Above is the video documentation of the trip and below is a photo gallery. This is of Padaviya, Vavuniya documentation will be added shortly.
ACT members present
Govindha Tidball
Indi Samarajiva
Simon Wijegooneratne
Thamara Spitzner
Accompanied by 2 lorry loads, 2 drivers including 1 Supervisor provided by the Medical Supplies Division, Ministry of Health, Sri Lanka.
Contact person Padaviya District Hospital
Dr. Mahinda Uyangoda
District Medical Officer
General
The two ACT teams traveling to Vavuniya and Padaviya Hospitals separated at Medawachchiya check point. The lorries were thoroughly checked for approximately two and a half hours following which the teams went their separate ways.
Upon arrival the general atmosphere of the hospital was very quite; there were no persons/families settled outside nor were there any new patients being brought in. Very evident was the large stock of government provided medicine boxes piled up in the corridors as well as ongoing construction work at the site.
Dr. Uyangoda was available in his office and immediately requested staff to ready the wards and army personnel to grant us permission to visit the factory where patients with minor injuries and their families had been settled. District Hospital staffs were requested to ready themselves to assist us with unloading the lorries.
Dr. Uyangoda welcomed us in to his office and gave us a general overview of the current situation at the hospital. He stated that things had drastically changed within the last two days; the government had provided large quantities of very basic medicines required and was upgrading the hospital through major renovations.
At present the hospital had 300 patients with the capacity to host another 100. In total 3 surgeons, 15 doctors, 60 nurses and 70 minor staff were based at the location.
Dr. Uyangoda was very pleased with the donation of medicines provided by Heart to Heart. He stated that Padaviya Hospital was currently overstocked with basic medicines in order to manage well but did not have anything extra to treat for example fungal skin conditions, the latest outbreak very apparent in children being Scabies.
Examining the inventories Dr. Uyangoda decided on sending excess toys and clothes to the factory where the need was more apparent. He was very particular about ensuring that each item inventoried was delivered especially with regard to expensive medical equipment. He was overjoyed to receive the ultrasound scanner (which they did not have), foldable as well as water mattresses which he said would be extremely useful for his patients. Concerning the large stock of milk he said there is a huge need for high energy food and drink at the factory where he would advise army personnel to distribute according to how they normally do.
2 lorry loads
The MOH drivers, Padaviya hospital nurses and ACT members unloaded the lorry. Dr. Uyangoda requested that the person in charge of medicines and inventories assists us. As a time consuming matter he suggested that the Heart to Heart medicines are checked at a later stage, he promised to sign and seal the list and fax ACT as well as MOH a copy of it. The majority of toys, all foldable mattresses and most of the milk powder were separated for the factory by which time permission was granted for us to visit.
Dr. Uyangoda suggested that we move on to visiting the wards while distributing toys.
Wards
Everything was in order and several beds had been made vacant at the time of visit as Padaviya hospital serves as a transfer hospital, once patients stabilize they are bussed out to make room for the next ones coming in. Roughly 20% of the patients that come in are in critical condition, the rest have minor wounds. At any given time Padaviya hosts 200 patients in addition another 100 local patients were on site. When IDP buses come in the total number will swell to around 500 patients. As soon as the patients stabilize they are sent across to one of five hospitals depending on the availability of space (GH Polonnaruwa, Dambulla Base Hospital, Kurunegala Teaching Hospital, Vavuniya Hospital or Mannar).
The toys were a huge hit with the children, the number one request among the toys that we had were for cars, even among the girls (many wanted to exchange an initial toy for a car if at all possible). In discussion with the ACT team it was recommended to send in toys again. The people really lit up when the box was opened. More importantly next time if possible toys that spark more social involvement and interaction among the children should be included i.e. cricket bats, soccer balls etc. space in the factory field for this type of activity was available and ongoing.
Factory
The factory though not so well maintained as the hospital had an almost full ward of females including a few new born babies. The general impression is that the level of hygiene is poor due to so many flies on the infants and very dirty toilets. Scabies was very apparent in many, Dr. Uyangoda pointed out many children with this skin condition. The men’s ward was rather empty upon our arrival they were all smiles. It was nice to see two of them enjoying a nice game of chess. Our visit at the factory was short as we had to get to Medawachchiya before 6.00p.m in time for road closure. We observed if could be said a lot of happiness amongst the children in the factory field engaged in a serious game of cricket. Therefore it is suggested that equipment for group activity is sent in the next delivery.
Dr. Uyangoda stated that he would be in touch with us about specific medicines, equipment and any other items required by the hospital. He sincerely together with the nurses thanked us for the gift items and our visit.
ACT hereby confirms that we are cleared for travel to Vavuniya and Padaviya Hospitals on Saturday 16th May.
Two ACT Teams will manage the delivery, each accompanying the lorries that will be packed by us. Items delivered will be listed and signed for by the District Medical Officer in each hospital.
We will stop collecting by this afternoon.
Please make sure all goods are delivered and inventoried by Thursday evening. To confirm your delivery, please contact inventory@actlanka.org.
Packing Team is same as before, please liaise with krishni@actlanka.org .
We will publish journey details, approved photos and a detailed inventory of donated items on our website, once delivery is complete.
Now is the time for last minute collection. Please contact toys@actlanka.org if you can donate toys before Friday.
All other purchasing is on schedule and within budget as per our assessment of the need. For details, please see www.actlanka.org .
Thank you once again, for your tremendous support.
ACT has collected a sizable amount of toys but we want to ensure that it is enough for no child to be left out. Our volunteer Annika has arranged for wholesale pricing from Bambino’s on Galle Road. You can contribute by either dropping of toys at the address below or contacting 0777 686 787 to arrange a donations.
Note that ACT is transporting toys in addition to urgent medical supplies because many children are affected and they need hope as well as medicines.
Soothers – Rs.400 per dozen, approx. Rs.33 per piece
For purchase of toys and soothers at above prices, they can visit Bambino (83, Galle Road, Bambalapitiya) and leave items there as it is a collection point. Or can contact me on 0777 686 787 to donate money for purchase.
ACT is requesting donations of toys, games and colouring items for displaced children in the Vavuniya and Padaviya Hospitals. Apart from the urgent medical needs, it is important to remember that there are many injured children here and they need to have some fun and distraction as well as medication.
If you have any clean used or new toys (or games, coloring books, stickers) please drop them off this week at the collection point below.
Collection Point (Mon-Fri, 9-5)
Radhika Philip/ACT
c/o Investor Access Asia
60, Fifth Lane
Colombo 3
Alternately, you can make a donation into any Sri Lanka NDB branch to the account below or via bank transfer from abroad. Please send a mail to accounts@actlanka.org with your name and donation number and that you’d like the amount allocated for toys.
Action & Care Trust
NDB Bank, Sri Lanka
Account No: 100001018418
SWIFT Code: NDBSLKLX
For any queries about the Toy Drive please contact toys@actlanka.org.
This need is not medically urgent these children need hope as well as healing. It’s a small thing, but a toy or a game can mean a lot to a child, especially one who’s seen significant trauma and has very little. We hope you can help.
Awaiting clearance, still stuck in airport. These are life-saving drugs and lives are being lost so as soon as we clear these goods, we will load them in army trucks and send them straight to Vavuniya and Padaviya Hospitals. We have the contact numbers and know the doctors on the other side who will confirm they received the shipment.
Goods Raised By ACT
We are spending considerable resources on medical equipment. These include everything from amputation saws to foetal heart-rate monitors. The list is based on the “Needs Assessment” by our Chairman.
Help Needed
Funding – we can furnish proposals for how we will spend the money and we will issue receipts. However, based on the “Need’, we really need the big corporates to donate something, anything.
Toys – We are presently debating whether we should spend on purchasing toys when medicines are a priority. Thus, some sort of “Toy Drive” that will raise old toys would be most useful. Bearing in mind the high number of kids under 10, of which at least 70% are under 5, toys can have a huge impact on easing their mental anguish. Annika from our Trust is the liaison on this, please contact her at toys@actlanka.org if you can help or mount a toy initiative of any sort.
Pillows – Once again an item that will increase comfort but not be justifiable in our budget. Not a single patient has a pillow. Can anyone manage this area?
Delivery – We hope to deliver on Sat May 16th (except for medicines that we pre-send). We will need more people to accompany us upto Madawachchiya (approx 20km from Anuradhapura). This is where we have to unload everything and reoad into army vehicles. This time we will have a lot more stuff and need more support on this. Let us know if you are available.
Packing Team – Stays the same, please be available on Friday night 15th May.
We will be in touch with more shortly. The ACT website www.actlanka.org will have more news.
All in all the doctors, nurses and minor staff together with the paramedical staff are doing a heroic dedicated service. They work almost 20 hours per day with the arrival of every new batch of patients which is once every 2 to 3 days! It is almost a miracle that the health of this staff has been able to withstand the trauma both physical and mental. The stories that the patients come out with are unbelievably tragic and will no doubt affect the health of the patients and staff treating them in the long term. They need to be protected.
The DMO of the Hospital Dr.Mahinda Uyangoda, is a remarkable person in whom one sees a combination of compassion, selfless service, good personal relationships with staff, forces and the public and a quick mind looking for solutions to complex problems. He was a very tired man when I met him having slept less than 4 hours the previous night. But he took time to go round the entire hospital and garment factory showing us the entire facility and explaining to us the problems and how he has overcome many of them.
He was ably supported by Dr.Muditha Amerasinghe MO, who too is doing a marvelous job working very hard to hold the facility together.
STAFF:
General Surgeon – adequate
Orthopaedic team of 1 SR, 3 nurses from Kandy and Karapitiya go in rotation. Need to encourage other Teaching Hospitals to send teams.
Junior doctors- At least another 10 Medical officers are urgently required.
Apart from persuading doctors to go there, there is in addition the problem of accommodation for all grades of staff sent to Padaviya. Doctors apparently demand single rooms with attached toilets. Currently rooms are shared. A solution to this problem is hard to find. There are no more suitable houses available for renting. The nearest town is Kebbetigollawa where suitable houses are not available. Mihintale appears to too far.
The only solutions appear to be:
Rent houses in Mihintale and work out a scheme where doctors spend 3 days in Padaviya staying in “on call” rooms and getting one full day off.
Rapid construction of prefabricated semi permanent quarters.
Nurses are also highly overworked. There are 15 permanent and 25 Pupil nurses from Ratnapura who were due to leave the next day. There is fear amongst the parents of nurses regarding security. A good public relations exercise is needed to allay their fears. Nurses live in overcrowded rooms. At least 30 more staff nurses are needed. A facility to house extra nurses too should be planned as for doctors.
Attendents/Labourers/orderlies (Minor staff) Casual labourers are forced to work under threat of dismissal. Hence their commitments are minimal. Persuade ICRC to hire labourers/volunteers as in Vavuniya
MAJOR ADMINISTRATIVE PROBLEMS
When patients are sent to TH Kandy especially with head injuries, the attendant and nurse accompanying the patients have to attend to the admission, accompany them tothe Ward, be present near the CT room, and get the report. If negative, the patients back are brought back to Padaviya i.e travel usually lasting a full day or more. The reasons for this during normal situations are understandable. A meeting with the Director and Consultants explaining the current situation of shortage of staff and the hours of work of the staff at Padaviya may be useful to get a temporary “amnesty” from their rigid rules. Traffic is not allowed on these roads after 6pm.
No accompanying persons are allowed to stay with the patient. If a child is injured and has 2 other young brother and sister, and father is dead the mother has to take the children along when the injured child is transferred e.g. to TH Kandy. If the policy of TH Kandy is not to allow “bystanders” a solution has to be worked again meeting the Director and Consultants to accommodate them temporarily.
EQUIPMENT & CONSUMABLES
ICU needs at least 2 portable ventilators to transfer acutely ill patients safely.
Wards need 4 to 5 Pulse oxymeters to monitor acutely ill patients not needing ICU care.
2 Defibrillators needed, one in OT and the other for Wards
General: Packets containing the following will help: Plastic Mug/cup, Plastic plate, soap, sarong/sari/children’s clothes, male/female. Numbers are difficult to predict. An INGO supplies such packets on arrival. There are over 200 patients in the Wards with another 300 to 400 accompanying persons/family/children in the Hospital. The abandoned garment factory has almost 150 patients and 279 accompanying persons looked after by 3 nurses.
REPORT OF IMPRESSIONS GATHERED DURING MINISTRY OF HEALTH SPONSORED VISIT TO DH PADIVIYA AND GH VAVUNIYA
BY PROFESSOR A.H. SHERIFFDEEN, ACCOMPANIED BY DR. JAYALAL
All in all the doctors, nurses and minor staff together with the paramedical staff are doing a heroic dedicated service. They work almost 20 hours per day with the arrival of every new batch of patients which is once every 2 to 3 days! It is almost a miracle that the health of this staff has been able to withstand the trauma both physical and mental. The stories that the patients come out with are unbelievably tragic and will no doubt affect the health of the patients and staff treating them in the long term. They need to be protected.
Doctors interviewed: Dr. Bhavani Pasupathiraja, Medical Superintendent who appears confident and in total control of the difficult situation and appeared to command the respect of all grades of staff; Dr.Purupananda, MO Anaesthesia who was familiar with almost every patient in the ICU and wards, working well above the call of duty; Dr. Akhilan Registrar, Surgery who was confident and looked capable.
Conclusions: Sending extra staff is a priority. Whilst the logistics of this are being worked out, it is important that at least the equipment and consumables requested are sent as soon as possible so that the doctors working under trying conditions are made aware that the Ministry is listening to them and trying to help.
STAFF
Surgeons with SHOs work round the clock dealing with emergencies and infected wounds, resulting from delayed access to treatment. The delay is caused by the difficulty faced by patient in getting to a medical facility from the site of injury. Infected compound fractures are the rule rather than the exception.Extra MOs for Wards urgently needed especially since WHO and Pradesha Sabha funded temporary Wards are coming up.
Anaesthetist SRs support the surgical team admirably. They could do with extra medical officers in OT and more in the Wards.
Permanent orthopaedic Surgeon urgently required. External fixators required for the compound fractures.
EQUIPMENT & CONSUMABLES
OT: Sutures 3/0 and 5/ Proline needed. Also needed are bone wax, Gelfoam and artery forceps of all sizes. Elastoplast and Micropore plasters needed in OT and Wards.
ICU: Requires a Paediatric ventilator and 2 Monitors. Total Parenteral Nutrition (TPN) solutions are not available.
Extra supplies of inotropes: adrenaline,dopamine, dobutamine needed.
3 way urinary catheters required especially for patients with haematuria.
Path Lab: no facilities for Histopathology and Microbiology. The latter is urgently needed in view of the large number of infected wounds.
Consumables: consumption of antiobiotics and analgesics very high needing urgent replenishment of stocks.
Cefuroxime (intravenous) is not available and urgently needed.
Other frequently use antiobiotics are Co amoxyclav, Ciprofloxacin, Metronidazole, Cloxacillin and oral Norfloxacin
Consultant Physician needs the following: 4 adult and 1 paediatric nebulizers
Calcium resornium sachets for management of over 100 patients in chronic renal failure. Initially 1000 sachets.
Azithromycin 250 mg tabletsx 200
Tramadol tablets 50 mg x1000
Antibiotics and analgesics are consumed rapidly since over 90% wounds are infected
General: Packets containing the following will help: Plastic Mug/cup, Plastic plate, soap, sarong/sari/children’s clothes, male/female. Numbers are difficult to predict. An INGO supplies such packets on arrival. There are over 2000 patients in the Wards with another 500 to 600 accompanying persons/family/children in the Hospital.
The next delivery is scheduled for early May and will cover Vavuniya and Padaviya Hospitals. A date will be fixed as soon as our imported items arrive.
Medical Imports
All credit to ACT Member Govinda Tidball whose close relationship with an international aid organisation has led to their anonymous donation (their 2nd to ACT) of over $60,000 in medical supplies.
Based on the shortfalls noticed and lists provided by doctors at the scene, ACT will raise the following aid:
Vavuniya & Padaviya Hospital Delivery List
For kids:
Pedia Sure
Nan 1 & 2/LACTOGEN
Nutrigen
Anchor 1+
Nebulisers
Pediatric Nebulising Masks
Domperidome Syrup/Suppositories
Volteron suppositories, for kids
Blood Pressure Monitors, for kids
Anti-biotics
Painkillers
Kids clothes
For Adults
Roll up mattresses
Bed pans
Adult Diapers
Macintoshes
Sterilised Gauze/Dressings
Housecoats/Sarongs
Local Applications (Fucidin, Soframycin etc)
Drugs (Anti-bios, Painkillers)
Rehydration Salts (Jeevani)
IV Stands
High-energy Supplements
How To Help
We need to buy goods and put them on trucks up North. You can contribute either money or goods.
Donations
If you’re in Sri Lanka please contact Krishni at accounts@actlanka.org. Internationally please make a wire transfer to our NDB account, but do make a personal contact first.
Goods
You can drop-off goods at the location below. You can also contact Michelle (medicines@actlanka.org) or Tamara (supplies@actlanka.org) for wholesale purchasing and better pricing.
Collection Point (Mon-Fri, 9-5)
Radhika Philip/ACT
c/o Investor Access Asia
60, Fifth Lane
Colombo 3
Act representatives visited Vavuniya Hospital on 4th April 2009, accompanying the 1st donation of aid by our Trust. The hospital had a capacity to treat 300 patients, which it has currently expanded to 430 patients. However, warded patients are now at 1,200. In addition, there are accompanying family members plus those with minor/healing injuries, who are prohibited from leaving (and have nowhere to go). As such, the number of Survivors presently residing in Vavuniya Hospital, are approximately 3000 in number.
It is a well run hospital, under the care of Dr. Bavani Pasupathyrajah (Medical Director, Vavuniya Hospital). The sheer number of patients is the major problem they are facing. Of these, a very large number were children under the age of 5. There were a lot of babies and breast feeding mothers, newborns and toddlers with injuries.
Based on the data collected and upon request from the doctors in Vavuniya, Phase 1 Part 2 will include another delivery of relief items to Vavuniya.
Padaviya Hospital
Emergency treatment is provided as civilians come off the boats in Pulmodai. Patients with a good chance of survival are dispatched to Padaviya Hospital.
Our Trust Chairman Professor A.H Sheriffdeen travelled to Padaviya Hospital on 19th April 2009, to assess the medical situation. He confirms that treatment facilities are overcrowded and Padaviya Hospital is over capacity (despite an expansion into a donated garment factory). Human resources are limited (doctors, junior doctors, nurses, orderlies) and as such, need to be expanded.
As expected, there were a large numbers of babies and children under 5. Total number of patients is around 1,500.
Pulmodai Field Hospital
Very little data is presently available to ACT. Reports range from the existence of a fully equipped hospital, to quick “on-the spot” emergency treatment facilities after which, patients are transferred to Vavuniya or Padaviya. We will be researching how to help Pulmodai Field Hospital shortly.
Continuing the efforts of providing children a carefree environment where they could forget their sad and disturbed childhood, brought about by war, one more “Mahilchi Illam” (Happiness Centre) for psychological well-being (children’s psycho-social centre) was declared open at Nedunkerny Maha Vidyalayam in Wanni. ...
ACT under the scope of rehabilitation will support the efforts in the North and East to set up psychosocial centers for the well being of children. ...
ACT worked closely with the Disaster Management Unit to assess the needs and supply urgent and essential medical supplies to the Kilinochchi & Pullmodia area hospitals. ...
http://www.heartsforharmony.ca/
Visit this site for details of the fundraiser organised by Hearts For Harmony of Canada for medical relief items for the Internally Displaced Persons. ...
