Field note update on January 14, 2005

The field team in Sri Lanka is working hard and have made a great deal of progress in the first weeks: our site will be a small community in the Battiocola region called Ponochimunai serving 1100 families; we are now members of the Women's Coalition for Disaster Management working closely with a local NGO called Suriya to design a women's health project addressing safety and violence, and our practitioners will be working in many capacities with local Doctors and Midwives, as well as with other Ex-pat practitioners.

According to the UN, roughly 50,000 of the 150,000 pregnant women in disaster-affected areas will go into labor in the next three months. A lack of food, clean drinking water, and shelter, combined with the destruction of clinics and hospitals, and the injury and deaths of doctors, midwives, and other key staff make giving birth both dangerous and scary (IPPF). COHI was created specifically to respond to these needs and due to your on-going support; we are able to do so.

The needs and concerns, as identified by the female disaster survivors of this region are:

• Decision-making initiatives must take into account the opinions and concerns women have about the types of shelter, livelihood opportunities, social support and physical security and psychological attachments to their home area and community.
• Women are particularly concerned about the alcohol consumption by men in camps, as this increases the risk of sexual harassment, abuse and violence. Measures must be taken to both protect women through security arrangements as well as preventative mechanisms to engage men within useful and fulfilling activities in and outside the camps.
• Women and girls' reproductive health needs require special measures. We recommend that regular clinics for women (only) be held at each location, preferably with an all-female medical team. Special attention must be given to the needs of pregnant and feeding mothers.

Thanks to your immediate response to our call for support our team of 11 are either on the ground already, or will be within the next week's time. We have also secured an official COHI house and office where we are all safely sleeping, eating, and working. We are feeling deeply inspired about the work we are doing and the support we continue to receive from all of you feeds our spirits. We plan on staying in Sri Lanka for another 6 weeks to complete the initiated projects, but are also pursuing the possibility of staying on more long term. We will keep you posted of developments as they occur.

We could not be here without each one of you, and on behalf of the women COHI humbly serve, we thank you for your continued and inspirational support.

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Field note update on January 25, 2005

Batticaloa, Sri Lanka is in a state of flux today. The displacement camp has disappeared from the town cricket stadium to hopefully a better place -- with better shade, with cleaner latrines, and with more permanence. School begins today, and children are returning to class finding missing classmates and friends. Some lucky ones are returning without uniforms but wearing donated clothes, and sharing stories of survival with their classmates and teachers.

And today, COHI gave its sendoff to four amazing volunteers: Cliff, Rhonda, Jane, and Diane. In the past week, our amazing team has been addressing logistical issues like placing our medical practitioners, securing housing, transportation, and translators, for the team, advocating for small, grassroots, local NGOs, and cleaning up the rubble alongside the extraordinary Sri Lankan Red Cross volunteers. The work is exhausting, but also therapeutic and inspiring. Thank you for all your hard work, folks. We will miss you.

This week, our midwives Cynthia and Lylaine are hard at work attending deliveries and managing life-threatening complications. In their free time, they are visiting remote camps and providing the best in pre-natal care - care every woman deserves. Our accomplished psychiatrist Lin is facilitating counseling and secondary trauma sessions with the hard working staff at the Sri Lankan Red Cross.

And all of this could not be possible without the contributions of generous and gracious people like you. We will continue to work hard for the Sri Lankan people on your behalf, and you will be hearing more from us soon.

Poytu Varukirehn (Goodbye) and Nandri (Thank you)

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Field note update on January 31, 2005

It's been another busy week for the COHI field team in Batticaloa. This week was full of time spent visiting our practitioners at their clinic sites and recruiting local Sri Lankan women to train as women's health researchers for the Needs Assessment COHI is heading.

The midwives have made a magnificent impact on the medical communities they've served. Cynthia Flynn was able to demonstrate to the midwives in the wing of the hospital where she has worked for the last three weeks the value of patience and compassion to birthing women. Cynthia also traveled to several refugee camps to conduct prenatal clinics with local midwives to instruct them in the essentials of quality prenatal care. Lylaine Gavette was serving as a COHI midwife at the Maternity wing in a region where four other local hospitals were destroyed in the Tsunami. She was able to model the midwifery model of care: competent, capable, and compassionate. Both Cynthia and Lylaine are presently traveling to the capitol of Sri Lanka to give a lecture to the National Sri Lankan Midwifery Association before heading home to get back to their birthing communities. Thank you so much, Cynthia and Lylaine, for representing COHI in Sri Lanka with your wisdom, commitment to women, and grace. We've been honored to get to work with you both.

Lin Piwowarczyk has been leading counseling sessions for trauma survivors in the Batticaloa region through the Sri Lankan Red Cross. Through her involvement there, the counselors have learned how to cope with their own tragedies and trauma in order to better serve the others who are coming to them for help. Lin came to Sri Lanka to listen with an open and compassionate heart to those grieving here at the incredible loss of life, home, and safety. She did a beautiful job and because of her commitment to psycho-social care, hundreds of trauma counselors had someone to help them heal. Lin, COHI thanks you for bringing your gifts to the people of Batticaloa and we've been honored to share this experience with you.

Kloie Picot, a Canadian documentary filmmaker, joined the COHI field team and will be capturing our work here on film for the next two weeks. Through her magical talents we hope to be able to show all of you at home the work we are doing here, how your dollars are being spent, and how the women of Sri Lanka have benefited through COHI's involvement in the relief efforts.

As for the rest of us, we have been busy trying to get our logistical ducks in a row to begin the training on Monday for COHI's field researchers. After working with COHI for two weeks, they will be able to get jobs as trained researchers with other NGOs in the area. Together, we are conducting a survey at the refugee camps to determine the level of safety and health care women are receiving there. We will share the results with local NGOs, camp leaders, and Sri Lankan health offices to help design women specific strategies for the camps.

I would like to say thank you to all of you and ask you to continue your generous support for the work we do at COHI. We are doing our best for the women here, and you are with us -- in heart and mind -- every step of the way. Until next time.

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Field note update on February 7, 2005

Another bustling week in Batticaloa found the Sri Lanka field team bidding a fond fair well to Adam Rosenbloom and welcoming in Lynne Hudson. On the ground here, the rubble is clearing and people are returning to what is left of their homes to rebuild not only the physical structures but also their sense of safety and community. More children are returning to school, and we saw Sri Lankan Independence Day celebrated last week as the people of Sri Lanka focused their energy on celebration with the hopes of starting anew. We've heard so many stories about mothers, fathers, children, and life savings washing away in the sea never to be seen again. It is an honor for the COHI field team to be here sharing this time with the women of Sri Lanka who are so courageously putting their lives back together in the face of such sadness, poverty, and destruction.

The Field Team this week consisted of Project Manager Adam Rosenbloom, COHI Executive Director, Sera Bonds, and Kloie Picot a documentary filmmaker. We piloted a Women's Health Needs Assessment last week at the Central College Camp for Internally Displaced People with the assistance of our 16 Sri Lankan interviewers. It was a smashing success. We were we able to fine-tune our research methods and tools, and our researchers demonstrated a competency in conducting the interviews that makes us hopeful for the accuracy and usefulness of our results. We have also received a grant from an INGO working in Sri Lanka in order to fund the undertaking and distribution of the needs assessment. They are keen to see our results in order to design appropriate women's health programming and begin to actively address the women's health needs as our survey identifies them in the Batticaloa district of eastern Sri Lanka. We also have begun purchasing medical equipment and supplies to distribute to the women at the camps in our time that remains here.

We said goodbye to Sri Lanka Project Manager, Adam Rosenbloom, this week. Thank you for your commitment to COHI, your grace in the face of such dispair, and for undertaking the often thankless job of getting all the proverbial ducks in a row so that the rest of the team can focus on getting to work. We also welcomed Lynne Hudson from Austin, Texas, who is a women's health Nurse Practitioner. She is already making herself useful by conducting impromptu women's health clinics in the camps we are surveying and gathering information about what women would like to see in the camps. Next week we hope to set her up with a lecturing opportunity at a local Nursing school to address family planning issues and to have another training for our interviewers on women's health and hygiene. Johnny Lee Park returned from a few days of much needed rest and hit the ground running with the data entry and analysis phase of the needs assessment.

The field team passed the half-way point of our stay here and we are doing all we can to make a difference in our time that remains. Thank you for your support of Circle of Health International and the work we are doing for conflict, post-conflict, and disaster affected women. We couldn't do this important work without you. Until next time

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Field note update on February 11, 2005

The COHI Sri Lanka field team members were recently reminded of the violence and upheaval that characterized life for the people of Sri Lanka for the past twenty years. Long before the tsunami disaster compounded Sri Lankans struggle for survival, this was a country embroiled in a civil war that ended in a delicate ceasefire in 2001. Though it is tempting to believe that the most pressing needs for the people here are food and permanent housing, the reality of the situation is far more complex.

Earlier this week, a car carrying a faction of LTTE members, including a well-known guerrilla leader, from the Ampara district was ambushed by an unknown faction and resulted in six deaths. Consequently, a sympathy strike in the northeastern regions of Sri Lanka is currently underway, and the region of Batticaloa has come to a complete stand still. Indeed, large numbers of Tamil Sri Lankans still consider themselves marginalized and would like to see their issues addressed by the Sri Lankan government. Some Tamils believe that the Tamil controlled areas, such as the Batticaloa region where COHI conducted its needs assessment, as well as areas that enjoy a Tamil majority are currently receiving less aid than other parts of the county and continue to be denied equal treatment at this time of unprecedented need. Others have expressed fears that this could lead to an increase in violence in the region.

Since the western press is covering the political situation in Sri Lanka, we wanted to share with you our perspective from the ground. Although a strike is in place, it is primarily a sympathy strike. As such, violence is unlikely to spread during or immediately after the funeral for the LTTE members and life is expected to normalize within a day or two. We hope this helps to clarify the dynamics of the political situation, and to ease the hearts and minds of those of you who have express concern for us.

While countries like Sri Lanka have worked hard to make peace a reality, times like these clearly illustrate that as much as the women here need our medicine and skills, what they truly need is peace in order to move on with their lives. May they soon find it.

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Field note update on February 19, 2005

The Sri Lankan field team recently finished the Women's Health Needs Assessment and we have spent our last days in Batticaloa distributing it to INGOS, local organizations, and interested individuals in the area. We are very happy with the document as well as with the promise that the results will be utilized by the INGOS, local organizations, and donor communities that want to contribute in a long-term and sustainable manner to women's health issues.

When we weren't busy writing and analyzing data, we were hard at work this last week spending your generously donated dollars here in Batticaloa. This is how your money has been allocated thus far:

• $1000 to the Butterfly Garden Children's Sanctuary which serves as a place of healing for conflict-affected children;
• $4000 to Suriya, a local women's organization focusing on violence, safety, and health issues in Batticaloa for the past ten years;
• $6000 to the clinical sites that hosted our nurse-midwives and MD trauma specialist to support the purchase of new equipment, supplies, and staff trainings;
• $1000 for underwear, bras, sanitary napkins, and soap (the most immediate needs identified by women participating in our survey) delivered to six of the ten camps in the area;
• $1500 for all of our home and office equipment donated to local families that lost their belongings;
• $1000 to Home for Human Rights, a local NGO, to support organizational development while they work with the community to rebuild homes, schools, and water systems;
• $1000 in donations to specific families we have met and befriended, to cover medical costs, reconstruction of their homes and fishing boats, and to return their children to school.

You kindly entrusted a total of $25,000USD to COHI for relief work in Sri Lanka, and it is our hope that we will be able to make reoccurring donations to several of the above- mentioned institutions. We are also researching the possibility of our practitioners returning for a long-term teaching program for midwives practicing in the area.

The COHI field team says a formal good bye to Johnny Lee Park who was the first field team member on the ground and will be the last to leave. Johnny secured a long-term position with the United Nations High Commission for Refugees (UNHCR) and has accepted a one-year paying post in the northern city of Jaffna. Johnny, thank you for your commitment to COHI, your competency, and your friendship. COHI has been lucky to have you and we wish you the best of luck with UNHCR. We would like to take a moment to thank Lynne Hudson who has been busy serving in both a clinical capacity on mobile health teams in the camps and helping Johnny and me with the Women's Health Needs Assessment. Lynne, it has been an honor and a privilege to work alongside of you here and we hope this is just the beginning of many baby-catching adventures we will share together.

While traveling to Valechinai yesterday to visit one of our practitioner's clinical sites, Lynne and I arrived just in time to assist in the birth of a perfect little girl. Bearing witness to the serenity and calm this delivering mother embodied in spite of her physical struggle to give birth sums up our work here perfectly. I hope that having COHI's clinicians, public health professionals, and our other volunteers in their midst has helped to ease some of the despair presently characterizing the lives of the women here.

To the women of Sri Lanka, thank you for your grace and welcoming nature, and we hope that it is not too long before you find the peace you deserve. And for all of you who have journeyed here along with us, thank you for your generous and timely support. We look forward to the next opportunity we have to represent COHI again in the world working alongside conflict, post-conflict, and disaster-affected women on your behalf.

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