At the entrance of Hambantota’s Great Love Village leading to Tzu Chi National School, one would often get to see a white figure that travels alone. Upon reaching her destination at the Tzu Chi Clinic Center, nurse Pathmalatha will begin preparing for her day’s work. The clinic patients are mainly women and young children below age of five, and Pathmalatha had been contributing relentlessly towards the well being of these women and young children of the village. caption:Prenatal diagnosis in Sribopura was done using the most traditional method. Photo shows nurse Pathmalatha using a traditional listening tool to monitor the heartbeat of Mdm Naseer’s fetus.

H P Pathmalatha, the only nurse in the Great Love village. She had shouldered the responsibilities as the health guardian for the many women and young children in the village. Her target patients are women and young children below the age of five.

Little patient Hafsa is underweight and is suffering from hypogenesis. Apart from teaching her mother on how to provide proper nutrition for the child, Pathmalatha also gave supplementary food to the family.

Weight measurement for babies and young children are performed using a hanging type weighing scale, where baby is put in a fabric bag and hung on the scale to measure their weight. Young children will be secured using a trouser sling and lifted to have their weight measured.

Besides daily clinic work, making regular home visit is also one of the main duties of Pathmalatha. When the weather is good, she would either ride motorcycle or bicycle to do her home visit. During rainy season, where roads are slippery, she would travel on foot.

Naseer is pregnant for 35 weeks and is very close to her perinatal period. Pathmalatha had come to conduct prenatal check up for her and had also brought her vitamins and supplementary food.

Nayana Chamdani is a young mother who had just given birth to a baby girl a month ago. Pathmalatha had come to conduct check up for the baby as well as to ensure that the young mother knows how to give proper breast feeding and changing of diapers.

Nayana sees Pathmalatha as a mother who not only cares for her but  also gives her great peace of mind.

Siribopura, which is situated four kilometers away from the city of Hambantota, used to be a township with undulating terrain and vast expanse of wild jungle. The area was the habitat for monkeys, peacocks, lizards, small wild animals, and birds and was also the crossing ground for wild elephants. After the disaster of the South Asian tsunami in December 2004, Tzu Chi Foundation had constructed a total of 649 houses in the township to provide accommodation for the affected villagers.

The houses were labeled sequentially from ‘A’ to ‘S’ and joined together to become the Tzu Chi Great Love Village. The affected villagers were allocated into the houses in April 2006 and the place eventually became a warm and safe haven. There are also public transportation that link up the village and the city. Apart from the one and only paved road that leads from the village entrance to Tzu Chi National School, all other roads within the village are mostly mud tracks.

The clinic in the village

There will be at least five mornings in a week where one could see a white uniform figure traveling alone on the paved road to Tzu Chi Clinic Center. H P Pathmalatha, the only nurse and midwife in Great Love village, begins her day’s work from the moment she open the clinic’s iron grilles.

The clinic was officially in service on June 2008. Since Pathmalatha was appointed by Hambantota’s Office of Community Health to serve the village community, she had shouldered the responsibilities as the health guardian for the many women and young children in the village.

Pathmalatha has 18 years of experience in obstetrics and gynecology. The scope of gynecology includes prenatal and postnatal review as well as home visits to ensure that women undergoing confinement and their new born baby are all in good health. The clinic also provide basic medical services like vaccination for young children, health checkup, as well as education for women on topics of nursing, health education, nutrition, infectious disease prevention and family planning. A gynecologist is scheduled monthly to the clinic to carry out maternity examination; at times when there are more patients who needed medical care, the Ministry of Health will send three additional midwifery nurses to come and assist.

Pathmalatha revealed that pregnant women and expectant mothers in the past would have to go to Hambantota General Hospital whenever they needed body check up or child delivery. The journey was inconvenient and time consuming due to poor traffic condition. As the Great Love Village is the largest community in Hambantota, setting up such a clinic in the village had brought great convenience for the women and young children, saving them long and tiring trips to the general hospital.

Inspection, listening, inquiring, and palpation

Early in the morning on a monthly scheduled day of doctor’s visit, there were already more than 10 women waiting at the clinic waiting to seek for consultation. A glance of their attire tells that they are all Muslim. Some were pregnant, while some brought their babies or young children.

The prenatal diagnosis was conducted using the most traditional way. Apart from taking basic measurement on weight, blood pressure and performing urine test, the size of abdomen was also measured with a cloth ruler. The nurse would use their hands to feel the abdomen of the expectant mother to determine the fetal position and they would use a traditional hearing tool to check for the fetal heartbeat.

Weight measurement for babies and young children are performed using a hanging type weighing scale, where the baby is put in a fabric bag and hung on the scale to measure their weight. Young children will be secured using a trouser sling and lifted to have their weight measured. Every child would have a health record book which records information of their weight and vaccination injection.

Without the aid of advanced medical equipment, the methods employed are rather simple and primitive – essentially, treatment to be carried out relies a lot on the medical practitioner’s abilities in judging the patient’s condition by inspection, listening (smelling), inquiring, and palpation. However, the most important complementing factor is in fact the inherent trust and care between the healer and the sick.

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Mr M H Haneeffa, who is staying at Unit G53, was not able to fish offshore for two days because of continuous raining. Hence, he accompanied his wife and daughter to the clinic for review. The daughter is only 15 months old but the couple looked rather aged. According to Mr Haneeffa, who is in his 40s, he had lost his previous wife and two children, both more than ten years old then, to the 2004 tsunami. He remarried three years ago and his current wife gave birth to their daughter, Hafsa, last year.

The skinny little girl would shy away and stick close to her parents whenever she saw strangers. For Mr Haneeffa, having a daughter at his age is considered a blessing for him; his eyes were filled with affection whenever he looks at his daughter.

After Pathmalatha checked Hafsa, she told Mr Haneeffa and his wife that Hafsa is underweight and is suffering from hypogenesis. Apart from teaching the mother how to provide proper nutrition for the child, Pathmalatha also gave supplementary food to the couple.

Inquiring and visits to ensure healthiness

Besides daily clinic work, making regular home visit is also one of the main duties of Pathmalatha. Home visiting encompasses prenatal and postnatal care as well as imparting knowledge on family planning. On the day of home visit, Pathmalatha would display a message board outside the clinic window to indicate the time and venue where she would be doing home visits.

When the weather is fine, she would either ride motorcycle or bicycle. During rainy season, where roads are slippery, she would travel on foot and would only be able to complete the visits to families within two alleys.

It is frequent to make empty trips because of the poor communication infrastructure in Sri Lanka ─ not every household have telephone or handphone set. In such cases, Pathmalatha would request the neighbour to pass on the message that she had came visiting, or she would make a revisit on a later day. Despite the often scorching heat, Pathmalatha hanged on to make her trips without a word of complaint.

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21-year-old Nayana Chamdani is a young mother living in Unit A18. Her husband is a teacher at Tzu Chi National School.

The beautiful young mother had just given birth to her daughter, Gihara, a month ago. The baby is sleeping on the bed, surrounded by a mantle to protect her against mosquitoes and flies. Pathmalatha had come to conduct check-up for the baby as well as to ensure that the young mother knows how to fulfill basic mother’s chores like giving breast feeding and changing of diapers.

Nayana said that as this is her first child, she had very limited knowledge in handling the baby. Fortunately, Pathmalatha visits her often to look after her as well as imparting her on knowledge relating to birth giving and nursing baby. Apart from that, Pathmalatha had also given her vitamins and body supplements. Nayana commented that Pathmalatha is like a mother to her, who not only cares for her but also gives her great peace of mind. Nayana hoped that her daughter would grow up well to become a teacher like her husband.

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Naseer who lived in Unit G36, is pregnant for 35 weeks and is very close to her perinatal period. Pathmalatha had come to conduct the prenatal check up for her. Naseer’s husband, who is a fisherman, needs to fish offshore every evening and would only return on the next morning. As Naseer is about to give birth, Pathmalatha advised her husband of the need to engage their neighbours to stand by for assistance. She had also urged him to prepare the necessary items to be brought to the hospital when his wife is due for delivery.

Pathmalatha recalled that she started to conduct house visits as soon as she came to Great Love Village. When she first visited Naseer’s home, she realized that her four year old son was suffering from cerebral palsy. Naseer had related her grief to Pathmalatha on her bitter experience during the 2004 tsunami, where she failed to grip hold of her two other sons and eventually lost both of them during that disaster. It was through the continuous encouragement from Pathmalatha that Naseer was able to have the courage to conceive again. Her greatest wish is that the new baby would be able to grow up healthily.

A motherly nurse

Pathmalatha disclosed that over the past one year, Great Love Village already had more than 100 newborn babies. Till today, Pathmalatha had virtually tracked every corner of the village and there’s no one in the village who doesn’t knows her.

Pathmalatha remarked, “Even today, most of the people in the aftermath of the tsunami still have difficulties finding job. It is the tough economic situation that created the greatest problem which leads to family problems.” As such, Pathmalatha had silently vowed that she would fulfill her due responsibilities as a nurse with the caring heart of a mother, so that the health of all women and children in the village will be well taken care of. At the moment she speaks, Pathmalatha could not help but shed tears, her figure portrayed a touching scene reflecting “a motherly nurse” ’s compassion.

Pathmalatha has a son and a daughter. She lived with her in-laws in Ambalantota town, four kilometers away from Hambantota. The distance normally costs her three hours traveling to and fro her home and the Great Love Village each day. Pathmalatha said that she wished to apply to live in the village so that she could be readily available when the women and children in the village needed her help, especially in the middle of the night to perform emergency child delivery. She also vowed that she would continue to serve the community even after her retirement, so that she could take care more babies to come.