In the wake of the tsunami disaster, the largest remaining challenge in Sri Lanka is finding housing for 900 000 displaced residents, says the press officer for Médecins Sans Frontières Canada.
MSF is taking on that challenge, even though “It's quite different from what we usually do,” says Isabelle Jeanson. Initially, MSF provided tents and semi-permanent structures. Now it is helping people obtain land and build houses.
When MSF workers arrived Jan. 1, there were some medical needs, but “there were tons of clinics, hospitals, doctors and mobile clinics,” says Jeanson. More than 30 000 Sri Lankans died in the Dec. 26 tsunami, making it the second hardest hit country after Indonesia. But Sri Lanka was more prepared to handle its own medical needs than some of the other nations, primarily because it is more politically stable and has a strong medical infrastructure. The 36 MSF workers continue to help with medical needs, mostly lacerations, upper respiratory tract infections, some diarrhea and skin or eye infections. As of Feb. 1, Sri Lanka was not experiencing any epidemics or water-borne diseases. “Instead of walking away, we decided to stay and ... find a role for MSF,” says Jeanson.
The most pressing need was housing. Internally displaced persons are living in camps, schools and mosques all along the southwestern coast. “Many people are living with hundreds of others. It's unbearably crowded,” says Jeanson.
MSF and other NGOs are providing tents or semi-temporary structures.
The aim is to get plots of land and help people build or rebuild their homes. “If not, they will go into temporary camps and they could get stuck in them,” says Jeanson, who worked on the island Jan. 10 to 30.
This task is complicated by the fact many residents fear returning to the coast, says Jeanson, who conducted 70 interviews to determine local needs. “They will only go back [to the coast] if all their friends and neighbours are going back so they won't be alone.”
MSF is providing mental health services for about 70 families who are suffering from grief and symptoms of post-traumatic stress, including nightmares and insomnia.
MSF recently sent over a nonmedical evaluative team including logisticians and water sanitation experts. Most wells are unusable because they are contaminated with salt water and debris.— Barbara Sibbald, CMAJ
Figure. MSF's Isabelle Jeanson (left) talks with a fisherman who lost his home. Photo by: I. Jeanson/MSF