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In Tsunami's Wake, the Need for a Sustained Commitment in Sri Lanka Is Evident “They smile during the day time and they cry at night,” says
Joanne Cossitt, a second year M.P.H. student in the Division of Global Health
and director of the Griffin Center for Health and Human Rights, of Sri Lankans
affected by the December 26 tsunami that ravaged coastal parts of the country.
Cossitt was one of a team of seven physicians and health professionals from Yale-New Haven and other area hospitals who assisted in the relief effort in Sri Lanka from December 31 to January 15. Other team members included Ramin Ahmadi, M.D., assistant clinical professor of medicine and director of the internal medicine residency program at Griffin Hospital in Derby, author Sherwin B. Nuland, M.D., clinical professor of surgery, Padmini Ranasinghe, M.D., a resident at Griffin Hospital and second year M.P.H. student in the Division of Chronic Disease Epidemiology, Majid Sadigh, M.D., associate clinical professor of medicine at Yale and a physician at St. Mary's Hospital in Waterbury, Monique Tello, M.D., a pediatrics resident at Yale-New Haven, and Anu Walaliyadda, M.D., a primary care physician at the Hospital of St. Raphael in New Haven.
In preparation for the trip, the team, not knowing the extent of the destruction and anticipating a range of medical needs, packed tents, a water filtration system, medicines, and a variety of medical supplies. In addition, Ranasinghe, who is Sri Lankan, contacted the Sri Lankan Ministry of Health. Upon the team's arrival, the Ministry of Health sent them to Batticaloa, an area on the country's eastern coast that was home to 94 refugee camps and had not yet seen the arrival of relief teams. In the week they spent there, the group treated approximately 260 patients per camp visit for medical problems including respiratory infections, wounds, and diarrhea. Cossitt noted that because most refugee camps were established in schools, churches, and temples that held only about 200-250 people, “epidemics could… be easily contained.” Cossitt created epidemiologic data collection forms, which the team and district health authorities used to identify the beginnings of epidemics, coordinate relief efforts, and determine which camps needed more help.
In their second week in Sri Lanka, the team headed to the southern coastal town of Matara. On the way there, they drove past mile after mile of destroyed homes and vegetation, where the smell of decaying plant and animal matter mixed with the garbage being burned as part of the clean-up effort. Cattle, typically a prized possession, wandered loose and rooted through garbage in an effort to find food in the absence of their dead or displaced owners.
By the time they arrived in Matara on January 8th, the team found that many international non-governmental organizations had arrived in Sri Lanka and were already meeting the medical needs of the people there. In response, they shifted focus and met with Sri Lankan Prime Minister Mahinda Rajapakse, Ministry of Health officials, and ordinary Sri Lankans about post-emergency needs and the long-term reconstruction effort. The need for mental health services, already being manifested in the many people suffering from acute depression and anxiety, was identified as a crucial part of Sri Lanka's recovery.
“The question becomes,” says Cossitt, “once the next disaster happens, or once the next conflict happens… what happens? The key is to now build capacity, while we have time, to set them up so that when the international focus shifts, and the donors stop donating… they have the ability to deal with it themselves.” To that end, she notes, a second team of eight physicians and other health professionals from Yale and other area hospitals traveled to Sri Lanka in February to do a mental health assessment of the population and to train Sri Lankan doctors and nurses to recognize and treat mental health disorders. That team included Haq Nawaz, M.D., M.P.H. '97, Program Director for Preventive Medicine and Director of Research at Griffin Hospital, and Tara Rizzo, M.P.H. ‘01, epidemiologist at Griffin's Women's Health Coordination Center.
Cossitt emphasized that the Griffin Center for Health and Human Rights is “interested in a long-term effort in Sri Lanka.” Her own particular interest is in the eastern part of the country, where a civil war between Sri Lanka's Sinhalese majority and Tamil separatists killed tens of thousands of people before a cease-fire brought relative peace in 2002. She noted that due to the psychological stresses of war, the poor health status of residents, and the physical, emotional and economic damage caused by the tsunami, the resource needs of the area are enormous. She envisions an effort that rebuilds the community and fosters peace, saying “something like a long-term peace center would be just perfect.” –Story by Christy Gordon
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