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Thileepan health Care Centre & its services in the North-East

Activities and objectives

The prolonged war has caused health care problems for the inhabitants of the NorthEast of Sri Lanka. The destruction caused by war in the NorthEast has given these inhabitants two major issues. One is the health service and the other is the education service. Both these services are in a deplorable state and pose a challenge to those concerned with the welfare of the people. The medical service run by the government in the north east is rarely in operation. The lack of medical equipment, personnel and transport is a major problem in the existing service.

During the war the North East Tamils temporarily moved to trouble free areas and when they returned later the public health service could not cater to the needs of the people to the extent required as war has caused extensive damages to the establishments of the state health services. In this situation of a very unsatisfactory public health service, health complaints and epidemics like malaria and septicaemia were on the increase.

The Sri Lankan government did not meet the humanitarian needs, and the health needs of the people were very badly neglected. Hence the Tamils suffered miserably. In a sorry state of this sort the Tamil National Leader Mr. V. Prabaharan would not let the Tamils live in such pain. He saw to this immediate need of the Tamils for health care. He got a primary health centre opened up and named it after martyr Thileepan. Thileepan's name is etched in Tamil National Freedom history because of his commitment to the course and attainment of martyrdom by fasting till death. Incidentally Thileepan was a medical student when he joined the liberation movement and willed that after martyrdom his body be donated to the medical faculty in the University of Jaffna for the benefit of the medical students. The centre formally commenced functioning in a small village known as Poothanvayal in the Mullaitivu District on the 10th of June 2002.

This service has been gradually extended and is now available through a chain of 12 centres serving many more villages in the whole of North East. The required categories of personnel have been trained with the facilities and expertise provided by the LTTE and these health centres are today manned by professionally educated personnel including physicians and nurses who are truly dedicated and accurately conforming to standards. Each centre has only one physician and the number of nurses for a centre ranges from four to eight. Thileepan health centres are invariably located in villages where health hazards are at the highest and ominous.

The services rendered by these centres have been effective enough to show marked improvement in most of the cases taken care of and looked after and complete recoveries in many.

What Thileepan Health Care Centre offers and prioritises

Tamils have been left with nothing after the war. They have been affected by the loss of their health too. Even though the loss of their essentials has not been made up for, the need to make good the loss of their health remained uppermost for urgent attention. Thileepan Health Care Centres (THCC) offers these people the most needed health care service. In the villages where these centres are working all the people seeking health care are being successfully treated. The services of Thileepan Health Care Centres are very valuable especially when the Sri Lankan government has not made any health service available in these villages where the people have resettled in large numbers. As these people had been incredulous of the proclaimed assistance and services of the Sri Lankan government they were reluctant to move back to these villages prior to the founding of health services at least.

In that backdrop the chain of THCS encompassing many needy villages have facilitated the resettlers and gained the confidence of many more displaced people to move back to their villages.

THCS having established a chain of centres to serve as many resettled villagers as they could, realized, in their earnest endeavour for an extensive service, that the most needy at locations in the periphery of the areas covered by these centres have to be cared for. As a result, there are now mobile units attached to the centres and moving about in the peripheries equipped with necessary medicine and personnel to serve those groaning in pain and incapable of reaching the centres for want of transport.

These units are also helpful at times of unforeseen calamities like snakebites when they rush to rescue the victim by providing 'on-the-spot' attendance and thereby set off against the lack of ambulance service for these areas. This health service also instructs school children including those in the pre school nurseries on nutrition and balanced diet and helps the small children with dietary supplements in addition to treatment against worms as per diagnosis.

As a characteristic example the village of Maruthankerny would serve to illustrate the indispensability of a health care centre that is typical of one run by THCS. Maruthankerny is a small village in a very remote area in Vadamaradchi in the Jaffna peninsula. Before the war became horrendous and residents were displaced there was a government dispensary for outdoor patients and a government rural hospital. When the ravages of war were escalating there were damages and destructions all over the village and the village fell into the hands of the Sinhalese army and continued under their occupation and control for over a decade. Even after the war the displaced people of Maruthankerny continued to keep away as the widespread occurrence of Malaria and the threat of landmines prevented their coming back. In the anxiety to get back to their native village these people were more worried about their need for health care facilities to help their survival in view of the prevalent health hazards and liabilities for epidemics to breakout in an environment polluted by war through the loss of lives both human and of lower species such as cattle, poultry and domestic animals and stray ones.

For them it was going to be a question of struggle for survival in a godforsaken place long deserted due to mass scale evacuation and supposed to have been haunted by spirits. In this backdrop THCS founding the Health care centres and extending their services through mobile units of these centres were all a solace to these people and soothing their minds that were desperately longing to get back to their beloved sweet soil. This motivated more and more displaced people of Maruthankerny to return home. As THCS offered an overall health care with all the health related services needed, life at Maruthankerny did not anymore seem so risky and frightening for the peoples to fight shy of coming back and the number resettling there grew from strength to strength.

It is the same story with places like Mankulam, Aiyankulam, Katchilaimadu, Poonakari, Nainamadu, Adampan, Puliyankulam, Punkuduthivu, Paddalipuram and Kathiraveli. These are all small villages and most of them very remote where health services were not even dreamt of. So the people were reluctant to come back to these villages thinking it would jeopardise their health. In their sad state and tedium caused by the indefinite and prolonged displacement THCS gave them comfort and the fortitude of mind to be willing to come back and resume their homely rural life among their kith and kin and to revive their good old community life. In this instance it is appreciable this health care project after the name of martyr Thileepan is more than a success as it has not only effected relief and recovery in respect of the health of the people but also helped to recover these villages and to regain community living there.

" These health centres serve the neighbouring villages as well.

" The health centres in developing villages provide extended services through their mobile units that cover the peripheries.

" The services of these centres also reach the villages that are ear-marked for centres to establish. At the moment these villages are being served by teams of THCS personnel deployed by the nearest existing centres. These teams camp in these villages putting up tents from time to time and meet the essential health needs like treatment of maladies on complaints, inoculation to promote immunity against diseases and also instructions on dietetics and cost effective food habits against malnutrition and safeguarding against liabilities for health defects and on sanitation for community health.

" THCS have the personnel to do home visits in villages where centres are not likely to be established soon. This helps the invalids and serves where transport is an acute problem.

" At times of disasters caused by torrential rains or floods or even prolonged drought when occurrence of illness is widespread and rampant THCS teams rush to such locations of calamities to check up and provide relief.

" THCS also have a skeleton fleet of ambulances for emergencies like accidents and severe illnesses requiring immediate attendance.

" Malnutrition is a major problem in the NorthEast. Thileepan group of health care centres instruct people for awareness on nutrition, and supply dietary supplements to children in areas where their foods lack nutrition necessary for their health.

" It is part of the duties of some of the personnel in THCS to keep vigil of sanitary conditions prevailing in densely populated residential areas especially in respect of water and toilet system. They see if the water is maintained clean and free of pollution and the toilets conform to sanitary requirements. They help chlorinate water obtained underground through wells particularly at residential and commercial areas. The personnel from THCS travelling around include hygienists who would advise on conditions and practices conducive to safe health of households especially in respect of drainage and disposal of refuse.

Role of THCS and their scope of expansion THCS are today overgrown beyond expectations and people in need of health care make the best of the services of these centres. The centre at Mullaitivu was the first one established and it had its second anniversary on the 10th of June 2004. There are today twelve of them successfully functioning at various locations all over the NorthEast. The chain of these centres runs through the following locations;

Mullaitivu district-The Katsilaimadu centre:

District: Mullaitivu
AGA Division: Odduchuddan
Number of villages: 13
Total number of families: 1789
Population: 7552
Occupation: Cultivation & Cattle farming

Before the year 1998 there was only one central dispensary at Oddusuddan and a primary health unit at Thanduvan. They were no more functioning as they were destroyed during the war in 1998. After 1998 the hospital nearest to these villages served by THCS in the Mullaitivu District was the peripheral unit 14km away. The second nearest was at Mallavi, 39 km away. The essentially required transport to reach these institutions was almost non-existent. Under these circumstances THCS came into being as a boon to the people. More than 100 patients a day are now getting treatment at this centre of THCS at Katchilaimadu. The centres are generally at such locations that the patients could easily reach them. Cases of emergency and severe illness are helped with transport to bigger hospitals in Vavuniya and Jaffna.

During the period from 11.03.2002 upto 31.12.2002 outdoor patients numbering 12333 and indoor patients numbering 520 including one maternity case of delivery received treatment at this centre.. A maternity case for delivery is seldom admitted here. They are usually sent in time to bigger hospitals.

During the whole two year period of its existence so far a total of 49121 outdoor patients and 5418 indoor patients including seven maternity cases of delivery were treated at this Katsilaimadu Centre in the Mullaitivu District.

Vavuniya District - The health center in Puliyankulam

District: Vavuniya
AGA division: Vavuniya North
Number of villages: 7
Total number of families: 276
Population: 979
Occupation: Cultivation and cattle farming
Area: Puliyankulam

People in Puliyankulam area were displaced during the military operation "Jayasikuru" of the Sri Lankan State Armed Forces. These people came back to their villages soon after the LTTE recaptured this area in the course of their military operations styled "Oyatha Alaikal" to mean offensive in never ending succession.

There was a government central dispensary upto 1997 when it was destroyed in war. When the people returned to the Puliyankualm area after the LTTE recaptured it there were no facilities for medical aid. The patients had to walk up either 17km to Vavuniya or 60 km to Kilinochchi to obtain treatment. These patients today receive their treatment at THCS at Puliyankulam or through its mobile unit that does its routine rounds at regular intervals of at least once a week in the neighbouring village of Semamadu. THCS mobile unit also attends to cases among those working at check points near Puliyankulam and the visitors passing by this station. During the period of less than nine months upto the end of 2002 outdoor patients numbering 89654 have been treated and indoor patients numbering 224 including a maternity case of delivery.

Adampan Centre in Mannar District.

District: Mannaar
AG division: Manthai west
Total number of villages: 28
Total number of families:
Population: 8315
Occupation: Cultivation, cattle farming and fishing

Consequent to the war Government Health Services could not meet the medical needs of the people in Mannar. The hospitals in Adampan and Vidataltivu and the Central Dispensaries in Pesalai and Periyamadu were all spoilt and ruined by the Sri Lankan Armed Forces. Only a part of the Vidataltivu hospital is usable as it is partly rebuilt. Yet it is working only part time. Due to the dearth of medical personnel here especially doctors, satisfactory and sufficient service is not available to the people in this district. In this backdrop Thileepan Health Service meets the crucial health need of these people. THCS at Adampan treats an average of 80 patients a day. In cases of severe illness they give first aid or preliminary treatment before they are taken to bigger hospitals.

A total of 8292 outdoor patients and 321 indoor patients including maternity deliveries have been treated during the nine months upto 31.12.2002. During the first twenty one months of its functioning upto 31.12.2003, 13206 outdoor patients and 1304 indoor patients including 13 maternity cases of delivery were treated. The TRRO in the US has donated one ambulance for use by THCS in Mannar.

Kilinochee District-Poonakari

District: Kilinochchi
AGA division: Poonakari
Total number of villages: 28
Total number of families:<
Population: 8315
Occupation:Cultivation, cattle farming and fishing

The peripheral unit functioning before the year 1991 was later destroyed during the war. The people who returned to their villages after the war suffered due to the lack of health service in this District. They had to walk a distance of 15 km to reach the nearest hospital which was in Mulangavil but today as many as 90 patients receive treatment at THCS at Poonakari. In addition to this daily service this centre visits Pallukodu and Vadiyadi and treats patients there.

The Tamil National Resurgence Movement donated an ambulance to THCS at Poonakari.

Paddalipuram Centre in Trincomalee District

THCS at Paddalipuram was established on the 3rd of June 2004 and the area served by this centre is not under the control of the LTTE. Health Service is now easily accessible to the people in this area who earlier had difficulties in obtaining medical aid as they had to go to Trincomalee hospital which is 15 km away.

Kathiraveli Centre in Batticaloa District The health Centre at Kathiraveli in the District of Batticaloa was established on the 8th of June 2004. The neighbouring villages of Kathiraveli are also served by this centre through its team of health workers and medical personnel who often camp at places needy of medical aid.

Thileepan Mobile Medical Unit and its significance

The Mobile Units of THCS work at 17 different villages. In these villages there are no health services other than Thileepan Mobile Health Service. The mobile unit visits a village at least once a week. Thus it covers two or three villages a day. In addition to the routine clinics these mobile units also attend to nurseries, elders' homes, homes for the deaf and blind and such other homes as those of physically handicapped.

Special Medical Groups

Medical Service has been an acute problem in many a village consequent to the war and the scarcity of transport disable the people from getting to places where medical services are obtainable. Thileepan Mobile Medical Unit camps at needy villages for 2/3 days a week and give them general medical treatment as well as optical and dental services. In furtherance of their medical aid they also go on health instructions at schools as well as at community meetings they convene for this purpose which have hitherto proved worthy of their endeavour.

Plans and prospects

THCS are so welcome that the building them up have been lighter than they seemed before and whatever difficulties that posed in their way were swiftly overcome. The inhabitants of the areas the centres serve are more than satisfied and their blessing go a long way to make the centres grow from the size of a molehill to that of a mountain. It is hoped that these 12 centres run under the humanitarian and social welfare programme of the LTTE would soon double up. As per immediate demands the plans of the organisers have scope for 12 more centres at the moment and ground work is afoot for them to come up in due course.

The plans are ambitious to go as far as men and material in hand would permit and then to see to what extent the needy could be taken care of and looked after. Adequacy of service is what is ultimately aimed at. The primary requirement of professionally educated and trained personnel especially general physicians and specialists are to be met. It is hoped that local and foreign aid and encouragement would enhance the interests of the professionally educated sons and daughters of the soil to join THCS to fulfil the ambition of keeping the Tamil Nation ever hale and hearty.

17 July 2004

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