OfERR’s medical and health care programme aims to make every Ceylon refugee in India physically and mentally able to lead a socially and economically productive life. The government health service provides primary health care to refugees in the camps throughout Tamil Nadu, and OfERR supplements this care and organises a range of awareness campaigns to improve community health. Special attention is paid to mothers and children, but we aim to meet the needs of the whole refugee community.

OfERR health workers face significant challenges. The continuing arrival of new refugees puts strain on already limited resources. Most camps are located in isolated areas some distance from hospitals and other medical institutions. The people requiring treatment often struggle to meet medical fees, and some refugees suffer mentally from their protracted insecurity and exile from their homeland. OfERR responds to these challenges with a range of reactive and preventative work.

Communicable Diseases
OfERR combats locally endemic diseases with preventative measures in the camps, including efficient sanitation. Health workers are trained to respond quickly to any outbreak of disease in the community. However, OfERR’s health education has been extremely successful; in the past year, no epidemics have occurred in any of the 117 camps. This achievement depends on the knowledge and preventative actions of the community.

Non-Communicable Diseases
To detect and manage common non-communicable diseases, OfERR conducts three programmes:

• Regular screening of high risk groups by health workers

• General medical camps conducted at camp level

• Specialist medical camps conducted at district level

Various ailments are identified through these activities, including hypertension, diabetes, epilepsy, heart disease, tuberculosis, cancer, HIV/AIDS and mental illness. OfERR volunteers can respond with both direct treatment and referral to higher levels of care. Our workers ensure that essential drugs and resources are accessible and affordable for patients with minor and chronic problems. Last year 68,000 refugees received some kind of care from our health workers, with over 3,000 referred to institutions for further treatment. OfERR provides continuous assistance to chronic patients, ensuring they receive drugs regularly and monitoring their response to treatment. The protracted stay in difficult conditions has contributed to these illnesses in many cases. OfERR currently supplies medical support to over 2,000 hypertension patients, 200 diabetics, and over 500 people suffering from epilepsy and heart disease, among many others. Our pro-active screening programme helps us to provide the best possible care for these refugees.

Sexual and Reproductive Health
Refugee mothers and children are given special care by OfERR. In the past year 95% of births were institutional deliveries (only three home deliveries took place); the presence of skilled professionals reduces the risk of complications in childbirth. Infant mortality has been reduced, and the vast majority of babies are born at an acceptable weight.

OfERR promotes all areas of sexual health and conducts awareness sessions on family planning and transmission of STDs, providing free contraceptives for participants. Drugs are also provided for treating STDs. OfERR health workers have taken part in a national campaign aimed at encouraging people to report sexual diseases and seek treatment, and government health workers were invited to meet the refugee community. STDs have been identified in refugees across the camps, and these people are being treated by nearby institutions and given nutritional support by OfERR.   

Immunisation
OfERR has attained 100% immunisation coverage of children under 5, with around 1,000 infants receiving the BCG, measles and DPT or oral polio vaccines last year. This achievement has precluded the outbreak of any vaccine-preventable diseases in the camps. OfERR’s health workers co-ordinate with local health care providers to ensure that Sri Lankan refugees benefit from national immunisation programmes.

Mental Illness
OfERR’s experienced counsellors conduct regular home visits and hold individual and group counselling sessions in response to the mental health problems experienced by the refugees. Many have undergone years of mental and emotional trauma while living in Sri Lanka and then as refugees within the camps. A number of psychosocial problems affect the lives of these refugees, including depression, suicidal tendencies, marital problems, alcoholism, drug addiction and family violence. OfERR volunteers aim to recognise the causes and effects of these issues and help those affected to overcome them. This vital intervention is making a positive difference to many people trying to recover from years of violence and uncertainty, and over 2,500 refugees engaged in counselling activities last year.

Medical Camps  
OfERR conducts medical camps at both camp and district level. The former provide general care for patients seeking a range of treatment. The district medical camps give refugees the opportunity to seek quality specialist treatment for particular problems. In addition, special screening camps are held for STDs and tuberculosis. Government doctors and local GPs participate in all these camps and OfERR supplies medicines. Over 200 district camps have been held in the past year, benefiting some 20,000 refugees.

Awareness
OfERR’s mission to raise health awareness among the refugees takes the form of workshops, meetings, rallies and exhibitions. Over half the refugee population in Tamil Nadu has participated in these initiatives. Medical matters as well as diet and lifestyle issues are discussed and explained. This spread of knowledge and consequent action has led to some great successes in OfERR’s health programme: improved sanitation, zero incidences of camp epidemics, decreasing cases of diarrhea, fewer respiratory infections, and increasing use of contraception to counter sexual disease and unwanted pregnancy.

Our Team
OfERR health workers based in the camps are the first point of contact for the refugees. They provide basic medicines and first aid, and keep records of the drugs dispensed. Health workers maintain sanitation facilities and monitor the growth of children in the camps. They refer patients for hospital treatment and recommend financial assistance to pay for drugs, X-rays, food and travel. They are an accessible source of information and advice for all camp residents. Committees at camp and district level co-ordinate with health workers to identify patient needs and maintain the supply of necessary resources.

MIOT (Medical Institute of Tamils), an organisation of Sri Lankan doctors now living in the UK, supplies training to our health workers, which includes examinations and the award of certificates. The training focuses on primary health care including preventative measures, and also covers nutrition and child and maternal care. Communication skills are developed as well, helping our health workers to carry out effective awareness campaigns.  

Several other groups provide vital contributions to OfERR’s health programme.

• Refugee medical students, whose education is supported by OfERR, visit the camps to treat chronically ill patients identified by health workers.

• NGOs such as Indian Red Cross, TNVHA and CMSI provide support for our medical camps.

• Several expatriate doctors from the west have visited OfERR to give treatment and conduct motivating training sessions for our volunteers.

• Government hospitals and clinics liaise with OfERR to provide continuing treatment for refugee patients.

Current Projects
OfERR is trying to improve its health programme in several ways.

• Recruitment and training of new health workers and counsellors

• Opening of new community canteens providing low-cost nutrition supplements to refugees

• Mobilising support to acquire resources required by rising refugee numbers

• Promoting healthy living among the refugee community.