The most powerful earthquake in 40 years erupted under the Indian Ocean near Sumatra on the 26^th of December 2004. It caused giant, deadly waves to crash ashore in nearly a dozen countries, killing tens of thousands of people. A long stretch of Sri Lanka's coast was devastated by these killer waves, with more than 30,000 dead and staggering 2.5 million people displaced. Although 1,600km from the epicentre, the waves struck with huge force and swept inland as far as 5 kilometres. It was the worst human disaster in Sri Lanka history. 

The Paediatric Unit of Southend University Hospital NHS Trust - is currently setting up an Aid Programme initiated by Dr. V. Nerminathan (Clinical Director and Paediatric Consultant) and co-coordinated by Dr. Marc Tebrügge (Paediatric Specialist Registrar), in collaboration with a local hospital, to help the victims of the disaster in Batticaloa, Eastern Sri Lanka. This area has a particularly poor infrastructure and international aid is very restricted. In the local hospital, which is covering a population of about 500.000 people, care is currently provided by a single Paediatrician. Many children have lost family members and are suffering from post-traumatic stress disorder. In addition the incidence of diarrhoeal illnesses has risen sharply; cases of malaria are expected to increase significantly, given that the mosquito breeding season is about to commence and flooded areas will provide ideal breeding grounds.

The first team will fly out to the area on the 29th of January 2005, followed by further teams of nurses and doctors from Neptune Children’s Ward and the Special Care Baby Unit in February and March (with a view to expand this effort if help is still needed). We are planning to take medication and medical equipment, as well as to provide medical aid (including mobile clinics for remote areas) and counselling for those who have survived the tragedy. 

For us to be able to help these victims we urgently require additional funding. Most team members will pay for the travel expenses themselves and have additionally donated money to cover some of the costs of medication and equipment. However, we are hoping that others will actively support us in this effort. 

We would be most grateful for donations which will enable us to provide help to children and their families in Sri Lanka.

If you would like to make a donation, please contact the PID Web Team or Dr. Marc Tebrügge at Southend University Hospital NHS Trust -

 Thank you for your generosity !

The Nurses and Doctors of the Paediatric Unit, Southend University Hospital NHS Trust, United Kingdom

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Progress / Recent Developments

17/01/05

Dr. Nerminathan, Clinical Director of the Southend University Hospital Department of Paediatrics, gives an interview on BBC Essex Radio. He outlines the current situation in Eastern Sri Lanka and the details of the project. He appeals for further donations, and mentions that the team urgently requires a laptop computer, which will be used to establish medical records, keep track of equipment and medication and maintain communication links with the hospital.

18/01/05

BBC Essex Radio, which has shown great support for the cause, broadcasts the interview at 8 am. Thirty minutes later the station receives a phone call from Jan Smith, director of End-o-line Services, who kindly donates a laptop to the team. Dr. Marc Tebrügge gives a second interview at 12 am expressing his gratitude for this generous offer. He is also given the opportunity to talk about the project in greater detail.

19/01/05

Members of the Tsunami Relief Project Team meet with Jan Smith and are accepting the laptop. The event is covered by the newspaper "The Evening ECHO" (image from left to right: Jan Smith, Katherine Knight, Dr. V. Nerminathan (sitting), Dr. Marc Tebrügge, Katie White).

29/01/05

The first team flies out to Sri Lanka. The team consists of 2 paediatric doctors (Dr. V. Nerminathan and Dr. Minju Kuruvilla) and 2 paediatric nurses (Lisa Duggin and Katherine Knight). 

02/02/05

The team at Southend University Hospital receives the first report about the situation in Batticaloa. While the hospital in Batticaloa has not been directly affected by the Tsunami many smaller hospitals and health centres in the immediate surrounding have been swept away. This has caused a massive rise in case loads in the unit. The hospital is currently holding sufficient supplies of medication and intravenous fluids but there is an acute shortage of oxygen masks and tubes, nasogastric tubes and equipment for venous cannulation. Other equipment which is urgently required in includes: otoscopes, ophthalmoscopes, stethoscopes and sphygmomanometers.

The team members spend their busy days helping in the Paediatric Unit of Batticaloa Hospital, as well as undertaking regular visits to the camps in the surrounding region, where they are providing medical care for children - many of whom have lost their homes and their families.

7/02/05

The team approaches several companies from the biomedical sector enquiring whether they would be willing to donate some of the equipment which is needed in Batticaloa. The first company to respond is Morton Medical Ltd. , which kindly donates two combined sets of ophthalmoscopes/otoscopes. The team expresses their gratitude for this very generous gesture.

18/02/05

The first team, led by Dr. V. Nerminathan, returns to the United Kingdom. The team reports that the situation in the refugee camps remains stable - there are currently no major epidemics despite the relatively poor conditions. Most camps are not connected to a continuous water supply and thousands of refugees are relying on regular deliveries of fresh water. Sanitation also remains poor. The majority of displaced persons are still living in tents - usually 10 people in each tent. As Sri Lanka is experiencing a major heat wave at that time the temperatures in the tents have become unbearable. The tents are poorly ventilated and since cooking takes place inside many refugees are suffering from respiratory problems secondary to smoke inhalation. On the brighter side - the team reports that they greatly enjoyed bringing presents for the children to the camps (including books, utensils for school and sports equipment) and playing with them after the clinics.

In Batticaloa Hospital the conditions remain difficult. On the neonatal period there are still some babies who have lost their family, while many children in the Children's Wards are still recovering from the physical and emotional trauma of the disaster. The hospital is poorly staffed and is lacking vital equipment. The facilities are severely limited - the only portable x-ray machine is broken (for 5 weeks), the laboratory cannot perform basic investigations including electrolytes, liver and renal function tests or even blood cultures. These limitations make good clinical management extremely difficult and compromise positive outcomes in many patients.

21/02/05

The second medical team consisting of one doctor (Dr. Marc Tebrügge - Paediatric Specialist Registrar) and three nurses (Sister Amanda Chapman, Sister Katie White and Nurse Anne Francis) are flying out to Sri Lanka. They arrive in Batticaloa after almost 48 hours (following a 13 hours flight and a 14 hour train journey from Colombo to Batticaloa).

Amanda Chapman and Marc Tebrügge spend most of their time in Batticaloa in the Neonatal Unit (Baby Unit), while Katie White and Anne Francis are helping out on the two large Children's Wards (40 patients each). The team brought supplies of the urgently needed equipment including oxygen tubing, oxygen masks, cannulas, sterile plasters, endotracheal tubes, introducers, ambu bags, lancets, urine analysis stix, capillary tubes, stethoscopes and two combined ophthalmoscopes/otoscopes.

The work on the Neonatal Unit proves to be difficult. The unit has to cope with a large case load and a large number of sick babies admitted from the community. These babies often present with septic shock and require a lot of support, frequently including ventilation. Unfortunately the unit only has one ventilator and no nasal CPAP devices (nasal prongs), which can also be used to provide respiratory support in premature and sick babies. This meant that when a new baby was admitted at a time when another baby was already on the ventilator no support other than facial oxygen could be given, which profoundly limited the chances of survival.

The number of babies that die on the Neonatal Unit each month used to vary between 20 - 25. In contrast, during the time our team was there we managed to reduce the mortality down to 3 babies in two weeks. However, at least one or two of these babies could have been saved if an additional respiratory support had been available. The team therefore proposed to raise money to purchase another ventilator and at least 2 CPAP devices for the unit.

In addition to the clinical work the team also holds regular teaching sessions for the nursing and medical staff. The post-graduate teaching opportunities for staff in Batticaloa are quite limited - most teaching seminars are taking place in Colombo or Kandy (14 and 12 hour train journey respectively), the library only holds a small number of medical journals, the books are outdates and internet facilities are very limited.

28/02/05

The team is visiting the Ollikullam Tsunami Refugee Camp close to Batticaloa joined by a team of three American doctors from Kaiser's Hospital (California). During this busy day the team is holding clinics in three different make-shift health stations inside the camp seeing a total of 145 patients. The main complaints are chronic coughs, lethargy and poorly healing wounds (sometimes with secondary infection) which were sustained during the tsunami. After the clinics have finished the team finds some time to hand out presents to the children (such as pens, books, balloons, footballs and radios) and to play with them before it is time to head back to the base.

5/03/05

After having spent the last few days in Batticaloa Hospital the team heads off to Colombo to meet up with Dr. Rahman (Paediatric Specialist Registrar), who arrives from the UK on the same day. After a brief hand-over meeting Dr. Rahman leaves for Batticaloa - taking a portable ventilator (for use on the Children's Ward) and further medical equipment with him. The members of the second team fly back to the United Kingdom on the following day.

20/03/05

John Chapman (third from right) organises a charity event to raise additional funds for the Children's Unit Tsunami Relief Project. He is planning to pull an ambulance with the aid of a dozen supporters from Westcliff on Sea, via Southend on Sea to Shoeburyness (approximately 4.5 miles). The team intends to raise public awareness about the project and collect money on the way as well as holding a raffle at the finishing point. The test run soon makes it very clear that any uphill stretch will pose a considerable challenge. After a number of alterations it is finally decided that eight people at a time will have to pull the ambulance with harnesses in the more challenging parts of the course.

27/03/05

The ambulance pull goes ahead as planned. Starting in Westcliff at 10.30 am the team reaches the finishing line after almost 3 hours (John Chapman, Wayne Taylor, Shelley Daniels, Mark Vincent, Dan Taylor, Dan Holmes, Kevin King, Nathan Strange, Simon Davis, Stevie Killworth, Michael Venton, Amanda Chapman and a few other supporters).  Major sponsors of the event included the Southend Transport Corporation (who provided support transport), St. Johns Ambulance Service (provided the ambulance and drivers), the Forrester's Pub (provided refreshments), Compass (provided food and drinks, as well as providing the event t-shirts), Speedy Hire (provided the harnesses) and the Royal Bank of Scotland (financial support) as well as a number of local companies that provided items for the raffle event. The impressive amount of 1.800 pounds sterling was raised in the process.

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