From Sri Lanka with Love: Lessons in Primary Care for Remote Rural Australia
Last week I visited Rangiri primary health care centre in Dambulla district, Sri Lanka, with a group of Australian GPs who were there for a continuing medical education program. We were all impressed. The facility had a lovely kitchen garden with cassava, brinjal, leafy greens and chillis. It was clean, well maintained, and full of bustle.
Families pulled up in autorickshaws and kids spilled out, running to the playground in the grounds of the facility, while their mothers took their babies to the centre to get immunized.
While the mothers waited for the cooler of vaccines to arrive from the district headquarters, midwives gave the waiting mothers a talk about important practices for child health. Mothers listened attentively, bouncing their babies on their knees. They all carried their baby’s records in folders, which they had taken the time to illustrate themselves with pictures of babies from magazines.
On the wall was a “skill map” that listed all the extra curricula skills that the facility staff had, like carpentary, cooking and cultural knowledge. This seemed like a great initiative to illustrate the ways the team could contribute to the life of the facility beyond their job role – recognizing the whole person in the workplace. Also on the wall of the facility were pictures from cultural events and festival celebrations that the facility had hosted for the community.
I thought this facility must be model facility, but I was told by our host Dr Sampath Tennakoon the Head of Community Medicine at the University of Peradeniya, that it is typical of all such primary health centres – it was only chosen as our visit site because it was open the day we had scheduled the visit.
Some husbands had accompanied their wife and kids to the facility in autos, or taken them on motorbikes. These men had a clear sense of a division of labour, they all pateintly waited outside near the gate. Child health was clearly “women’s business”.
Aleeta, a doctor from Darwin who serves remote rural indigenous communities was inspired to see the kitchen garden. She mentioned they really need this at the facilities where she works – where she is often the only doctor for 300kms. Her communities experience real hunger and food insecurity, and a garden at the facility provides a chance to teach communities how they can feed themselves.