AFTER CYCLONE DITWAH: CLIMATE-PROOFING SRI LANKA'S HEALTH SYSTEM

As Sri Lanka currently counts human and economic costs of Cyclone Ditwah, the images are both disturbing and somewhat familiar: flooded hospitals, access roads buried by landslides, evacuation centres overflowing with displaced families, and officials in health and Disaster Management Services scrambling to meet everyone’s needs. The death toll is at 355 and rising, with hundreds more missing and over 200,000 displaced, with effects being borne disproportionately in the central hills and low-lying river basins across the country. It has once again placed the spotlight on the preparedness of our disaster response ecosystem, and with climate-related disasters no longer a few and far between, Cyclone Ditwah is a tragic but predictable reminder and caution of the same vulnerabilities that have persisted for years.

- By Pulasthi Amarasinghe and Usha Perera

A recent chapter of the Institute of Policy Studies of Sri Lanka’s (IPS) State of the Economy report examines how climate risks intersect with Sri Lanka’s health infrastructure, disease profiles, and governance. In the aftermath of Ditwah, there must be an urgent call to reassess Sri Lanka’s disaster preparedness.

Cyclone Ditwah and Vulnerabilities in Health and Communities

A considerable number of hospitals and divisional medical centres of Sri Lanka operate in flood-prone and landslide-risk areas throughout the country. Figure 1 shows that the analysis of health facilities against national hazard information reveals the location of hospitals by type that exist in districts that currently face the most severe Ditwah impacts in the central highlands and Sabaragamuwa Province, Gampaha, and Colombo’s surrounding low-lying urban areas. When rivers overflow, health facilities themselves become vulnerable, not just lifelines.

Moreover, the physical exposure quickly becomes an epidemiological risk. Flood-prone districts tend to report some of the highest average annual numbers of dengue and leptospirosis cases. While access to routine care and emergency transport is disrupted, heavy rainfall and poor drainage create ideal conditions for the spread of vectorand waterborne diseases. Ditwah will therefore not only create an immediate trauma burden, but likely a second wave of climate-sensitive illnesses among people in the most exposed communities.

Climate projections suggest more intense and frequent extreme weather, with a large share of Sri Lanka’s population expected to live in climate “hotspots” by mid-century. However, the transformation of the health system to address the climate reality is occurring at a slower pace than the rate at which climate change is affecting Sri Lanka.

Figure 1: Hospital Exposure to Flood Risk