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
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