Progress Report: Real Medicine Clinic, Yayawatta,Tangalle, Sri Lanka

Date: July 28th, 2013 Prepared by: Stephney Minerva Fernando

I. Demographic Information1. City & Province:Tangalle, Southern Province, Sri Lanka2. Organization:Real Medicine Foundation Sri Lanka3. Project Title:Yayawatta Health Clinic4. Reporting Period: April 1st, 2013 – June 30th, 20135. Project Location (region & city/town/village):Seenimodera, Yayawatta, Tangalle, Sri Lanka6. Target Population:94 Tsunami affected families and the surrounding communities of four villages with a population of 4,000.II. Project Information7. Project Goal:Provide medical care to Tsunami affected families and the less privileged to help build a healthy community.8. Project Objectives:

1. Support the community with free high quality healthcare services2. Help to create a healthy community, especially amongst the younger generation

9. Summary of RMF-sponsored activities carried out during the reporting period under project objective (note any changes from original plans):

The clinic was opened 10 days per month to provide free healthcare services to the community of Yayawatta, Seenimodera in Tangalle, Sri Lanka, and its surrounding villages and communities of Palapotha, Kadurupokuna and Seenimodara.

10. Results and/or accomplishments achieved during this reporting period:

The clinic was opened for 10 days each month and for the Second Quarter of 2013, we saw an average of 20 patients per day with a total of 635 patients treated.

In the month of April, 214 patients were treated In the month of May, 210 patients were treated In the month June, 211 patients treated.

11. Impact this project has on the community (who is benefiting and how):

This project benefits two categories of patients; the community of Yayawatta (direct beneficiaries) who had lost their livelihoods and loved ones in the Tsunami of December 2004, and the lower income groups of families that live in the villages and communities around Yayawatta (indirect beneficiaries).

12. Number served/number of direct project beneficiaries (for example, average number treated per day or month and if possible, per health condition).

A total of 635 patients were treated at the clinic during this reporting period.

13. Number of indirect project beneficiaries (geographic coverage):Approximately 4,000

14. If applicable, please list the medical services provided:The clinic was opened 10 days per month from 7.00 am to 11.00 am.

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The most common diseases treated at the clinic for the month of APRIL 2013:

01. Heart Disease02. Hypertension03. Gastroenteritis04. Skin Disorders05. Arthritis

Family Planning Program:Intra muscular injections of Depo-Provera were administered to 5 women; 4 women started oral contraceptive treatment in April 2013.

The most common diseases treated at the clinic for the month of MAY 2013:

01. Arthritis02. Respiratory Tract Infections03. Gastroenteritis04. Skin Disorders05. Hypertension

Family Planning Program:Intra muscular injections of Depo-Provera were administered to 4 women. 5 women started oral contraceptive treatment in May 2013.

The most common diseases treated at the clinic for the month of JUNE 2013:

01. Gastroenteritis02. Arthritis03. Skin Diseases04. Heart Diseases05. Hypertension06. Pneumonia/ Respiratory Tract Infections

Family Planning Program:Intra muscular injections of Depo-Provera were administered to 4 women; 4 women started oral contraceptive treatment in June 2013.

15. Please list the five most common health problems observed within your region (for Children):

Respiratory Tract Infections Arthritis Gastrointestinal Tract Infections Heart Disease Skin Diseases

16. Notable project challenges and obstacles: None

17. If applicable, plans for next reporting period:

Ongoing reporting of clinic attendance, disease prevalence and family planning utilization for Quarter 318. If applicable, summary of RMF-sponsored medical supply distribution and use:

Monthly Lists of Medicine are attached in Annex 1.19. Success story(s) highlighting project impact:

1) Sonal is the 1-year-old son of Mrs. Dimuthu who serves as the RMF Assistant to the Medical Consultant at our Clinic. He had recurrent episodes of fever for several weeks. Sonal was referred to the Base Hospital of Tangalle and underwent many medical tests so he had to be kept inpatient in the Children’s Ward. Tests included a full blood count and a C-reactive protein test as well as a chest x-ray. He was diagnosed with pneumonia, and started on IV antibiotics for a 3-day treatment which allowed him to recover from the pneumonia. However, during the course of his treatment, he contracted hand, foot and mouth disease and was prescribed topical acyclovir.

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2) Mrs. Sriyani is a woman from Palapotha and came to the Clinic with pain and swelling in her right foot. She was diagnosed with severe cellulitis and referred to the Base Hospital in Tangalle for inpatient treatment. Mrs. Sriyani was fortunate as her illness was diagnosed early enough for her to make a full recovery.

3) This is Mrs. Chitra, the new nursing officer who has been appointed by the government to do field work in rural areas. She visits Yayawatta every first Thursday of the month. This has been very helpful for the mothers and babies who come to the clinic. All the mothers from Yayawatta as well as the surrounding areas of Palapotha, Kadurupokuna, Moraketi-Ara and Seenimodera are aware of this program.

4) Mrs. Surancika is the mother of a 3-month-old boy. She lost her first child in the Tsunami of December 2004. Mrs. Surancika suffered from high blood pressure during her pregnancy. Because of RMF’s supervision and treatment, she delivered her baby safely; mother and child are both healthy.

5) The Koogan family from Australia donated some clothing to the Yayawatta community. They had been staying at Palm Paradise Cabanas at Goyambokka in Tangalle and had inquired there how to find people who had been affected by the Tsunami. They were directed by the hotel to the Real Medicine Clinic. The people of Yayawatta felt very grateful that they were chosen this many years after the Tsunami. Mrs. Dimuthu and Mrs. Lasanthie, of the clinic staff did a marvelous job organizing the community of Yayawatta to be present at the clinic to collect the clothes which the Koogan Family had brought from Australia to distribute among the needy people of the community.

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Ravindi from Palapotha is 7 years old. She presented to the Real Medicine Clinic with shortness of breath and fever. Ravindi was diagnosed with bilateral bronchitis. She was treated with a nebulizer while her labs were evaluated. Upon the return of her complete blood count, she was diagnosed to have a bacterial infection and was sent for a chest x-ray. She was then sent to Tangalle Base Hospital and admitted as an inpatient to be treated for bilateral bronchopneumonia. Ravindi was treated with IV medication and has recovered. Her parents thanked Real Medicine Foundation for all of the help it gives to the people of Yayawatta and its surrounding communities.

20. Photos of project activities (file attachment is fine):See Appendix AIII. Financial Information

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21. Detailed summary of expenditures within each budget category as presented in your funded proposal (file attachment is fine). Please note any changes from plans.

APPENDIX A

A patient being evaluated for respiratory disease

Staff organizing supplies before clinic opens for the day

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Dr. Chamal at work

Patients waiting to be seen

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Mrs. Chitra, the Nursing Officer

RMF Clinic staff at work

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Another happy patient

Patients wait their turn to be seen

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Morbidity Report

Beneficiaries

Direct Beneficiaries:

Yayawatta Year Month Patients Male Female Average2013 APRIL 135 60 75 13.5

MAY 132 58 74 13.2JUNE 136 63 73 13.6

TOTAL 403 181 222 40.3

Indirect Beneficiaries:

Villages Year Month Patients Male Female AveragePalapotha,Seenimodara&Kadurupokuna

2013 APRIL 79 38 41 7.9MAY 78 35 43 7.8JUNE 75 36 39 7.5

TOTAL 232 109 123 23.2

Disease Chart of the Real Medicine Clinic in Yayawatta, Tangalle, Sri Lanka For the Months of APRIL, MAY & JUNE 2013 Month of APRIL 2013

Disease Type PERCENTAGE PATIENTS MALE FEMALE01. Heart Disease 20% 38 18 2002. Hypertension 20% 40 17 2303. Viral Gastroenteritis 20% 44 20 2404. Skin Diseases 20% 42 18 2405. Acute Gastroenteritis 10% 24 13 1106. Rheumatoid Arthritis 10% 26 12 14TOTAL 214 98 116

Month of MAY 2013

Disease Type PERCENTAGE PATIENTS MALE FEMALE01. Arthritis 50% 105 48 5702. Respiratory Tract Infections 20% 42 19 2303. Viral Gastroenteritis 10% 20 08 1204. Acute & Chronic Gastroenteritis

10% 22 10 12

05. Skin Diseases 05% 11 05 0606. Hypertension 05% 10 03 07TOTAL 210 93 117

Month of JUNE 2013

Disease Type PERCENTAGE PATIENTS MALE FEMALE01. Viral Gastroenteritis 25% 53 24 2902. Chronic Gastroenteritis 25% 52 25 2703. Arthritis 20% 42 20 22

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Place Year Month Patients Male Female PercentageReal Medicine Clinic 2013 APRIL 214 98 116 21.4

MAY 210 93 117 21JUNE 211 99 112 21.1

TOTAL 635 290 345 63.5

04. Skin Diseases 10% 21 09 1205. Heart Disease 10% 21 10 1106. Hypertension 05% 11 05 0607. Pneumonia 05% 11 06 05 TOTAL 211 99 112

Total Patients number by Village:

Village APRIL MAY JUNE TotalYayawatta 135 132 136 403Palapotha 31 32 29 92Kadurupokuna 30 29 26 85Seenimodara 18 17 20 55Total 214 210 211 635

Total Patient Numbers by Age & Gender:

APPENDIX B

EXPENDITURE FOR MEDICINE FOR THE MONTHS OF APRIL, MAY & JUNE 2013

FOR THE MONTH OF APRIL, 2013

NAME QUANTITY COSTCAPSULES & TABLETS01. Amoxicillin (250mgs.) 300 Rs.900/=02. Brufen (200mgs.) 300 Rs.270/=03. Cephelexin (125mgs.) 300 Rs.2,550/=04. Dexamethazone (0.5mgs) 1000 Rs.515/=05. Ciprofloxanin (500mgs.) 300 Rs.1,650/=06. Derriphilinne 300 Rs.400/=07. Orron 300 Rs.2,400/=08. Diclofenac (50mgs.) 300 Rs.290/=09. Erythromycine (500mgs.) 300 Rs.2,970/=10. Ferrous Sulphate(Iron) 300 Rs.160/=11. Mebandazole (100mgs.) 300 Rs.180/=12. Multivitamin 500 Rs.500/=13. Omeprazole (20mgs.) 300 Rs.1,260/=14. Parenting (125mgs.) 300 Rs.1,800/=15. Vitamin B Compound 1000 Rs.290/=16. Glycoside (80mgs.) 200 Rs.1,150/=17. Zinnet (500mgs.) 30 Rs.3,270/=SYRUP01. Derriphyillin 06 Bottles Rs.720/=02. Fersovite 06 Bottles Rs.1,080/=03. Mumfer 06 Bottles Rs.1,818/=04. Phenycof (Adult) 06 Bottles Rs.792/=05. Piriton 750mls. Rs.198/=06. Salbutomol 750mls. Rs.220/=07. Paracetamol 750mls. Rs.280/=08. Erythromycine 06 Bottles Rs.1,980/=09. Domtic 06 Bottles Rs.1,092/=

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By Age APRIL MAY JUNE Total Male Female0 – 05 years 39 37 45 128 58 7006 – 15 years 41 41 40 129 60 6916 – 24 years 35 30 22 79 35 4425 – 49 years 52 55 58 148 68 8050 years+++ 47 47 46 137 58 79Total 214 210 211 621 279 342

OINMENTS & CREAMS01.Betnovate N 06 Tubes Rs.1,560/=02. Mycorol 06 Tubes Rs.1,020/=03. Ciplox 06 Tubes Rs.450/=INJECTIONS & OTHERS01. Depo Provera 06 Rs.1,320/=02. Syringes 06 Rs.35/=03.Mithuri 06 Rs.600/=

TOTAL(PAID) Rs.33,720/=

FOR THE MONTH OF MAY 2013

NAME QUANTITY COSTCAPSULES & TABLETS01. Cloaxicilline (500mgs.) 300 Rs.1,800/=02. Brufen (200mgs.) 300 Rs.780/=03. Cephalexin (250mgs) 300 Rs.1,710/=04. Dexamethazone (0.5mgs) 1000 Rs.515/=05. Vitamin A & D 500 Rs.400/=06. Buscopam 300 Rs.2,970/=07. Digene 300 Rs.1,098/=08. Emitop (Domperadine.) 300 Rs.540/=09. Famotedene 300 Rs.300/=10. Flagyl (Metronidozole 400mgs.) 300 Rs.2,250/=11. Piriton 1000 Rs.135/=12. Mebandazole (100mgs.) 300 Rs.180/=13. Paracetamol 1000 Rs.610/=14. Atorustatin (20mgs.) 200 Rs.920/=15. Dianil 300 Rs.930/=16. Mefanamic Acid 300 Rs.300/=SYRUP01. Amoxicillin 06 Bottles Rs.612/=02. Amino Plus 06 Bottles Rs.2,664/=03. Becadex 06 Bottles Rs.1,350/=04. Phenycof (Jun.) 06 Bottles. Rs.642/=05. Belcid 06 Bottles Rs.1,182/=06. Cephelexin 06 Bottles Rs.930/=OINMENTS & CREAMS01.Betnovate N 06 Tubes Rs.1,560/=02. Mycorol 06 Tubes Rs.1,020/=03. Chloramphenicol 06 Bottles Rs.210/=04. Jonac gel 06 Tubes Rs.462/=05. Soframycine 06 Tubes Rs.564/=INJECTIONS & OTHERS01.Mithuri 06 Packets Rs.600/=02. Envelopes(Medicine) 06 Vials Rs.250/=

TOTAL(PAID) Rs.27,490/=

MONTH OF JUNE 2013

NAME QUANTITY COSTCAPSULES & TABLETS01. Ciprifloaxanin (500mgs.) 300 Rs.2,400/=02. Calcium Lactate 200 Rs.60/=03. Cephelexin (125mgs.) 300 Rs.2,550/=04. Dexamethazone (0.5mgs) 1000 Rs.515/=05. Diazepam 200 Rs.40/=06. Derriphilline 200 Rs.400/=07. Diclofenac (50mgs.) 300 Rs.300/=

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08. Dolcolax (5mgs.) 300 Rs.900/=09. Folic Acid 300 Rs.90/=10. HydroCoThalazide 200 Rs.80/=11. Multi Vitamin 500 Rs.500/=12. Mebandazole(Endal – 500) 30 Rs.900/=13. Omeprazole 300 Rs.1,800/=14. Parenting (125mgs.) 300 Rs.280/=15. Salbutomol (2mgs.) 1000 Rs,270/=16. Vitamin B Compound 1000 Rs.290/=17. Augmentin (375mgs.) 30 Rs.1,440=18. Zinnet (500mgs.) 30 Rs.3,270/=19. Glycoside (80mgs.) 200 Rs.1,160/=SYRUP01. Amoxicillin 06 Bottles Rs.660/=02. Derriphilline 06 Bottles Rs.720/=03. Salbutomol 750mls. Rs.250/=04. Paracetamol 750mls. Rs.280/=05. Belcid 06 Bottles Rs.1,188/=06. Piriton 750mls. Rs.220/=07. Domtic 06 Bottles Rs.900/=08. Erythromycine 06 Bottles. Rs.1,320/=09. Mumfer 06 Bottles Rs.1,818/=10. Phenycof (Adult) 06 Bottles Rs.792/=OINMENT & CREAM01.Betnovate N 06 Tubes Rs.1,560/=02. Sofrmycine 06 Tubes Rs.564/=03. Cipolex 06 Bottles Rs.450/=04. Jonac Gel 06 Tubes Rs.462/=INJECTIONS & OTHERS01. Depo Provera 06 Vials Rs.1,650/=02. Syringes 06 Rs.36/= TOTAL (NOT PAID) Rs.30,435/=

Clinic Staff PaymentsAPRIL MAY JUNE Total

Rs.45,800/= Rs.45,800/= Rs.45,800/= Rs.137,400/=Medicine Rs.33,720/= Rs.27,490/= Rs.30,435/= Rs.91,645/=Other Expenses Rs.2,325/= Rs.2,847/= Rs.600/= Rs.5,772/=Photo Copy, Internet Rs.1,192/= Rs.1,272/= Rs.1,813/= Rs.4,277/=Total Rs.83,037/= Rs.77,409/= Rs.78,648/= Rs.239,094/=

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