Tensions between ethnic groups and demands for an independent Tamil state erupted into civil war in the early 1980s. The war lasted for two decades and violence still plagues the country, despite a 2002 ceasefire agreement.
The escalating cost of the war took a large toll on Sri Lanka, with funds that could have been used towards health diverted to the military. The war also forced hundreds of thousands of people to flee their homes, placing them in unsafe conditions – without adequate access to health facilities.
HOW MERLIN IS HELPING:
Merlin has worked in Sri Lanka since January 2005. The initial focus was on emergency relief for the populations of Batticaloa and Ampara Districts affected by the Indian Ocean Tsunami. Merlin continues to operate in these districts, working with the Ministry of Health to lay the foundations for sustainable health infrastructure and to improve access to health facilities for disaster and conflict-affected populations. In country, there are currently 60 Sri Lankans and four international staff working for Merlin.
Support for tsunami and conflict-affected populations
Merlin is strengthening health systems and providing a better level of care for the populations in Batticaloa and Ampara. Activities have included school health and dental care promotion; improving and equipping antenatal clinics; mobile medical and dental clinics; equipping hospitals; training health and hospital staff and volunteers and infection control practices. By the end of 2007 Merlin had helped an estimated 287,000 households in Ampara and Batticaloa.
Rehabilitation and reconstruction of health facilities
Merlin has constructed and rehabilitated clinics and hospitals damaged by conflict and the tsunami. It is completing the construction of two hospitals that will serve a combined population of 1.25 million people.
Infection control
Merlin has improved infection control practices in hospitals in response to high rates of illness and death caused by hospital-acquired infections. Merlin worked alongside the Department of Health to implement the infection control programme - strengthening local capacity, training hospital staff, and supplying health facilities with equipment. It was highly successful in reducing infection rates. Ampara Hospital, for example, had an infection rate of 33.3 per cent at its surgical intensive care unit when Merlin began work there in August 2006. By December 2007, the rate was down to 0 per cent. The Ministry of Health has decided to implement the measures advocated by Merlin at every hospital in the country.
Key achievements
• Rehabilitation of Navakkadu central dispensary and maternity ward
• Assisting the Kalmunai regional epidemiologist in developing a disease outbreak response plan based on World Health Organization guidelines and experience Merlin has gained from working in other countries
• Four antenatal clinics were rehabilitated and handed over to the Ministry of Health; five more are ongoing
• Merlin’s work in Batticaloa has been highly praised for supporting the strengthening of health systems in collaboration with key stakeholders by the regional director of health services
Donors supporting Merlin's work
The Disasters Emergency Committee; AmeriCares; Jersey Overseas Aid Committee; Ajhama Trust; Westminster Foundation
Read more about Sri Lanka
Sri Lanka: Health care on the frontlines
Feb 12 2008: Merlin is undertaking major renovations of Navakadhu clinic after years of looting and neglect.
SURVIVORS' STORIES: Tharapan Saraswathy
Mar 14 2007: The Saraswathy’s family home in eastern Sri Lanka was destroyed first by the tsunami and then a second time by a recent military offensive.
Bringing healthy teeth to Batticaloa and Ampara
Jul 28 2006: Two new mobile dental clinics have screened and treated more than 600 children during their first week of operation.
Conflict displaced families receive vital care in Sri Lanka
Jul 28 2006: When fighting broke out in war-torn Trincomalee district, Merlin set up a mobile clinic to help 2,700 families in the area.
Hospital building continues despite strikes and landmines
Apr 10 2006: To date, Merlin's team in Sri Lanka has refurbished four temporary medical facilities, restoring vital services to almost half a million people.
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