A Free Medical Team visits the Vanni

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Last week, Thaya, Director of the Centre for Holistic Healing, asked me to accompany her and a medical team on a visit to the Konavil district of the Vanni area where the worst battle of the civil war took place. This was one of the Centre’s “Free Medical Clinics” held at a recently rebuilt school in this isolated rural region south of Jaffna which had experienced very severe fighting six years ago. With support from the Centre for Holistic Healing, Thaya organises these free clinics in different remote areas every 2 months or so.  There was a pediatrician, nurses, social workers and three doctors, (all volunteers apart from the pediatrician who is paid a small fee), plus various members of the church who helped to set up and organize the consultations and the medicines.  The medicines are given out free to the patients, as the people living in this area are poor and the hospital dispensary is around 20 kilometers away.  Funds now have to be raised by the Centre for Holistic Healing to pay for these medicines.

This area is one of saddest I have seen since arriving in Sri Lanka in May this year.  The countryside here is very hot and dry. Many of the houses are really just huts with one or two “rooms” with cooking done outside on a fire. Water is drawn from outside wells. Some homes are made of bare concrete bricks with unlined tiled or tin roofs, and others are just palm leaf thatch. I even saw two blue emergency tents that have been in continuous use by a local family since six years ago when were first supplied by a charity at the end of the war.  I have not seen such poverty “up close”.  Some of the concrete houses still bear the marks of shells and bombs.  As well as the very basic housing, the area is rundown, overgrown and dilapidated. The bumpy dirt roads seem to meander for miles through the bushes and trees, and there did not seem to be many farm animals or crops.  I saw people washing clothing and children swimming in channels of murky-looking irrigation water.

The school is the only substantial building for miles around.  It is an imposing large two storied brick and concrete building built by the previous government only a couple of years ago to replace the school that bombs had razed to the ground.  The school looks quite incongruous in this area.  Because Friday was a school holiday, the medical teams were able to use two large classrooms on the ground floor – one for consultations and one for dispensing medicines. The windows of the classrooms are all “open air” with just grilles so there was absolutely no privacy as people from the local villages and farms queued outside along the veranda.  About 300 people came from surrounding villages throughout the day.

The patients are all ages, including many mothers with their children – some children are dressed in their white school uniforms. To my eyes, some of these children looked to be undernourished.

When we arrived, there was already a long line of people waiting patiently on rows of classroom chairs that had been set out for them in the shade.  Others sat waiting under the trees.   The people live on farms and in the surrounding villages, and publicity for the medical clinic is through handbills, announcements and word of mouth. The queue included a number of very thin and frail-looking elderly people. Local people came on their own and in family groups to the clinic all through the day – most walked, some rode push-bikes and a few came by motor-cycle with their children on board. Public transport is very infrequent here, and often people cannot afford it. The clinic was on the other side of the school’s large dusty playing field and it was quite moving to watch people trudging across this hot open space to get to the clinic. I was told that even though there is a free public health system in Sri Lanka, for most of the people in these outlying rural areas it is simply not possible to travel the distances required to visit a doctor or a hospital because they have no access to vehicles and even a bus-fare can be beyond their means.

The social workers and doctors keep an eye out for people who are particularly disadvantaged, have severe health problems or appear to be quite distressed.  CCH will visit their homes to assess their circumstances and help them with on-going medical expenses if any further treatment is required.

I met one little child, Niroshan, whose situation was quite concerning. This seven-year-old boy was wearing grubby clothes and was very thin.  I was told he doing well at school, and has potential to succeed in his education, but that his home situation was not good.  Thaya visited his home and told me later that he and his two siblings live in a tiny house with their grandparents because both their mother and their father were killed in the war.  The grandparents are both frail and in poor health and have almost no form of income , existing on food they try to grow in their yard and milk supplied by their cow, which has to be fed by hand by collecting grass from around the local area every day.  This family has usually one meal per day, at 3:00pm after the children get home from school. When asked about their meals, the grandmother said, “How do I feed them? If I have anything, I feed them, otherwise what can I do?”  Niroshan’s family will be given assistance for food for six months, and sponsorship will be sought to help him with his education.

The day was very educational and informative for me because it opened my eyes to the long-lasting effects of the civil war. Many people still have shrapnel scars including two young sisters – one had an enormous scar on her head and suffers from bad head-aches, and her young sister was blinded in one eye during the bombing. One boy may be referred for surgery on his damaged leg and foot.  Another little girl about one year old has already had four operations for a severe cleft palate – such a quiet and subdued little girl – she faces many more operations to heal her deformity so that her mouth can function properly.  Perhaps today she was aware that this was a medical clinic and was feeling a bit scared?  Many people have eye problems. There are elderly people suffering from mental health illnesses such as depression – and no wonder – it must be so hard for older people in particular to feel any hope that their circumstances will ever improve.  Other patients had symptoms of schizophrenia and other mental conditions including two PTSD clients who were referred to a psychiatrist for the right medication to manage their symptoms which can be very unpleasant – war flashbacks, rage, and inability to maintain good relationships with other people. Those suffering from depression can feel constantly exhausted, lacking in motivation and hope, over-sleeping, with strong negative thoughts.  It is very hard to work and care for a family when you suffer these symptoms.

There were many times during that day when I couldn’t help reflecting that the contrast between the circumstances of the people I saw and met, and my own life back in Melbourne, Australia, could not have been starker.

“Free Medical Clinic Day” is clearly a day that people from this area will remember with much gratitude. It was a privilege to be able to see at first hand the benefits that the Centre for Holistic Healing brings to these isolated rural communities.  I was touched by the patience of those who waited in line to be treated and by the kindness and support of the volunteers who helped on the day. This visitor from Australia will not forget “Free Medical Clinic Day” in Konavil.

Margaret Neith

August 2015