1. Climate Change & Healthcare Organization: Sri Lankas perspective 2008 Global Ministerial Forum on Research for Health - Bamako - 17-19 November 2008 - Neelamani Rajapaksa Hewageegana Sarath Samarage

2. Country Description

3. Sri Lanka 20 M population 62,705 Sq km Adult Literacy rate 90.7 Life expectancy at Birth 76.4-Female 71.7-Male Population growth Rate 1.1 Total fertility rate 1.9 Human Development index 0.743

4. Vital Statistics Crude Birth rate 18.7 per population Neonatal Mortality rate 8.4 per 1,000 live births Infant Mortality rate 11.7 per 1,000 live births Maternal Mortality rate 14.3 per 100,000 live births (data Annual Health Bulletin 2006)

6. The information flow of the notifiable diseases of Sri Lanka HospitalMOH Office Bed-head Tickets Notification Card Notification Register (Ward) Notification Register (Institution) Special Notifications Cholera Acute Flaccid Paralysis Neonatal tetanus Measles/Other EPI Diseases Japanese Encephalitis Dengue Haemorrhagic Fever Rabies Notification Register Weekly Return of Communicable Diseases Infectious Diseases Register EPIDEMIOLOGICAL UNIT PHI BY TELEPHONE/TELEGRAM FOR SURVEILLANCE INVESTIGATION

7. Responding to climate change and health Major Activities in epidemiology 1.Disease surveillance (communicable and non-communicable diseases) 2.Planning, monitoring and evaluation of the Expanded Programme on Immunization 3.Control of diarrhoeal diseases and acute respiratory infections 4. Control of dengue haemorrhagic fever, Japanese encephalitis and rubella 5.Planning, monitoring and evaluation of the new, emerging and re- emerging iseases (NERD)surveillance Immunizationdiarrhoealacute respiratory infections dengueJapanese encephalitis rubellanew, emerging and re- emerging iseases (NERD) Establishment of epidemic preparedness, rapid response teams at central and divisional levels 6.Providing feed back on selected communicable diseases 7.Conduct research activities relevant to epidemiology

8. Leading Causes of Hospitalization, 2006 SL Rank OrderCauses of Hospitalization 1 Traumatic injuries 2Diseases of the respiratory system, 3 Symptoms, signs and abnormal clinical and laboratory findings 4 Viral diseases 5 Diseases of the gastrointestinal tract 6&7 Direct and indirect obstetric causes 8 Diseases of the urinary system 9 Intestinal infectious diseases 10Diseases of the skin and subcutaneous tissue

9. Diarrhoea associated with Floods and Drought Aggravate the problem of access to safe drinking water Contaminated water supplies. Poor hygiene, and increased risk of illness.

10. Vector dynamics with respect to to climate change Vector-borne diseases (Malaria, Filariasis, Chikun Gunya, Dengue, Japanese Encephalitis,Leptospirosis) Premises Index Container Index Breatue Index

11. Climate change and Health… Increased accidents due to Lightning and Tornadoes Increased Road Traffic Accidents Psychological problems –Loss of income – loss or displaced family members

12. The way forward Research on climate change related health issues Improve health surveillance systems to allow assessment of the impact of climate variability and change on health to facilitate better integration of data sets across sectors review and redistribute the existing roles and responsibilities of the community health worker the PHM and PHI in Sri Lanka

13. Thank you.