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

Abstract

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.

Primary Health Care Actions in Natural Disasters

“…Farley JM, Suraweera I, Perera WLSP, et al 19 Evaluation of flood preparedness in government healthcare facilities in eastern province, Sri Lanka.…”

“…The psychological vulnerability to traumas and stresses considering permanence in shelters and distancing of their support networks for a long period, after these events, imply an intersectoral action that includes PHC. 15 PHC actions for disaster preparedness are identified for the multidisciplinary dimension of PHC as the responsibility of health teams in preparing vulnerable families to deal with potential disasters14,18; promotion of continuing education for PHC professionals with the purpose of reducing deficiencies in the readiness of events [18][19] ; territory recognition, based on sociodemographic data to identify and prioritize needs and provide guidance to families in the community. 13,14,18 Specific recommendations about the risks to which the community is exposed must be raised in the territory and based on the population profile.…”

“…15,20 The literature emphasizes the priority of community and family preparedness actions to disasters. 16,19 Contact by different means of communication between PHC teams with families and rapid mobilization for protective measures are fundamental actions in the first 24 hours of the alert to the event. 21 Authors emphasize that proactive dissemination strategies prior to the event can be useful in identifying health needs and facilitate access to services by the population in a disaster.…”

“…The studies 21,[25][26][27] point to the need to invest in continuous training of multidisciplinary PHC teams; qualify for action in emergency situations 19 ; encourage good interpersonal relationships, synchronism in health care actions with functions by level of domain; define responsibilities and positions that contribute so that technical skills and expertise are properly applied, reflected in the conjecture of plans. A study of health services that were hit by floods in Sri Lanka reported a lack of professional education promoted by the government to act in disaster situations.…”

“…Health professionals participating in the study reported seeking knowledge and preparation on the internet or in private courses, which for teams in rural areas is at a greater disadvantage due to geographical isolation and difficulty in accessing information. 19 In addition to investing in vocational training as an action to prepare for disasters, studies show that attention to workers' mental health minimizes losses and consequences to income at work at various times and after disasters. 12 Policies and guidelines are recommended to develop PHC more fully as a disaster preparedness resource, with the capacity to respond effectively and operationally to plans for events characteristic of the territory 28 , expanding over time the preparation for other types of disasters other than those of natural origin.…”