are involved in organising these

events which attract more younger

people. I am hopeful that these

events will inspire even more of our

youngsters to get involved in MIOT

activities in future.

Our major goal is to build a good

quality healthcare system for the

benefit of our people in our home-

land as well as to address health

inequalities faced by Tamils in the

UK due to cultural and language

barriers. We continue to support

hospitals in Moolai, Manipay &

Puthukkudiyiruppu.

With all our committee members

working hard to increase our mem-

bership and to improve on our ser-

vices to our community, I am very

optimistic about our future.

There remain many challenges in

meeting the healthcare needs of our

people in our homeland. But to-

gether we will meet them. I appeal

to you to encourage other healthcare

professionals, known to you, to join

MIOT; a non political organisation

which is mainly focused on the

healthcare of our people.

Dr Saratha Natkunarajah

Dear Member

It is with great pleasure I sub-

mit MIOT’s 2014 Newsletter

which contains details about

our activities in the past year

and our outline plans for the

coming years. I hope you are

pleased with our services to the

community and I thank you for

your continued support. By

being a member and participat-

ing in our various events, you

strengthen our hands to do

more to our commu-

nity. MIOT is in its 25th year

of existence and we plan to

initiate new health projects.

MIOT is endeavouring to play

a significant role in meeting the

enormous healthcare needs of

the Tamils of North and East of

Srilanka. The regional MIOTs

have taken ownership for vari-

ous projects for the welfare of

our people in our Home-

land. We are supporting medi-

cal students with underprivi-

leged backgrounds as well as

looking after orphaned chil-

dren. We have also been in-

volved in providing cataract

surgery and Eye clinics in

Kandy, Batticaloa, Jaffna,

Moolai and Nuwara - Eliya,

giving life changing services

while providing the clinicians

an experience of immense pro-

fessional satisfaction and a great

sense of achievement. The

BMA had also contributed to

this by providing a donation of

£3000 to allow us to perform.

We aim to do more health re-

lated projects in NE Srilanka

and with your continued support

we can undertake many more

projects in the near future. We

are about to start providing a

Mobile Health Unit that would

provide essential health care to

remote areas in the North and

East of Sri Lanka

Educational events by MIOT

are of infinite standard and

many of our younger generation

President’s Message - 2013/2014

CONTACT

DETA ILS

339 South Street

Romford

Essex

RM1 2AP

E-mail

admin@miot.org

Web:

www.miot.org.uk/

Dr Saratha

Natkunarajah

07860175773

Dr S Uthayakumar

07916167114

Dr Girija Kugapala

07801339960

Youth Forum

Dr Thuvaraga

Chelvan

07540770641

Dr Thulasi

Balakumar

07908526376

MIOT Newsletter

Medical Institute of Tamils Charity No.(106684)

O C T O B E R 2 0 1 4

P A G E 2

1

Community Health Project

Dr Kantha Niranjan

MIOT (UK) has been involved in doing community health screening and clinic since 2010.

This service was provided to UK residents who are mostly elderly and who could attend a

community centre. Most of them are regular attendees in these community centres. In the

past this type of service was provided in Edmonton and Manor Park where many Tamil re-

tired and elderly people meet weekly. It was noted that not only elderly but Tamils over the

age of 50 years too attended these centres and they were keen to attend the Community

Health Clinic.

On 19thJuly 2014 MIOT (UK) committee

members met at Edmonton Community Cen-

tre to meet the attendees of various age

group all of them were over 50 years. The

day started with Health talks to the group

and interactive discussion.There were about

35 peopleattended, 28 needed consultation

by us.The age range of these people was

51-83 .5 males and 23 females had consultations.Over the age of 80 years it was

noted all were females.They reported the following illness,75 % hadHigh blood pressure,

57 % hadHeartdisease,42.85% hadDiabetes,7.14% hadpreviousStroke (2 persons),46.42%

had Arthritis,28.57% hadAsthma/Lung diseases,7.14%had Depression,10.1 %had Memory

problems,10% had cancer (One Lymphoma and One breast cancer),50 % reported some

pain needing to take regular analgesics.100 % mentioned they found it was useful to meet

the doctors today.100 % mentioned they would like to have this service again.It is evi-

dent clearly similar community work is of great benefit in the centres for the elderly population

to give a great satisfaction to them to be able to provide enough time to listen to their medical

problems in detail and giving advice on the necessity of taking their medications.

Paediatric Unit—Puthukkudiyiruppu, Vanni

Dr Jayanthy Gnananandan

Financial assistance for furnishing and equipment for the new paediatric unit in Puthukkudiyiruppu

hospital was given by MIOT. The hospital had been completely destroyed during the war. This region

deserves more help to rebuild the healthcare infrastructure.

P A G E 3

Delete text and

It has been a remarkable year, marked by MIOT’s involvement in several noteworthy

projects. Our primary focus has been on health projects which have provided both vital

services to patients as well as essential training for staff in Sri Lanka and in the UK.

These are the projects that we have supported over the last year utilising funds gener-

ated by membership, donations and fund raising events.

• Daily free health care clinics for low income patients at Moolai hospital

• Weekly free health care clinics for low income patients at Green memorial hospital

Manipay

• We support a 10 bedded Acute Stroke Unit at the Jaffna teaching Hospital.

• Renovation & Refurbishment and supporting the staff of a rehabilitation centre

at Green memorial hospital Manipay

• Sponsorship for 25 Medical students from low income families, at Jaffna medical

faculty.

• Annual Paediatric gold medal award for high achiever in final year.

• Research grants to support 4th year medical students looking into:

• MRSA incidence among surgical patients

• Betel chewing and incidence of upper oesophageal carcinoma

• Eye Camp Project—Kandy, Batticaloa, Jaffna, Moolai &Nuwara Eliya

• BLS training in Jaffna & Manipay for health care personnel.

• Repair of ENT neonatal audiology equipment in Jaffna Hospital

• Monthly distribution of BMJs and other journals to Jaffna medical library

• Support Orphanages

• Thilagawathiyar illam, Batticalo - 34 children

• Thambuvil girls home, Batticaloa - 8 children

• Akilandeswary illam Vavuniya - 13 children

• Educational events in UK

• MOBILE HEALTH CLINIC in Vanni (to be extended to the East)

• Support FAR REACH CLINIC—Batticaloa

• Community Health Project in Edmonton & Wembley

• Health Education Programmes on GTV

• Refurbishment and Equipment for the new Paediatric ward in Puthukkudiyiru Hos-

pital.

M I O T N E W S L E T T E R

What have we done so far?

P A G E 4

Delete text and

Eye Camp 2013- 2014 By Mr M Logendran

It’s been busy two years with several projects in the north and east of Srilanka.

Batticaloa July 2013: we carried out our cataract and oculoplastic camp at the Batticaloa

district general hospital in July 2013. Our project started in 2002 and after having done

Cataract surgical missions in Jaffna, Vauuniya, Moolai and Manipai this was our first

such camp in the Eastern Srilanka. This project was done in collaboration with the local

surgeons where we did 110 cataract operations and 17 oculoplastic cases. With this we

have so far done nearly 2000 free cataract operations in the North and East of Srilanka

since 2002.

Kandy April 2014 Vitreo retinal surgical camp. We did a vitreo retinal surgical camp at

Kandy teaching hospital at request of the local surgeons. This camp was attended by Eye

surgeon and nurses from Jaffna, they also brought several patients from Jaffna. As part

of this project we did a lot of surgical teaching and in afternoon educational lectures

were given as well. These lectures were attended by local trainees and surgeons from

Colombo and the surrounding areas of Kandy as well. We saw about 50 medical and

surgical retina cases and gave management plans and demonstrated surgical and Laser

techniques as well.

P A G E 5

Jaffna eye camp June 2014. The cataract project was done in Jaffna where 60 very poor patients received cata-

ract surgery.This project was done in collaboration with Dr. Chandrakumar, Consultant Eye surgeon, Jaffna.

Moolai hospital cataract project. This project was done with the help of Dr.Kugathasan

We did another project in Nuwareliya in August this year in conjunction with local eye surgeon Kala Sivayoga-

nathan and her colleagues. We saw over 1000 mainly estate workers and their families and distributed over 800

glasses and also identified a number of patients with bilateral dense cataract. We are now making arrangements

to operate on these patients

P A G E 6

Basic Life Support in the North of Sri Lanka—Dr Arani Pillai

Background

There are no regular training updates in the conduct of basic or advanced life support for all

healthcare staff in the Jaffna peninsula. Some healthcare staff have attended sessions ar-

ranged by the anaesthetists at Jaffna teaching hospital, which have been conducted at Holy

Cross hospital. The infrastructure for regular training sessions is not in place, with no formal

resuscitation department and guidance or record on the frequency in which updates must be

attended. There are only 4 consultant anaesthetists that cover Jaffna teaching hospital. They

cover a large amount of work between them and have also been tasked with creating and

running a formalised resuscitation training service.

I am an ST7 anaesthetic registrar from Nottingham and had arranged to work at Jaffna teach-

ing hospital as part of a training module in Developing World Anaesthesia. I was tasked

with teaching as well clinical anaesthesia under the supervision of Dr Premakrishna, the

clinical lead. I am also an APLS instructor with 4 years’ experience in resuscitation training

in the UK. I was planning to make this trip with my husband Dr Andrew Coulton who had

recently completed his GP training, my children and my mother.

Dr Saratha Natkunarajah and Dr Poolonathan from MIOT approached me and my husband to

help to set up and support basic life support (BLS) training in the Green Memorial hospital,

Mannipai, Moolai hospital and the Centre for Family Medicine in Jaffna. They aided us with

the donation of airway equipment and the purchase of 3 basic life support mannikins. They

also set up contacts at all these centres for the organisation of basic life support courses.

Basic Life Support (BLS) Training

The BLS training we ran was based on the UK Resusci-

tation Council guidelines and conducted on a weekly

basis at Green Memorial hospital, Mannipai. Two

groups of 10 candidates were taught each week via a

practical session lasting 90mins each. Each session be-

gan with a practical demonstration of the BLS algo-

rithm. The algorithm was then taught using the ‘4 stage technique’ recommended by the Ad-

vanced Life Support Group. The middle of the session involved practising the BLS algorithm

in two groups of 5 candidates and using two separate mannikins. At the end of each teaching

session there was an individual assessment of each candidate and a certificate was given for

satisfactory performance.

The candidates were mainly nurses from Green Memorial hospital, Mannipai, McLeod hos-

pital, Innuvil and Moolai hospital. We also taught the health care students, pharmacists, ad-

ministrative staff and two ambulance drivers. We ran a separate session for theatre staff at

Jaffna Teaching hospital and a separate session at the Centre for Family Medicine, Jaffna. In

total 105 people were taught over the period of 2 months.

P A G E 7

The general knowledge of BLS was good however the practical application of this was

variable. Some candidates really struggled with aspects of resuscitation such as the con-

duct of effective chest compressions and the provision of ventilatory breaths. We ini-

tially taught the process of bag-mask ventilation as all our candidates were based in sec-

ondary care. We later also included mouth to

mouth and mouth to mask ventilation teach-

ing as some candidates found these tech-

niques easier to master.

The sessions were conducted in Tamil and

English and there was help with translation by

Dr Yogarajah, Medical Officer at Green

Memorial hospital, Mannipai.

There was a high level of enthusiasm and motivation amongst the groups taught. We

often found students coming to practice before we started the sessions and after we had

finished our sessions several weeks after their initial training day.

Summary

The initiation of BLS training was met with enthusiasm and lots of interested candi-

dates. There was an obvious need for the teaching updates as there was no regular facil-

ity for all healthcare staff to update their resuscitation skills. The quality of the current

resuscitation skills was also variable and practical teaching and assessment was clearly

needed. The equipment sent out to Jaffna was of good quality for teaching BLS but

other equipment and mannikins would be needed to teach advanced life support. To

keep this teaching schedule going will require the current doctors in Jaffna teaching hos-

Annual Educational Event

This year we held our Annual Educational Event on the 5th July at the Holiday

Inn, Newbury park. The event consisted of several talks from Consultants to Jun-

ior Doctors and were hugely enlightening and engaging. Topics that we covered

ranged from post—intensive care syndrome to applying for speciality registrar

training. The event was organised by young doctors Dr Dhaksha Sivayoganathan

and Dr Nishanth Sivarasan with the guidance from Dr Rajakulasingahm

P A G E 8

Supporting Stroke Care at Teaching Hospital Jaffna

Dr Arani Nitkunan

Rehabilitation Unit—Manipay Green Memorial Hospital

I left Sri Lanka at the age of 3. I organised an Out of Programme Training month in Teaching Hospital Jaffna in

August 2012. My days there were very similar to my days as a neurology trainee at St George’s Hospital, London

in that I had outpatient clinics and ward referrals. The annual number of inpatients admitted was almost double in

Jaffna (110,000 versus 67,000). The number of neurologists based at Jaffna compared to St George’s was vastly

different – 1 versus 36. Dr Ajantha Keshavaraj was appointed earlier in 2012 – prior to that there hadn’t been a

neurologist in Jaffna for over 30 years. The range of interesting cases that poured into Jaffna covered the entire

breath of the neurology curriculum. A full description of my month can be found in “Postcard from Jaffna, Sri

Lanka.” Nitkunan A. Practical Neurology 2013; 13: 346-349.

As a trainee who had completed a PhD on stroke, my focus was on stroke care. During my time in Jaffna, there

were many disparities in stroke management. Because of this, together with the rise in vascular risk factors and the

consequent rise in incidence of stroke in the developing world, I decided to focus my efforts in improving stroke

care in Jaffna. Towards this end, I approached MIOT to help fund much needed beds (all beds in Jaffna Teaching

Hospital do not have a head tilt and therefore patients who are

immobile are unable to sit up), pressure mattresses (pressure

sores are considered almost inevitable by staff in Jaffna) and

bedside chairs (to encourage early mobilisation). I am very

grateful to MIOT for having supported this. This equipment is

being purchased (see photos) and will be housed in the recently

refurbished neurology unit. Dr Ajantha (see photo of the neu-

rology team) and myself continue to liaise together (eg sharing

of stroke protocols) with the aim to improve stroke care to the

people served by Teaching Hospital Jaffna.

The Neuro-rehabilitation Unit in Manipay was a dilapidated building

which was refurbished by MIOT to the present high standard. It was

officially opened by Dr Natkunarajah in June 2014. It started func-

tioning in September 2014 and MIOT has been involved in financing the

equipment that was needed for this. This is a unit that provides rehabili-

tation to patients with stroke, other disabilities and disorders.

One of the rooms is used for weekly out patients health check clinics for

the under privileged. This is supported by MIOT.

P A G E 9

MOBILE CLINIC—MULLIVAIKKAL, VANNI

Dr N Sivayoganathan

MIOT Youth Forum

This is a flagship project of MIOT to support the war affected areas in the North & East of Sri

Lanka. We are starting the project in Vanni where there are a number of remote villages

which hardly have any access to healthcare. As medical professionals we feel it is an utmost

necessity that we meet the healthcare needs of these areas. Mobile clinics have been deliver-

ing effective healthcare to many remote villages in India, Africa and Nepal. We intend to use

their experiences and successes to deliver an effective

healthcare to the doorsteps of those who need it.

This project will be starting in November 2014. It is a

challenging project at the present situation and needs

considerable amount of resources. We intend to extend

the level of care further, including telemedicine.

The above project gives an opportunity to our young and

enthusiastic doctors to gain experience in this challenging

field. Your contributions are vital for this project to succeed.

We have set up a new committee of medical students and young junior doctors to form the ‘Junior MIOT’.

We will be working closely with our Tamil Society Representatives from each university to enable us to

achieve our goals as set out below:

Our goals for this year are to:

• Increase membership to MIOT

• To support medical students education and conducting electives abroad

• To fundraise to support MIOT Projects.

We will be involved in running a Mock Interview event for those applying for medical school places. This will

be a great way of helping students enter medicine as well introduce the younger generation to MIOT as well

as raising money. This event will co-ordinated by our Vice President Dr Ramyah Rajakulasingam.

Akilandeswary illam Vavuniya Thambuvil girls home, Batticaloa

Thilagawathiyar illam, Batticaloa

MIOT currently supports

55 children across the

three homes in the North

and East

We thank the sponsors

and invite others to par-

ticipate in supporting the

children through MIOT

Silver Jubilee - 2013

Mobile Clinic– Vanni

Your Contribution to this project

will enable us to reach

more remote areas