Special Health Progrmmes In The Province

Historical surveys done in Asian countries have revealed that 5000 – 7500 patients per 100,000 population are diagnosed with cataract each year. Annual number of cataract removal surgeries done in Ratnapura district with a million population, was only 2500 surgeries. The gap between the accumulations of hundreds of patients each year and the number of cataract surgeries done was considerable, that it is a major public health as well as a socio-economic issue. Cataract surgeries done in the government and the private sector, were done only for the people who could afford to buy the Intra-Ocular Lens (IOL), out of pocket. The cost of an IOL was in the range of Rs 30,000 to 60,000 in the private sector. Many of the patients could not afford the high cost of the IOL and gradually turned blind. The loss of man hours due to a blind elderly person in a family is immense, as all the family members had to standby the person in turns.

Screening, early identification and proper management of eye conditions such as cataract, diabetic retinopathy and glaucoma will prevent people ending up with permanent blindness, and “Suwa Desa” is an active programme involving in preventing the tragedy. It provides cataract surgeries free of charge to patients who are mainly elderly population to whom this disease affects the most as cataract is primarily an age-related disease.

Though the program started off with donor funds from Taiwan based NGO “Tsuchi” Foundation, which equipped a dedicated Eye Theatre at B. H. Kahawatta and donated 300 Intra Ocular Lenses in 2008, the Provincial Council understood the importance and the immense benefit that this program brought to the poor people and allocated funds from the PSDG each year (from 5 million in 2009 to 15 million at present) for the procurement of IOLs and its accessories. The average cost of a cataract surgery incurred by the Provincial Council was around Rs. 2,600.00 in 2010 to Rs. 8,500.00 in 2020. At the beginning of the programme, it was lined up with the “Vision 2020” program of the Ministry of Health as well

Under the “Suwa Desa” programme both institutional and well organized out-reach eye clinics have been conducted. Screening for common eye conditions, patient identification, and referral for specialist care, patient management and provision of necessary eye medications, preparation of patient waiting lists and referral for cataract surgeries, post-operative care are done in those clinics. Provision of necessary medicines and other facilities arranged for the patients is completely free of charge.

At the beginning of the program, diagnosed patients with cataract underwent the surgery on a scheduled routine from one waiting list at Wijaya Kumaratunga Memorial Hospital in Seeduwa by Dr. Shamintha Ameratunga. He was the first Consultant Eye Surgeon to undertake the program. The program provided transport to the patients to Seeduwa at that time. This was mainly due to the lack of Eye surgeons in provincial hospitals. Subsequently the surgeries were shifted to “Neth Setha Lion’s Eye Hospital” in New Town Ratnapura. They conducted it with a zero cost as a service to the public. Eye Surgeon Dr.Dharmapriya Dias is remembered for the hundreds of surgeries done at Neth Setha hospital. Since, a permanent Consultant Eye Surgeon was attached to B.H.Kahawatta in 2020 November, the surgeries have been carried out in B.H.Kahawatta, since then. The Consultants at Kahawatta has even started out-reach clinics at B.H.Balangoda and B.H.Kalawana. The plan for year 2023 includes starting surgeries at B.H.Balangoda too. At present people are screened in nine hospitals in Ratnapura and Kegalle districts (namely; B.H.Eheliyagoda, B.H.Kahawatta, B.H.Kalawana, B.H.Kolonna, D.H.Gallella, B.H.Warakapola, B.H.Karawanella, D.H.Rambukkana, D.H.Kithulgala).

In 2017, the Ministry of Health made a Landmark decision to provide IOLs through the Medical Supplies Division (MSD), but unfortunately the supply of these Lenses is very unorganized and irregular. Therefore, the IOLs supplied by the “Suwa Desa” program still remains the most efficient supply of IOLs for the low economic masses. The “Suwa Desa” program has given so much of happiness to the patients and their kith and kin who underwent the surgeries from all parts of the province. The program has become so popular and sought after by all who are waiting to get their sight back to normal again, as surgery gives instant results. It has created a major positive socio-economic impact on the lives of many people as well as for the society. Many individual donors have come forward to donate IOLs as it is considered as an extremely meritorious act by the Sri Lankan society. A couple of private sector companies, well-fare societies of government banks and post graduate batches of Colombo University and Open University of Sri Lanka have donated programs as a part of their CSR projects. The momentum of the program was stalled temporarily in 2020 and 2021 due to the COVID pandemic. The following table shows the number of cataract surgeries done under the “Suwa Desa” program since its inauguration in 2009.

Malaria has been a disease which caused significant outbreaks with very high death tolls in Sri Lanka. However, Sri Lanka was able to obtain the Malaria elimination certificate in 2016 since there were no indigenous malaria cases reported in Sri Lanka since 2012. Dry zone of the province had been a malaria endemic area. Regional Malaria Officers carry out the malaria control activities of the province in relation to the prevention of reintroduction of malaria through imported cases.

Provincial STD/AIDS control programme of Sabaragamuwa province is responsible for coordinating the health promotion and service provision regarding HIV and sexually transmitted infections in collaboration with National STD/ AIDS Control Programme (NSACP), provincial and regional stakeholders in health and non-health sectors. Sexual health clinical services are provided through four main clinics Ratnapura, Embilipitya, Balangoda (outreach clinic) and Kegalle.

FRabies, is a fatal disease which caused by a rhabdo virus, that transmitted to humans through the bite of all warm-blooded animals including dogs. About 50 deaths occurred in Sri Lanka due to rabies per year and the government spent about 600 million to treat patients who came to hospitals due to animal bites.

To prevent rabies,