WHO Country Office for Sri Lanka Members of the team: Dr N Sumanaweera National Consultant/EHA, WHO T Suveendran National Professional Officer/Mental Health, WHO Dilip Hensman National Professional Officer/Health Information Systems, WHO Persons met and contacted: Dr Janitha Tennekoon RDHS, Badulla Dr Samadara Neththasinghe MOH, Haldumulla Dr Ravi Nanayakkara Director/Health, Plantation Human Development Trust Madhu Munasinghe Clinical Psychologist, National Child Protection Authority (NCPA) Dr Pubudu Pandithasekera Consultant Psychiatrist, Provincial General Hospital, Badulla Dr A J B Croos Regional Dental Surgeon Dr Shiromi De Silva MOH, Bandarawela Dr E G Indrani Menike Medical Officer Mental Health (MOMH), Badulla Introduction On 29 October 2014, at approximately 7:30 am, a landslide occurred in the Meeriyabedde Division of Koslanda Tea Estate which is in the Haldumulla Divisional Secretariat Division in Badulla District. Approximately 38 people are said to have disappeared and to date only 12 bodies have been recovered from the mud and debris caused by the landslide. Only 6 sustained minor injuries out of which 3 were admitted to Bandarawela Hospital and 3 to Koslanda Hospital and later discharged. Search and recovery operations by the Sri Lanka Army are still on going. Around 72 families have been directly affected by this landslide and a large number of other residents from surrounding areas have been evacuated due to further landslide threats. At present, there are 22 evacuation camps in the Badulla region, 6 are in close proximity to the site of the Meeriyabedde landslide. Out of the 22 camps, 8 are within the Haldumulla MOH area. Only two of these camps are hosting immediately affected families (Poonagala Tamil Maha Vidyalaya 58 and Koslanda Tamil Maha Vidyalaya 14) and the rest are temporarily sheltering evacuated populations who are at future risk. Two small camps, namely Chelsea Estate and Namunukola Estate camps have been closed. Main Camps Poonagala Tamil Maha Vidyalaya 934 individuals Poonagala Sinhala Maha Vidyalaya 109 individuals Poonagala Primary School 329 individuals LLG Division Kovil 292 individuals Koslanda Tamil Maha Vidyalaya 818 individuals 1
Poonagala Factory Division 133 individuals Camp Males Females Total Families Pregnant 1 5 Year Infants Mothers Olds Poonagala TMV 473 456 929 286 2 16 90 Poonagala Primary School 169 160 329 87 3 9 46 Poonagala Lower Division Kovil 107 77 184 55 1 7 40 Poongala Sinhala Vidyalaya 47 57 104 34 0 8 11 Koslanda TMV 203 197 400 116 3 7 42 Apart from the newly setup Poonagala Factory Division centre, all others are receiving cooked food and plenty of NFR items Poonagala Tamil Maha Vidyalaya Approximately 934 individuals; 58 directly affected families and the rest evacuated or have voluntarily come to the camp Directly affected families have been segregated in a separate block in the school Directly affected individuals have been tagged with green wrist bands for easy identification from the rest who have been tagged with orange bands Cooked food is provided in sufficient quantity by the Army A 24 hour health post is in place providing health services and doctors and health from different hospitals in the region are sent on rotation. Specialist clinics are conducted by consultants twice a week from BH Badulla. Medical Officers attached to the DPRU of MoH also sent on rotation to the camp. However, the RDHS stated that sustaining the 24 hour health posts in the camps would be an issue due to HRH constraints and this issue has been discussed with Director, DPRU, MoH Preventive health is taken care by MOH Bandarawela along with a team of PMHs, PHIs. This includes sanitation, garbage disposal, food and water supervision 2 Estate Medical Practitioners attached to the PHDT are also serving in the evacuation camps in rotation No increase in number of cases of communicable diseases reported 2
Sufficient toilets available (10 permanent and 30 temporary); school regular toilets as well as specially setup temporary toilets. Separate toilets for males and females. However there is a requirement for child potties as the toilets were not conducive for children s use Water is being supplied in bowsers for general secondary use and bottled water being supplied for drinking The displaced receiving generous contributions from well wishers An abandoned factory complex situated nearby (Mahakande Tea Factory) is being renovated by the Sri Lanka Army to move directly affected families and facilitate the reopening school Children are being supported by the services of a dedicated young clinical psychologist and team from National Child Protection Authority (NCPA) and other agencies such as LEADS and student from the Aesthetic Department of the Eastern University who conduct various programmes for the children Mental Health and Psychosocial Consultant Psychiatrist, Provincial General Hospital, Badulla, visited the camp and observed the situation Medical Officer of Mental Health (MOMH) is visiting the camp regularly A clinical psychologist from NCPA has been at the camp site since 1 st November 2014 with her team 9 children have been identified so far who have lost either one or both parents o Youngest was 1 year and 4 months who now is being taken care by his grandmother in Haputale o 3 children from the same family, son of 12, daughter of 13 and son of 16 lost their mother and are currently being cared for by their grandmother in the neighbouring Ampitikanda Estate o Another set of siblings, a 12 year old male and a 14 year old female lost both their parents and are being taken care of by the welfare officer in the Poonagala Tamil Maha Vidyalaya o Another family with 3 children lost their mother. A 2.5 year old male and a 12 year old male are being taken care by their grandmother in Haputale while their 6 year old sister is in the Poonagala Tamil Maha Vidyalaya o One child who lost one parent is in the Koslanda Tamil Maha Vidiyalaya All children have been engaged in group activities and are being taught on measures of being protected from abuse 3
No issues of alcohol, substance use and GBV have been reported to date inside camps All the above children were assessed by the Clinical Psychologist and her team and NCPA is handling all court and legal procedures and handing over the children to legal custodians Females and male have separate places for bathing, changing clothes and sleeping Koslanda Tamil Maha Vidyalaya Approximately 347 individuals; 14 directly affected families and the rest evacuated or have voluntarily come to the camp Directly affected families have been segregated in a separate block in the school Until 4 November, a 24 hour health post was operational in the camp and since 5 November, the health post has been operational from 8am to 8pm and an ambulance is on standby for transfers to Koslanda DH at night. The Koslanda DH is 2km away from the camp. Specialist clinics are conducted by consultants twice a week from BH Badulla. Medical Officers attached to the DPRU of MoH also sent on rotation to the camp. Diabetic and hypertensive drugs have been issued to the displaced who have been under medication 14 toilets (4 permanent and 10 temporary) are available and have been segregated for males and females and separate bathing spaces are available form males and females NWSDB provides water for secondary use by bowsers. Gully suckers and spray units are available on site Bottled water supplies are provided for drinking water and sufficient stocks are being held One orphaned child (lost his father years ago and mother in the Meeriyabedde landslide) was in the camp and now has been removed from the camp by his legal custodian with the support of NCPA DMC is coordinating and providing cooked food 3 pregnant women who were in the camp were transferred to the Koslanda DH and were later discharged and have returned to their homes One child from the camp was operated for appendicitis in Diyatalawa BH and is now being cared for in the Koslanda DH Ordinary Level classes have resumed in the school Child recreational activities are being carried out by the NCPA whose team members are on site conducting various programmes since 1 st November Complementary feeding of children is prepared by MOH Staff 4
Health Facilities Koslanda Divisional Hospital is a well equipped 69 bed hospital with a well equipped ETU, minor surgery unit, labour room. It has 2 medical officers and 7 nurses and 2 midwives, 1 dental surgeon and 19 minor staff. The Medical Officer of Mental Health (MOMH) from District Hospital, Diyatalawa, has been conducting regular mental health outreach clinics Post mortem of bodies recovered from the landslide site are being carried out in Koslanda DH Water supply to Koslanda DH has been affected and is now pumped in bowsers Wewegama (Dimbulana) DH has been temporarily closed due to landslide warnings by NBRO. Only OPD is temporarily functioning and the staff has been moved to Uva Paranagama hospital. Continuous warnings have been issued by the NBRO in 2005 and in 2011. Udaveriya Estate Hospital roof has been damaged due to strong winds and needs repairs. Estate authorities have been requested for an alternative location to move the hospital which conducts 2 clinics per week and caters to 5 estate divisions There is a dearth in health human resources in the district and sustaining health services in the camps is a challenge to continue regular public health activities Poonagala Primary School The camp shelters 329 displaced persons from 87 families 10 temporary toilets and 2 permanent toilets are available There are no directly affected families in the camp Cooked food is brought from Poonagala TMV It is in close proximity to the Poonagala TMV (approximately 3.5km) and medical facilities are offered from there Preventive and curative services are being conducted by MOH staff Poonagala Sinhala Vidyalaya The camp shelters 104 displaced persons from 34 families mostly belonging to the Poonagala Lower Division 4 temporary toilets are available There are no directly affected families in the camp Cooked food is brought from Poonagala TMV Medical facilities are offered from Poonagala TMV 5
Poonagala Lower Division Kovil The camp shelters 184 displaced persons from 55 families mostly belonging to the neighbouring Poonagala Lower Division households who have been evacuated due to a warning by NBRO Just 1 toilet is available, however the displaced population go to their homes and return to the camp There are no directly affected families in the camp Cooked food is brought from Poonagala TMV The displaced fear the vulnerability of the location of this camp and are requesting for support to be relocated in a nearby church premises Way Forward Directly affected people may have to be relocated and sheltered and cared for until the new houses are provided in safe locations and schools will have to be reopened to resume regular classes Other indirectly affected persons who have been evacuated are living in fear and anxiety without knowing whether is it safe to return to their original dwellings. Coordination with DMC and NBRO will be required for recommendations With the interest of donors and well wishers slowly shifting, stocks of drinking water, food etc. will reduce and longer term mechanisms will have to be planned for sustaining support until they are resettled It is a challenge for the RDHS to sustain the health posts being run in the camps due to HRH constraints which is also affecting routine public health activities in the rest of the non affected areas Support has been sought by the RDHS to strengthen health services in two other hospitals within the estate sector, Udaveria DH and Wewegama DH which has been closed due to landslide warnings Fear and anxiety of staff at Wewegama DH is affecting their ability to deliver regular services Sustained psychosocial support for affected populations would be necessary through the provision of dedicated community support officers assisting the MOMHs and other mental health support staff to identify and intervene early Managements of estates are concerned about reduced productivity as significant workforce is staying in evacuation camps. They want to support resettlement and restoration of services in their estates as soon as possible Mental health and psychosocial assessment is recommended for the directly affected people, after three or four weeks, once they are settled in semi permanent sheltering 6
Support has been requested by the RDHS and consultant psychiatrist on capacity building of the existing mental health staff and counselors in handling stress, grief and long term rehabilitation of the community Further discussions to be held with Chairman, National Child Protection Authority regarding the sustainable service delivery of child programmes 7