Health System Resilience and Emergency Response in Kegalle District Following Cyclone Ditwah

In the aftermath of Cyclone Ditwah, Kegalle District faced one of the most severe disasters in recent history, marked by widespread floods and landslides that displaced over 26,000 families and affected more than 90,000 individuals. The devastation included significant loss of life, missing persons, injuries, and extensive damage to homes, health facilities, and infrastructure. The World Health Organization (WHO) Representative to Sri Lanka visited the Kegalle Regional Directorate of Health Services (RDHS) area on 30^th December 2025 to witness and firsthand the resilience, dedication, and recovery efforts of the district’s health system and communities.

A District Tested by Crisis

Over recent weeks, Kegalle District has faced severe floods and landslides, resulting in the displacement of thousands, destruction of homes, and significant damage to health facilities and infrastructure. At the peak of the crisis, more than 3,700 people from 1,343 families sought shelter in 31 welfare centers across the district. Access roads were cut off, power and water supplies disrupted, and health workers themselves were among those affected.

Kegalle’s health system was challenged by the magnitude and geographic spread of the disaster, with previously unaffected areas inundated and communities isolated. Major roads, including the Colombo-Kandy route, were cut off, and key health institutions such as Base Hospital Karawanella became isolated “islands,” suffering structural, vehicle, and equipment damages. Ten clinic centers and PHM offices were flooded, with records and equipment destroyed.

Health Services: Unbroken in the Face of Adversity

Despite these unprecedented challenges, the health system in Kegalle demonstrated remarkable preparedness and commitment. Emergency operations were activated swiftly, rapid response teams were deployed, and essential health services, including acute care, maternal and child health, mental health, and noncommunicable disease management, continued without interruption, even in the most isolated areas.

Disaster Management Plan: The district’s pre-established disaster management plan and recent simulation exercises enabled a swift, structured response. The Emergency Operations Cell was activated, with clear incident command and documented member roles.

^{Photo credit: Office of Regional Director of Health Services, Kegalle}

Rapid Communication: Pre-existing WhatsApp networks facilitated rapid intra- and inter-sectoral coordination.

Health Workforce Dedication: Health staff prioritized service delivery despite personal risk, exemplifying teamwork and leadership across all levels. Medical Officers of Health, Public Health Midwives, and Inspectors spearheaded the response, reaching even the most isolated clients, such as those in Dothaloya estate, sometimes by air or on foot.

Public health teams worked tirelessly in the field, ensuring that immunization, nutrition, breastfeeding support, and family planning services continued in Suraksha shelters. Active surveillance, mosquito control, leptospirosis prevention, food safety inspections, and health education were prioritized, preventing communicable disease outbreaks in the camps. Mental health was not forgotten where specialist teams provided screening and counseling, while community activities helped restore dignity and hope, especially for children and adolescents.

^{Photo credit: Office of Regional Director of Health Services, Kegalle}

Continuity of Essential Health Services

^{Photo credit: Office of Regional Director of Health Services, Kegalle}

Curative and Preventive Care: Acute care, maternal and child health, mental health, and NCD management continued uninterrupted, even in inaccessible areas. Outreach clinics in Suraksha camps provided medication for NCDs and treatment for minor ailments.

Immunization and Nutrition: Routine immunization and child nutrition services were maintained, with breastfeeding actively promoted and supported. Special attention was given to infant and child nutrition, including complementary feeding and distribution of Thriposha and BP-5 rations.

Mental Health Support: Four mental health teams led by consultant psychiatrists visited Suraksha shelters for screening, counseling, and management of psychiatric patients. Community activities, including music, dancing, and games, were organized to boost mental well-being.

^{Photo credit: Office of Regional Director of Health Services, Kegalle}

Disease Prevention and Health Education

Active Surveillance: Surveillance for communicable diseases, mosquito and fly control, and leptospirosis prevention (doxycycline distribution) were prioritized. No communicable disease outbreaks were reported in Suraksha camps.

Health Education: Health education played a vital role in camps and communities, supporting hygiene, nutrition, and disease prevention. Flood-affected stores were inspected, and damaged food was discarded under supervision. 

^{Photo credit: Office of Regional Director of Health Services, Kegalle}

Community Engagement and Recovery

Community Participation: Public Health Midwives and community members cleaned and restored damaged clinics, salvaged vital records, and resumed services within days. Donations of food, clothes, toys, books, and school supplies supported camp residents, while maternity and dignity kits were distributed to vulnerable groups.

Solidarity and Support: WHO Sri Lanka mobilized emergency funds (5.6 million LKR) for rapid response teams, equipment procurement, and disease surveillance. Technical guidance, training, and global best practices strengthened local recovery efforts.

Achievements and Way Forward

Achievements: No communicable disease outbreaks, continuity of routine immunization, safe management of high-risk pregnancies, rapid re-establishment of essential health services, and strong community engagement.

Way Forward: The district aims to update its disaster management plan, conduct regular simulations, disseminate standardized preparedness guidance, and integrate preparedness into routine health operations. Capacity building, school-based disaster simulations, and promotion of climate-resilient health infrastructure are prioritized for future resilience.

Challenges

Unprecedented Scale: The disaster’s magnitude exceeded prior experiences, with flooding in new areas and simultaneous multi-hazard impacts.

Resource Limitations: Equipment shortages and delayed external assistance due to access constraints.

Access and Communication Barriers: Isolation of communities and disrupted communication networks complicated response efforts.

WHO’s Emergency Response and Solidarity

Recognizing the urgent needs in Kegalle and other affected districts, WHO Sri Lanka mobilized emergency funds of 5.6 million LKR to support the district’s response. These resources enabled the deployment of rapid response teams, procurement of essential equipment, and strengthening of disease surveillance to prevent outbreaks of dengue, leptospirosis, and other water- and vector-borne diseases. WHO’s support extended beyond financial aid, providing technical guidance, training, and global best practices to strengthen local response and recovery efforts.

Stories of Resilience: Field Impressions

During the visit, the WHO Representative met with health staff and community members at key sites, including Thalduwa Maternal and Child Health Clinic (Dehiowita MOH area), Base Hospital Karawanella, Yatiyanthota MOH, and Mabopitiya Suraksha Center. At Thalduwa Clinic, floodwaters had risen to the roof, destroying vital records and damaging offices. Yet, with guidance from the RDHS and strong community support, the public health team restored records and resumed services, an inspiring example of resilience in action.

^{Photo credit: WCO Sri Lanka}

At Base Hospital Karawanella, the Medical Superintendent and curative care team shared their experiences of maintaining essential services despite severe flooding. The visit also highlighted the dedication of Dr. Dumith Senevirathne and the Yatiyanthota public health team, who continued outreach and surveillance in challenging conditions.

^{Photo credit: WCO Sri Lanka}

Recovery Needs and the Road Ahead

The scale of recovery required is immense. The health sector’s recovery needs are estimated at over 21 billion LKR nationwide, with Kegalle’s facilities requiring urgent repairs, equipment replacement, and support for displaced populations. Eight health institutions in high-risk zones require relocation, and major hospitals such as Base Hospital Karawanella have significant infrastructure and equipment needs.

Immediate priorities include restoring access to healthcare, ensuring safe water and sanitation, supporting nutrition for vulnerable groups, and addressing mental health and psychosocial needs. WHO’s operational plan for Sri Lanka targets 300,000 people, focusing on restoring essential health services, preventing disease outbreaks, expanding mental health support, and enhancing coordination among partners.

A Call for Solidarity

The extraordinary response in Kegalle reflects what is possible when preparedness, leadership, teamwork, and community participation come together. Special appreciation goes to the leadership of RDHS Kegalle, Dr. P. Nithershini, and the entire RDHS team, including Consultant Community Physicians, MO Planning, MO MCH, Regional Epidemiologist, MO NCD, MO MH, and the dedicated public health workforce.

As the WHO Representative emphasized, “Your unwavering commitment is the foundation of hope and recovery for thousands of families. WHO Sri Lanka remains your partner, today and in the months ahead, as we rebuild lives and restore health for all.”