Community Concern Society

Yesterday I visited the main CCS outreach center located on the western coastline. I was met by a long line of women rounding the corner, baby and bag in arms. They were there for the baby feeding/de-worming clinic. Mothers are given two plastic containers - one for powdered milk, and another for ground cereal. Bags are poored into these clear containers to prevent the mothers from selling the products on the market for money, a small assurance that the baby gets the nutrition intended. They also get an apple, and bottle of pyrantel pomoate - a cheep single dose de-worming agent good for hook/round/pin worms. Intestinal worm infection is a tremendous burdon on the tropical poor population, with prevelence reaching >70% of the population. Children with worms can suffer anemia, malnutrition, and dehydration.




I got a tour of the CCS campus and all of the various outreach activities there. It was humbling and amazing to see all that they accomplish at an otherwise small facility (compared to what they are able to do). Walking along the beach slums, where most of these children live, filled me with sadness and amazement that this could be "home". Therese said that this is a great improvement from when she arrived over 20 years ago. I didn't take many photos, because people often come to the slums to take photos, but rarely help people - and thus it is looked down upon. The one photo shown is of the "better part" of the slums with some concrete buildings. There is roting detritus everywhere, mixed with human feces and urine making its way to the ocean. Most of the slum community fishes, if they work at all. CCS has been working on housing projects and relocating many slum families, dropping the total number from 500 families to now around 100 (about 400 people now total). Most of these kids get their food, bathing, education, and medical care from CCS.
I spent the afternoon talking with Dr. Steve at the Navajeevana clinic in Colombo - a Christian based sliding scale clinic dedicated to providing excellent western care to everyone regardless of their ability to pay. He gave me a sobering overview of the medical climate in Sri Lanka. He said that most of the health and education statistics, interestingly, are misleading. They are based on "citizens" which often do not include the thousands of poor people with undocumented births and paperwork. So... among healthy and educated people, they are relatively healthy and educated! Medical school is relatively short here, with an over emphasis on producing MD equivalents. A hybrid pharmacist / doctor exists out of a shortage crisis about a decade ago where experienced pharmacists were made into primary care doctors in rural areas. Many pharmacies will give people medications without a prescription - especially if you are fair skinned and know the name of what you want. In reaction, doctors here (not the ones I'm working with) do not tell patients what they are being treated with to create dependence. If patients know what they need, they will stop seeing the doctor and just get it from the pharmacy themselves. It is often common practice to give patients placebo pills or saline injections and charge them for it. I'm trying to understand the culture here and not judge i - maybe more will come to light. In addition to all the clinics, my new project is to create a medical chart system and documentation for well-child visits for many of the children's homes in western Sri Lanka. Here, doctor's offices do not keep health records. They are the property and responsibility of the patient. As such, they are often lost, not brought to appointments, or disregarded all together. Could you imagine seeing patients and never knowing what their health history or prior care has been? Next Friday we will be driving 6 hours north (don't worry - not LTTE zone) to a family home and examining 90 children in one afternoon and starting their health files. I'll be training staff how to help me do all this in one day - one person each to do: vision check, health history, height and weight, vital signs, translation, and guidance counseling. I will go over all the accumulated information and do the physical exam, note red flags, and send special cases to local clinics that see kids. This is part of the new KidzNet program that Therese is starting to help support the growing number of new and unprepared children's homes in Sri Lanka.