TUBERCULOSIS: Sri Lanka: Over 11,000 Tuberculosis patients annually

Nadira GUNATILLEKE
Every year around 11,000 new Tuberculosis (TB) patients are discovered and 2,000 of them are from Colombo. Out of this number, 1,000 are detected from the Colombo Municipality, Health Minister Maithripala Sirisena said.
Addressing the gathering after opening a Direct Observation Treatment Centre (DOT) at Asiri Hospital, Colombo yesterday Minister Sirisena said the rapidly increasing population in the Colombo city, environmental pollution, and similar reasons are behind the increasing number of TB patients in the Colombo city. In the early nineties, TB was a scary disease that could not be cured. But now TB can be completely cured within six months with proper treatment.
Minister Sirisena pointed out that private and public sectors should join hands to deliver a better service to the public. President Mahinda Rajapaksa's Government always promotes the partnership between State and private sector. A healthy society can be created with the participation of both the State and private sector.
People like to visit private hospitals when they are concerned about their privacy and the confidentiality. Therefore they like to get treatment for TB from private hospitals than State hospitals.
Health Ministry officials, representatives and staff of Asiri Hospital and many others were present.
http://www.dailynews.lk/2011/02/10/news34.asp

POVERTY: SRI LANKA: From pipe dreams to piped water

 Photo: Amantha Perera/IRIN: Water used to flow here --a toppled water tower in Kilinochchi District

COLOMBO, 17 January 2011 (IRIN) - Widespread flooding in Sri Lanka has grabbed the headlines, but in the north of the country a more long-term problem is the absence of pipe-borne water for tens of thousands of civilians returning to the former conflict zone, known locally as the Vanni.
Flood waters that have affected about one million people across Sri Lanka have started to recede since 16 January, but for residents in the Vanni, their longstanding water-access problems are only growing.
Piping water there is now a top priority for the government, say experts, noting how decades of civil war have left water infrastructure in the Vanni in near or total disrepair.
The last wave of fighting between government forces and Liberation Tigers of Tamil Eelam separatist rebels from mid-2007 until May 2009 damaged or destroyed almost all the water facilities, said Samantha Wijesundera, water and sanitation expert at the World Bank Sri Lanka office. "You have to begin everything anew," he said.

Starting over
The coverage of piped water in the former conflict zone remains well below the national average of 34 percent as of early 2009, according to the government's National Water Supply Board.
On average, three out of 10 people have access to piped water in all the districts that fall within the Vanni: Kilinochchi, Mullaithivu, Jaffna, Vavuniya and Mannar, which has the lowest rate of coverage at 2 percent.
"There are areas of concern over the quality and safety of currently available water sources and resources," said Abdulai KaiKai, chief of water, sanitation and hygiene at the UN Children's Fund (UNICEF) in Sri Lanka.
The agency has helped fund the cleaning and disinfecting of 3,500 hand-dug wells in the region hard hit or neglected in years of fighting.
The main sources for drinking water in the Vanni are streams, unprotected wells and closed hand-pump-operated wells, the only one of the three considered relatively safe, or an "improved" drinking water source, according to water experts.
Sources other than piped water considered safe for drinking include boreholes, covered wells and springs, public standpipes and some forms of rainwater collection.

Projects under way
Water repair or reconstruction projects have already begun or funding has been allocated to increase the availability of piped water in the region, according to donors and public officials.
Imelda Sukumar, the top government official in Jaffna District, said US$1.8 million worth of projects were under way in Jaffna District and parts of adjoining Kilinochchi District.
"Over 350,000 people [out of an estimated total population of 850,000, excluding 50,000 military, according to government] will get access to pipe-borne water from these projects," she said. The first recipients are expected to have piped water by the beginning of 2015.
The World Bank's Wijesundera said water projects needed more time than roads or school construction due to the heavier workload involved. The World Bank has pledged $12 million for eight piped water projects in the Vanni and has also assisted in digging new wells and cleaning existing ones.
As the population resettles, water worries are only likely to grow. "Where there is high population density, there is bound to be concern because septic pits are also located on the same ground as wells [in the Vanni]," said Wijesundera.
http://www.irinnews.org/report.aspx?ReportID=91643

MALARIA: Malaria makes a comeback in Sri Lanka

Dec 18, Colombo:
Sri Lanka Ministry of Health says that the spread of malaria in the island has increased by 25 percent.
In 2010, Health Ministry statistics reported 580 malaria cases, says Dr. Sarath Deniyage, the Chairman of the Dengue and Malaria Carrier Suppression Committee.
He further stated that a number of reasons have caused the increase of malaria cases in Sri Lanka.
Health sources say that global warming also has an effect on spread of mosquito born diseases like dengue and malaria.
The Ministry of Health has planned to expand the network of clinics in the areas affected by the disease in the country.
Dry Zone districts such as Anuradhapura, Polonnaruwa, Hambanthota, Ampara and the Northern and Eastern Provinces are the worst affected by malaria, Health Ministry sources say.
http://www.colombopage.com/

POVERTY: Sri Lanka war widows

9 September 2010 (IRIN) - Fifteen months after the end of fighting between Sri Lankan government forces and the Tamil Tigers, women in the north are taking up a new and challenging role as breadwinners - with more and more becoming day labourers to support their families. A survey conducted by the Jaffna-based Center for Women and Development, a non-profit group, revealed that the northern region had approximately 40,000 female-headed households - including more than 20,000 in Jaffna District. "Three factors have reduced the male-headed households in number: the war, disappearances or being in military custody," said Saroja Sivachandran, the centre's director. The Sri Lankan civil war, which began in the 1970s, claimed tens of thousands of lives and displaced more than 280,000 people [ http://www.irinnews.org/Report.aspx?ReportId=90305 ], primarily in the north and east of the country. The government took control of the east [ http://www.irinnews.org/Report.aspx?ReportId=89717 ] in 2007, and declared victory in the north in May 2009. Although up-to-date statistics are hard to come by because many people remain displaced, Sivachandran and government officials say the northern and eastern regions combined are home to some 89,000 war widows. "This has drastically altered their livelihood options. Over 50 percent of them [women who head households] are single parents under 30 years of age supporting their own and extended families," said Visaka Dharmadasa, executive director of the Association for War-Affected Women (AWAW) [ http://www.awawsl.org/ ]. Women = cheaper labour AWAW and other support groups say many employers are discriminating against women, in some cases paying less than US$1 a day. Maillaiyappal Thangavelu supports her two children, parents and three sisters by working on a construction site. "My husband disappeared," said the 26-year-old Jaffna resident. "My sisters are still in school. My eldest child is in school. My parents are too weak to work." She earns a $1.25 a day - but according to Sivachandran, this is half of what a man would earn for the same work. "It has become cheaper to hire women - men would demand higher daily wages. Women unquestioningly accept what is given, often because they have many mouths to feed," Sivachandran said. "Women provide cheap labour, so they are preferred," said Nagarasa Thavaselvam, president of the Kampanai Camp Residents' Committee in Jaffna, adding that in some households, men are now becoming dependent on women for economic support. Thavaselvam himself is one of many house-husbands. Government security restrictions on traditional occupations - such as fishing and farming, the main industries of the north - have also driven women to work, Thavaselvam added. At a construction site, a manager gave his own reasons for hiring women over men: "Women report to work on time. They don't drink and provide cheap labour." Food, livelihood assistance Although many women are finding jobs, more assistance is needed to boost their livelihoods in a society where many women have never worked outside the home before, and had never imagined they would do anything other than care for their families. Imelda Sukumar, a government official for Jaffna and Mullaitivu districts, said industries had to be encouraged to create more jobs, but there had been some programmes for community-based income generation and cash for work at small infrastructure development projects. "These projects are vital for areas where women carry heavy economic burdens," Sukumar said. Meanwhile, unemployment - particularly with fishing and agriculture still being pieced back together - is fuelling food insecurity, she said. The UN World Food Programme (WFP) has provided returning families with six-month food packages, but because many households have been unable to access their land and "resume normal activities", they have given returnees three additional months of food support. While determining the extent of further assistance needed, WFP will move away from free food and to food for work on community projects or skills training - which will also benefit women. "It is critical that female-headed households are supported with skills training and other appropriate interventions," Giancarlo Stopponi, officer in charge and head of WFP's programme unit in Colombo said. "This will better prepare families for a successful transition from resettlement to early recovery, and thus achieving some form of sustainable household activity" The Center for Women and Development said one economic support programme for war-affected women is a $100 grant to help them open a shop, pack chillies and coriander for commercial distribution, or purchase a sewing machine. An AWAW programme assists farmers to secure farmland. According to an update from the UN Office for the Coordination of Humanitarian Affairs [ http://www.hpsl.lk ], nearly 6,900ha of abandoned land is being targeted for cultivation. "The next season is likely to be better, enabling farming families to return to their original livelihoods," said Dharmadasa of AWAW.

MALNUTRITION: Sri Lanka statistics

Child malnutrition is considerably high in the North and East Provinces and has reached 46 percent out of a national average of 29 percent, a Demographic and Health Survey (DHS) revealed.In two provinces the prevalence of malnutrition is significantly greater among boys, (50 percent ), than among girls (42 percent). This gender differential is in sharp contrast to the malnutrition pattern in the rest of the country, where malnutrition rates are very similar among boys and girls.The age pattern of malnutrition shows that children who are underweight reaches a peak in the age group 12-35 months, and then tapers of slightly to 36-59 months. This age limit is similar to the rest of the country, according to the survey.The differences in malnutrition in urban and rural areas are small, varying by one percentage point. The survey found that the lack of maternal education is strongly associated with the lower levels of malnutrition.The prevalence of child malnutrition among uneducated mothers is 63 percent. As the education level of mothers rises, the prevalence of child malnutrition declines to 54 percent for primary educated mothers, 42 percent among secondary educated mothers and 36 percent among tertiary educated mothers.This pattern is consistent with evidence from the rest of the country which also shows a favourable association between maternal education and child malnutrition.At the district level, within the Northern and Eastern provinces, Batticaloa 53 percent and Vavuniya 51 percent shows the worst levels of child malnutrition. The child malnutrition in Trincomalee is 45 percent, Ampara 44 percent and Jaffna 43 percent is the best among the Northern and Eastern provinces.
http://www.tops.lk/article19208-child-malnutrition-high-in-n-e.html

South East Asia malaria

Malaria, which poses a risk to 77 percent of the South-East Asian population and claims thousands of lives each year, needs more commitment and greater funds for successful interventions from donors and states, the World Health Organisation (WHO) said Friday.
Calling it a disease without borders, Samlee Plianbangchang, WHO regional director for South-East Asia said in a statement: “Increasing funding for effective interventions could significantly reduce malaria deaths in many countries”.
“In WHO’s South-East Asia Region, several countries have made good progress and demonstrated that support for malaria control is working,” he said ahead of World Malaria Day April 25.
For instance, Sri Lanka and South Korea have both reached the elimination stage in malaria. Bhutan has also made good progress and is now aiming towards malaria elimination. Reported malaria deaths have decreased significantly in Bangladesh, Thailand and Myanmar with improved case management, the statement said.
“Nevertheless, malaria is endemic in all the countries in the South-East Asian region, except the Republic of Maldives, and the situation is becoming increasingly difficult to control due to several technical and managerial problems,” Plianbangchang added.
Said Jai P. Narain, director, communicable diseases, WHO: “Repeated focal epidemics are common due to socio-environmental changes. Many cases are due to population migration. There is no doubt that malaria adversely affects economic development, particularly the livelihood of the poor.”
“It is well understood that to achieve the Millennium Development Goals (MDG) we have to reduce the impact of malaria significantly. But to do so, we need to address the social, economic, environmental and behavioural factors that contribute to the disease’s occurrence and its impact,” he added.
http://blog.taragana.com/health/2010/04/23/more-funds-needed-to-tackle-malaria-who-april-25-is-world-malaria-day-22038/

Sri Lanka: statistics on non-sustained eradication of malaria

History shows that malaria control efforts must be sustained to be effective. Sri Lanka is an example of a country where malaria roared back after nearly being eliminated in 1963. But those eradication efforts were not sustained and by 1990 there were a quarter of a million cases. Fortunately malaria control was stepped up again and levels have dropped once more to just 673 cases reported in 2008...
http://www.your-story.org/backsliding-in-malaria-funding-can-reverse-progress-and-increase-lives-lost-185202/...

Malaria bearing mosquitoes in brackish water

Anopheles culicifacies is the major vector of both falciparum and vivax malaria in Sri Lanka, while Anopheles subpictus and certain other species function as secondary vectors. In Sri Lanka, An. culicifacies is present as a species complex consisting of species B and E, while An. subpictus exists as a complex of species A-D. The freshwater breeding habit of An. culicifacies is well established. In order to further characterize the breeding sites of the major malaria vectors in Sri Lanka, a limited larval survey was carried out at a site in the Eastern province that was affected by the 2004 Asian tsunami.
Methods
Anopheline larvae were collected fortnightly for six months from a brackish water body near Batticaloa town using dippers. Collected larvae were reared in the laboratory and the emerged adults were identified using standard keys. Sibling species status was established based on Y-chromosome morphology for An. culicifacies larvae and morphometric characteristics for An. subpictus larvae and adults. Salinity, dissolved oxygen and pH were determined at the larval collection site.
Results
During a six month study covering dry and wet seasons, a total of 935 anopheline larvae were collected from this site that had salinity levels up to 4 parts per thousand at different times. Among the emerged adult mosquitoes, 661 were identified as An. culicifacies s.l. and 58 as An. subpictus s.l. Metaphase karyotyping of male larvae showed the presence of species E of the Culicifacies complex, and adult morphometric analysis the presence of species B of the Subpictus complex. Both species were able to breed in water with salinity levels up to 4 ppt.
Conclusions
The study demonstrates the ability of An. culicifacies species E, the major vector of falciparum and vivax malaria in Sri Lanka, to oviposit and breed in brackish water. The sibling species B in the An. subpictus complex, a well-known salt water breeder and a secondary malaria vector in the country, was also detected at the same site. Since global warming and the rise in sea levels will further increase of inland brackish water bodies, the findings have significant implications for the control of malaria in Sri Lanka and elsewhere.
http://www.malariajournal.com/content/9/1/106

Sri Lanka statistics malnutrtion

Anaemia or iron deficiency which leaves a child pale and weak has been found to be rampant with one in every four children (25%) falling victim, according to a recent survey. Sugar, coconut and rice are the staple food of 99% of Sri Lankan children, the national survey on nutrition has revealed.
This along with other disturbing findings on malnutrition has sent shock waves among nutritionists.Acute malnutrition among children under five is 12%, while chronic malnutrition (stunting) is 19%. Malnutrition is the lack of healthy food in the diet or an excessive intake of unhealthy food leading to physical harm.
"Anaemia or iron deficiency can lead not only to numerous growth problems but also affect their studies. When anaemic children become anaemic adults production and work capacity are low, having an impact on development," said Dr. Renuka Jayatissa, the, Medical Research Institute's Nutrition Department Head, who conducted the 'Nutrition and Food Security Survey'.
The survey had been conducted in collaboration with UNICEF and the World Food Programme in 2009 in nine districts, one each from every province, to get a national representative sample. The districts were Colombo, Ratnapura, Anuradhapura, Kurunegala, Trincomalee, Jaffna, Badulla, Nuwara Eliya and Hambantota.
http://www.sundaytimes.lk/100418/News/nws_05.html