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Medical volunteers help Sri Lanka restore health care
03 January 2008
by Faiza Elmasry

On December 26, 2004, a tsunami devastated Sri Lanka, claiming nearly 40,000 lives and displacing one million people. In the southern province of the country, the costal children hospital was destroyed and many nurses died in the tragedy. Three years later, much rebuilding remains to be done. As Faiza Elmasry tells us, efforts are underway not just to rebuild this hospital, but also to bring in modern technology, train medical staff and renovate Sri Lanka's health care system.

After the tsunami hit Sri Lanka the day after Christmas, 2004, Physicians for Peace, a non-profit that provides medical assistance around the world, was contacted by a group of people who wanted to help.

"A group of young physicians that were from Sri Lanka wanted to go and help their own country," says Carolyn Ramwell, a pediatric nurse practitioner and long-time volunteer with the group. "When they went back, they discovered that all the infrastructure had been devastated."

Ramwell says the scale of the devastation was so huge that these young doctors urged Physicians for Peace to get involved, and do more than just restore the buildings. They had a long-term goal of changing the way medicine is practiced there "in terms of bringing more modern techniques, having information centers and utilizing technology to bring education to the physicians and nurses and staff."

Achieving these goals required funding, which became available in early 2007.

The ground breaking was March 22, 2007. Ramwell says former Presidents Bush and Clinton donated $400,000 to the project, called Project Peace, which was started by the World Children's Initiative. That organization, she says, invited Physicians for Peace to join them.

Together with the World Children's Initiative's local affiliate, Physicians for Peace started work on a children's hospital in Matara, in the southern region of Sri Lanka.

"We want to set this as a sort of model pediatric hospital for other hospitals in Sri Lanka to follow," says Lionel Jayarante, the Initiative's director in Sri Lanka.

"The new hospital that we are going to construct will be away from the sea," he adds. "So there wouldn't be huge threats from tsunami. It will have more space for children and even for mothers."

Javarante says the land is ready. "The government has done the leveling, providing the other basic necessities like water and electricity for us to do the construction work. Our plan is to complete this project within 18 months."

And while the construction plans for the hospital are proceeding as scheduled, other efforts are underway to prepare the health care staff that will work there. "We went to the hospital and talked to as many nurses, as many physicians, as many technologists as possible, to find out what they wanted," says Carolyn Ramwell, who recently returned from Sri Lanka.

Ramwell was part of a Physicians for Peace delegation. The trip, she says, helped them understand the realities of the health care system in Sri Lanka.

"I was pleasantly surprised," she says. "Sri Lanka has a very comprehensive health care system, very much designed upon, originally, the British system. The problem really is supplies, amount of staff and opportunities for education. We found physicians and nurses were well-educated, but due to the volume of the patients that they have to see and because it's a public health program, they just don't have the opportunity for as much education as they wish."

Physicians for Peace will provide such training opportunities.

"We are looking at probably a five-year-project," she says. "We want to change the culture of accountability and responsibility for one's education. We go in and teach advanced pediatrics, basic life support, nursing education, advanced critical care."

Ramwell says the Physicians for Peace's education strategy is very simple: train the trainers.

"We will identify two nurse champions from the U.S., hopefully from Children's Hospital of Pittsburg and Children's Hospital in DC," she says. "We will have these champions go twice a year, alternating, to offer education every three to six months. We'll identify nurse champions there. They will be our focus for education. We'll offer them professional support, e-mail support, online community support, to get them to be in a position where they are the trainers."

Through this program, Carolyn Ramwell says, Physicians for Peace hopes to train 30 to 60 nurses who will eventually be able to train dozens of other health workers and raise awareness about pubic health issues in the local communities. So, by the time the hospital opens its doors, she says, everyone will have a role in making the health care system work better than it did three years ago.