Featured Publication – Evaluation of flood preparedness in government healthcare facilities in Eastern Province, Sri Lanka

Evaluation of flood preparedness in government healthcare facilities in Eastern Province, Sri Lanka. Global Health Action. Vol. 10, Iss. 1, 2017. doi: http://dx.doi.org/10.1080/16549716.2017.1331539 

Background: Sri Lanka is vulnerable to floods and other hydro-meteorological disasters. Climate change is projected to increase the intensity of these events.

Objective: This study aimed to assess the flood preparedness in healthcare facilities in Eastern Province.

Design: This was a cross-sectional, descriptive, mixed methods study conducted in Trincomalee District. Surveys were conducted in 31 government healthcare facilities, using a pre-tested, structured questionnaire covering the last 5 years. Seven in-depth interviews were conducted with randomly selected Medical Officers in Charge or their equivalent, and 3 interviews were conducted with Medical Offices of Health.

Results: Two general hospitals, 3 base hospitals, 11 divisional hospitals, and 15 primary care units were included. Six respondents (19.4%) reported flooding in their facility, and 19 (61.3%) reported flooding in their catchment area. For the health workforce, 77.4% of respondents reported not enough staff to perform normal service delivery during disasters, and 25.5% reported staff absenteeism due to flooding. Several respondents expressed a desire for more disaster-specific and general clinical training opportunities for themselves and their staff. Most respondents (80.7%) reported no delays in supply procurement during weather emergencies, but 61.3% reported insufficient supplies to maintain normal service delivery during disasters. Four facilities (12.9%) had disaster preparedness plans, and 4 (12.9%) had any staff trained on disaster preparedness or management within the last year. One quarter (25.8%) of respondents had received any written guidance on disaster preparedness from the regional, provincial, or national level in the last year.

Conclusions: While there is a strong health system operating in Sri Lanka, improvements are needed in localized and appropriate disaster-related training, resources for continuing clinical education, and investments in workforce to strengthen flood and other disaster resilience within the government healthcare system in the study district.

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Ebi, KL, Schmier, JK. A stitch in time: improving public health early warning systems for extreme weather events. Epidemiol Rev. 2005;27 :115-21. doi: 10.1093/epirev/mxi006. PubMed PMID:15958432 .

Ebi, KL, Gamble, JL. Summary of a workshop on the development of health models and scenarios: strategies for the future. Environ. Health Perspect. 2005;113 (3):335-8. . PubMed PMID:15743724 PubMed Central PMC1253761.

Kovats, RS, Edwards, SJ, Charron, D, Cowden, J, D'Souza, RM, Ebi, KL et al.. Climate variability and campylobacter infection: an international study. Int J Biometeorol. 2005;49 (4):207-14. doi: 10.1007/s00484-004-0241-3. PubMed PMID:15565278 .

Kovats, RS, Edwards, SJ, Hajat, S, Armstrong, BG, Ebi, KL, Menne, B et al.. The effect of temperature on food poisoning: a time-series analysis of salmonellosis in ten European countries. Epidemiol. Infect. 2004;132 (3):443-53. . PubMed PMID:15188714 PubMed Central PMC2870124.

Ebi, KL, Exuzides, KA, Lau, E, Kelsh, M, Barnston, A. Weather changes associated with hospitalizations for cardiovascular diseases and stroke in California, 1983-1998. Int J Biometeorol. 2004;49 (1):48-58. doi: 10.1007/s00484-004-0207-5. PubMed PMID:15138867 .

Kelsh, MA, Bracken, TD, Sahl, JD, Shum, M, Ebi, KL. Occupational magnetic field exposures of garment workers: results of personal and survey measurements. Bioelectromagnetics. 2003;24 (5):316-26. doi: 10.1002/bem.10112. PubMed PMID:12820289 .

Foliart, DE, Iriye, RN, Silva, JM, Mezei, G, Tarr, KJ, Ebi, KL et al.. Correlation of year-to-year magnetic field exposure metrics among children in a leukemia survival study. J Expo Anal Environ Epidemiol. 2002;12 (6):441-7. doi: 10.1038/sj.jea.7500245. PubMed PMID:12415493 .

Langholz, B, Ebi, KL, Thomas, DC, Peters, JM, London, SJ. Traffic density and the risk of childhood leukemia in a Los Angeles case-control study. Ann Epidemiol. 2002;12 (7):482-7. . PubMed PMID:12377426 .

McCool, FD, Wang, J, Ebi, KL. Tidal volume and respiratory timing derived from a portable ventilation monitor. Chest. 2002;122 (2):684-91. . PubMed PMID:12171851 .

Foliart, DE, Iriye, RN, Tarr, KJ, Silva, JM, Kavet, R, Ebi, KL et al.. Alternative magnetic field exposure metrics: relationship to TWA, appliance use, and demographic characteristics of children in a leukemia survival study. Bioelectromagnetics. 2001;22 (8):574-80. . PubMed PMID:11748675 .

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