Orthopaedics in Sri Lanka post-tsunami

On 26th December 2004 a large earthquake (Richter 9.3) occurred on the Indian/South East Asian tectonic plate intersection with an epicentre 800 Km south west of Sumatra, Indonesia.This resulted in the production of a tsunami which radiated across the Indian Ocean.Sri Lanka was the second most seriously affected country after Indonesia.There were 50 000 deaths of which 9000 were children, 20 000 people are still missing, believed dead.Nearly one million people were displaced following the destruction of 150 000 houses resulting in an enormous strain upon aid agencies providing tented accommodation and sanitation.The Sri Lankan Health Ministry requested assistance from the United Kingdom emphasising that a great number of people with orthopaedic injuries had been transferred to Colombo, the capital.It was reported that definitive surgery could not be performed upon the many patients with open fractures due to the lack of external fixator equipment.The Department for International Development (DFID) sanctioned a team from Leonard Cheshire International (LCI) to provide a Health Needs Assessment of Sri Lanka with particular emphasis on the provision of trauma/orthopaedic and psychiatric services.The team arrived in Sri Lanka nearly three weeks after the disaster.Their brief was to travel to the remote areas of the country assessing the hospital facilities available and the level of surgical expertise, before donating orthopaedic equipment such as external fixators.Our report was requested by the United Nations, International Red Cross and other Non Governmental Organisations (NGOs) to help co-ordinate disaster relief programs.