Friday I visited the MOH (Medical Officer of Health, it’s like a public health office) in Kadugannawa, a town near Kandy. I traveled with a doctor from the MOH to two maternal and child health clinics, one on a tea plantation, and one in a nearby village. The tea plantation was up at the top of a series of huge hills up a long, twisty road and was beautiful; green fields full of tea. The clinic and housing where the plantation workers lived was not so beautiful. The majority of tea estate workers are Tamils of Indian descent, and were brought over during the British colonial period to pick tea. The same families still work on the estates today, and they have some of the worst health outcomes in the country because of their poverty, low education level, poor nutrition, and limited access to healthcare.
At the clinic I couldn’t talk to anyone except the doctor I was traveling with, because everyone else spoke only Tamil, and a limited amount of Sinhala. Still I managed to observe how the clinic worked to some degree. Many of the babies were obviously underweight, and the moms malnourished. Still, everyone was very friendly, and the children giggled at me a lot and were cute and playful. The doctor I was with told me it was because they liked my skin color, a comment that made me somewhat uncomfortable, but may have been true. I also had a chance to see inside the estate housing, which was small, dark, and poorly ventilated. In this case the clinic and housing were the responsibility of the plantation, but the doctor I was with was there to check everything out, and report back to the MOH anything that needed to be improved. The clinic was in good shape, but the housing and toilets were going to be reported and the plantation would be expected to make changes.
The village clinic was equally interesting, but much less sad. The mothers and babies in the village clinic were energetic and healthy. The mothers brought us delicious snacks and tea. The doctor and nurses were able to see 20 pregnant mothers and 20 adorable babies in record time. The moms came in with booklets where the nurses marked the mother or baby’s health stats on a chart to monitor their progress. One baby was chewing on her booklet and screamed whenever the doctor tried to take it away to write in it. Once again, I wasn’t able to talk to the anyone at the clinic except the doctor, but being able to observe the way things work was still helpful.