by Dr. Sam Muthuveloe, Sri Lanka, October 2004
sangam.org/articles/view2/669.html
“Thank you for coming to our remote village, to meet us and give us comfort through your medicines and the gift of spectacles,” said an old lady named Letchumi.
It was dusk and as the sun was rapidly disappearing over the horizon and the gentle warm wind of the east was blowing with thunder clouds gathering overhead, this patient who had trekked three hours to get to our remote Rural Primary Medical Centre, stood erect with her gnarled, working hands clasped together in front of her chest, head slightly bowed, dressed in her best colourful festival outfit, face marked with deep furrows reflecting years of hard labour and civil war. There was something majestic and yet beautifully simple about her manner.
I was deeply moved to my inner being, as I realised what she represented amongst the people we had come to serve and what she had just said. This took place at Wadi Vadi, a distant agricultural village in the region of Pooneryn, an hour’s drive on a broken cart track road from Kilinochchi, a small, yet busy town of the Vanni district in the Northern Province of Sri-Lanka.
“Your very presence here has indeed made a difference to our lives and gives us hope that we have not been forgotten by the outside world,” this old lady went on.
Sri-Lanka the resplendent island, once referred to as the Garden of Eden of the east, named ‘Serendipity’ by the Arab traders of centuries ago and famed for its famous Ceylon Tea and cavalier Cricketers, has been in conflict with itself for almost 50 years. Since independence from the British colonial rule in 1948, two distinct racial groups of people have not been able to resolve their differences in respect to political ideology and state governance of the people. Failed political agreements of the late 50’s and 60’s later led to a bitter civil war that commenced in the early 80’s, lasted almost 20 years and left over 70,000 dead with untold damage to the infrastructure, economy and the very lives of ordinary people. Like in all wars it is the innocent civilians caught up in the middle who face the brunt and hardships of the viciousness of the conflict.
It is to this group of disadvantaged and neglected, hapless people that the Hope Medical Team, UK sought to bring relief and comfort through care and concern. It is to individuals like Letchumi who feel despondent and without hope that we desire to bring hope and comfort in practical ways.
Letchumi’s story is a particularly sad one. Her husband was shot and killed by the forces in the late 80’s while tending to his paddy field at midday and, just a month after his death, her two sons who were taking shelter during an air raid were killed. Her sorrow and grief are immense, her tears have known no limits. Heartache, malnutrition and poverty are etched all over her body. She looked well advanced for her years. At only 55, she looked like someone in their early 80’s! On several occasions she had been “internally displaced,” moving from place to place with her meagre belongings. We came across a number of very similar stories.
The Team
The team comprised three doctors, Julian Pedley, Peter Hill and Sam Muthuveloe, and four in the Vision Team, Nigel Gibson-Horrocks, Jonathan Pedley, Eileen Weston and Jacqui Watson. This team worked hard and tirelessly for the fortnight in Sri Lanka, starting at sunrise and concluding at sunset. The demand, as always, outstripped our resources of personnel, time, medicines and spectacles. The camaraderie, cohesiveness and support within the team for the task of bringing relief and comfort to the needy, despite the challenging ground circumstances, were without exception. The choice of venue, publicity, monitoring of patients and organising the local logistical support were in the hands of our hosts, who excelled in every aspect.
We were moved by the generous hospitality of these ordinary people who gave from their meagre resources to a point of embarrassment.
Travel
The team undertook a punishing pace, criss-crossing and travelling the country of Sri-Lanka in two simple Toyota Hiace vans. The uncarpeted, pot-hole impregnated roads, the muddy cart tracks and bouncy rides all contributed to a mission with a difference. The vehicles took a battering, as did the bodies of the pale-faced occupants, who had given up choosing the side of the vehicle that had any suspension left. The Sri Lankan motorists are a breed apart, who have their own interesting highway code and road courtesies. Vehicles may have faulty brakes, but they sure do have a state-of-the-art horn fitted. Tooting the horn is a national past-time, with secret messages passed between drivers, which could range from conveying ‘thanks,’ to ‘beware I am coming at you!’ or ‘watch out, the local cops are behind the tree with their speed camera!’ Often we thought the person at the wheel used the horn to feel their way round the hairpin bends on the mountain ranges like a partially-sighted person using a white stick!
Quiet Times & Reflections
As a group of volunteers who share a common Christian faith, we met regularly for morning quiet times and evening reflections. We were blessed from above and strengthened for the day’s work. We disciplined ourselves to say grace before meals, realising how much our hosts had sacrificed for our comforts. The times spent together in listening and sharing with one another was a source of spiritual encouragement and strength. Debriefing at the end of the day enabled us to conclude our special concerns and plan for the next day.
Samanala Estate Farm, Norton Bridge, Maskeliya
This is nestled in the beautiful, lush, green-carpeted, tea-growing hill country of Sri-Lanka. We felt at home in the morning mist and chill, which gave way to the bright beating sun at midday. The folk we saw were from the tea estates, working long hours under trying conditions, contributing to one of the leading foreign exchange-earning products of the faltering economy. They were from both the Sinhala and Tamil communities and from across the religious spectrum of Buddhists, Hindus, Christians and Muslims. Disease-like malnutrition and poverty is no respecter of persons.
Kilinochchi, Vanni
The Vanni is jungle terrain, mainly dry and flat with limited rainfall. Interesting wild life did roam freely in these jungles at one time. The Chola imperial kings of South India in centuries gone by imported wild elephants for combat purposes from these regions. Paddy cultivation, cash crops of chillies and vegetables were produced here. The coastline and fresh water lagoons gave up its exotic fish and prawns that graced the tourist’s dining tables. All this changed with the 20-year civil war that saw some of the most vicious guerrilla fighting ever seen in Asia. The once fertile and vibrant area is now without its basic infrastructure of electricity, water service, functioning schools, hospitals or factories of employment.
Centre for Health Care
We were invited by the CHC, an umbrella organisation that is registered under the government of Sri Lanka with its main headquarters in Kilinochchi. CHC seeks to improve the health care of the population at large in the NorthEast through various worthwhile programmes and projects while coordinating the work of the NGO’s, foreign individuals and liaising closely with the Department of Health.
We worked from the Rural Primary Medical Centres of Thileepan, and ran our Clinics at Iyankankulam, Wadi Vadi, Pooneryn, Puliyankulam and Mankulam in the Vanni District. The healthcare staff running these centres were mature, able and resourceful people. They were deeply committed to the local population and had undertaken a series of health awareness programmes engaging the population at large and co-working with the children at schools. We were impressed to learn that the Vanni district, that led the tables for mortality figures from malaria in 1997, now has shown zero figures for the last four years alongside a sharp decline of morbidity figures following effective public participant vector control measures of the mosquito.
There was a sense of deep desire and dedication amongst the people of the region to improve their lot and to acquire knowledge and skills. One could see agriculture picking up, the impressive reforestation programme and small industries sprouting. If given the opportunities and facilities, growth in this area seems assured.
The team assessed the vision of about 1,200 persons and gave away about 1,500 spectacles in all. About 2,500 persons were seen for their medical concerns, examined and treated carefully. Health promotion and disease prevention were emphasised. We gave away important and practical medical equipment and books as well as medicines. There is much more to be done.
The Need
There is a need for small teams of professionals to visit on a regular basis to encourage and enhance the Rural Primary Care Centres. The healthcare personnel who work at these centres need a professional development plan, specific and sensitive to their local requirements. This would require an ongoing, rolling teaching programme. There is an urgent need for professional counsellors, psychologists and psychiatrists to respond to the deep emotional trauma and fall-out from the bitter 20 years of civil war that gripped the helpless population that was trapped and displaced on multiple occasions. Hands-on practical clinicians such as teams of Primary Care Physicians, Dermatologists, Dentists, Dental Hygienists, Ophthalmologists, Opticians, Otolaryngologists, Audiologists and Physiotherapists would all find themselves immensely useful.
Mission Accomplished
Since my return to the UK, I have often been asked the question, “Was the mission a success?” I have struggled to give a coherent answer, as different people understand the word success in different ways. Like beauty being in the eye of the beholde, so it is true of success. We were invited by our hosts to bring professionals to treat the needy and to train and equip the local healthcare workers in their ongoing work, which we did to the satisfaction of our hosts. We have now been invited by our hosts to bring more teams at more frequent intervals to encourage the local medical services and to assist in the reconstruction of the fabric of the fractured community. All members of the October Team have volunteered to return to Sri-Lanka to continue the work of the Hope Medical Team working alongside the nationals to bring hope and comfort to the needy. Hence it is reasonable to conclude that the mission was accomplished.
Soli Deo gloria
For and on behalf of Hope Medical Team UK – October 2004
21 Lower Stonehayes
Gt. Linford
Milton Keynes MK14 5ES
UK
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HOMSA DINNER: Thursday, 24th February 2005, 7.30pm
Wilton Hall, Wilton Avenue, Bletchley, Milton Keynes
Tickets: £20 available from
Dr Sam Muthuveloe on 01908 661166/668829 or Margaret Whiteley on 01908 670