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Basic health practices prevented epidemic
A tribute to our medical system and dedicated local, foreign doctors
By Marisa de Silva
In a tragedy of the magnitude of the tsunami that struck our part of the world, 'what might have been' and how much worse things could be is arguably best exemplified by the fact that the feared outbreak of disease, did not happen.

This is not about a non-story, but a story by itself. A story of years of a basic health apparatus in the remotest parts of the country, and how local and foreign medical care came swiftly to prevent an outbreak of an epidemic or any other serious bouts of infectious illness.

Dr. Paba Palihawadana, Deputy Epidemiologist, Epidemiology Unit, of the Health Ministry, reaffirmed this fact by stating that except for some respiratory problems, diarrhoea and routine mild illnesses, there have been no report of 'anything very serious'. Quite contrary to the initial fears, especially the forewarning by the WHO that, usually, diseases spread in the aftermath of a tsunami and could kill as many - if not more - than the disaster itself.

Dr. Palihawadana, is familiar with managing health situations within camps. The drill was routine. It was the same as with floods, and she was confident of preventing the outbreak of widespread disease. She thought that those who predicted the worst were unfamiliar with Sri Lanka's local public health sector.

"The public health experts, staff and curative staff have really rallied around and worked hard and efficiently by taking the basic precautionary measures to ensure the well-being of all those affected" she said. Many expected a huge outbreak of measles, but due to the comprehensive island-wide immunisation campaigns, this too didn't occur, she said. Not just measles but, there have been no cases thus far of cholera either, she added, proudly.

Treating infected persons immediately was the key to success. As the majority of the victims leave the camps, and stay with relatives, the threat of disease, reduces.

The three-man Health Desk of the Centre for National Operations (CNO) despatched 560 doctors, nurses, paramedics and other medical personnel on to the field, in the first week after the tsunami, especially from the peripheral towns like Ratnapura, Badulla and Anuradhapura.

The main functions carried out by the medical teams was to ensure safe shelter by not overcrowding the camps and ensure the inmates were not unnecessarily exposed to the night air. Making provision for the supply of clean and adequate food and water per person/per camp was another one of their tasks. Providing proper sanitary facilities adequate to accommodate the numbers in each camp, was yet another task entrusted to them. If all these primary hygiene measures are adhered to, then the chances of illness are very low, doctors said. However, at the same time, early treatment of the sick and placing the sick in quarantine if the need arose, were means of keeping disease spread under control. From the onset, the Health Ministry headed by Additional Secretary Dr. Nihal Jayathilaka, had met to discuss the calamity at various committees to manage the situation. By 12 noon the next day a special provincial circular was sent out to the Public Health Inspectors (PHIs) and Medical Officers of Health (MOHs) on the periphery stating basic guidelines to follow when dealing with the aftermath of the tsunami. The PHIs and MOHs in turn passed on the information to the field workers.

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