From recovery to resilience: Rebuilding the health system in Uva and Central Province after Cyclone Ditwah

WHO and Ministry of Health team visit health facilities in Cyclone Ditwah affected districts

During 15-17 May 2026, the WHO Representative to Sri Lanka, together with the WHO team, the Director General of Health Services, and Provincial and Regional health authorities, conducted field visits to key health facilities across Uva and Central Provinces. The mission covered Monaragala and Badulla districts in Uva Province and Nuwara-Eliya in Central Provice, including Base Hospitals - Thanamalwila and Dickoya; Divisional Hospitals - Spring Valley, Hakgala, Lindula and Madakumbura North; Primary Medical Care Unit - Ella and Silmiyapura; and Medical Officer of Health Units in Ella and Lindula.

These areas were among those most severely affected by Cyclone Ditwah in December 2025, which damaged 243 health facilities nationwide and disrupted essential services for affected and displaced populations. Badulla District was particularly impacted, with several facilities severely damaged and some completely destroyed

Image 1 – The Director General of Health Services and WHO Representative to Sri Lanka reviewing plans being implemented to mitigate the impact of future disasters on health facilities at the Divisional Hospital – Spring Valley, Badulla District. (Credits – Ministry of Health & Mass Media)

Despite extensive structural damage and operational constraints, the visits highlighted the extraordinary resilience and commitment of frontline health workers and district leadership. Across the Uva and Central Provinces, essential health services have continued, ensuring that communities remain supported during both the emergency and recovery phases.

Emergency and outpatient services have been maintained without interruption, with essential medicines and supplies consistently available. Even where inpatient services have been suspended due to structural damage or facilities being located in high-risk or unsafe zones, health teams have adapted quickly to sustain service delivery.

Many of these facilities serve tea plantation communities, where common emergencies include wasp bites, trauma, and cardiovascular conditions. These cases continue to be stabilized and managed at facility level. Patients requiring inpatient care are promptly referred and transferred to the nearest base hospitals following initial management.

Patient records and follow-up systems remain operational, with routine data collected and shared with district health authorities on a monthly basis. However, disruptions caused by the cyclone have resulted in nearly one-third of patients missing scheduled follow-up visits, highlighting an ongoing challenge in ensuring continuity of care.

Image 2 – Patient records and follow-up systems for essential NCD services being ensured through use of digital tracking mobile apps at Divisional Hospitals in Lindula and Thanamalwila in the Nuwara Eliya and Monaragala Districts. (Credits – WHO / Dr Farrukh Qureshi)

At facilities such as Divisional Hospitals in Spring Valley, Lindula, North Madakumbura and Primary Medical Care Unit in Silmiyapura, health teams continue to operate under challenging conditions, often from partially damaged buildings or temporary arrangements.

Dr Rajesh Sambhajirao Pandav, WHO Representative to Sri Lanka noted, “What we have witnessed across these districts is resilience in action. Health workers have continued to deliver essential services under extremely difficult circumstances. “Their commitment reminds us that resilient health systems are built on people, on their dedication to care, even in the most challenging circumstances.”

Direct engagement with frontline staff underscored their unwavering commitment to ensuring uninterrupted care for their communities.

Image 3 – Reviewing cold chain management practices at MOH Ella to ensure the safe storage of vaccines and the continued delivery of quality health services, with the WHO Representative to Sri Lanka observing efforts to maintain functional and resilient systems. (Credits – WHO / Dr Farrukh Qureshi)

Leadership driving recovery across provinces

The recovery response has been driven by strong leadership and coordination between national, provincial, and district health authorities. Regional and Provincial Directorates of Health Services in both Uva and Central Provinces have played a critical role in restoring services while planning for long-term recovery. 

In the Badulla District, health workers mounted an extraordinary response - working around the clock, even from severely damaged facilities. Six months after the cyclone, recovery efforts are progressing steadily, with continued focus on strengthening systems.

A commemorative event held in Badulla on 16 May 2026, attended by senior national and provincial leaders, honored the exceptional dedication and sacrifices of the health workforce during the initial response and continuing in the recovery phase.

Dr Asela Gunawardena, Director General of Health Services (DGHS) emphasized, “The commitment shown by our health workforce across affected districts has been exceptional. Despite the damage to infrastructure, services were never fully halted. Our focus now is on rebuilding stronger systems that can withstand future shocks while ensuring continuous access to care." 

Image 4 – Recognizing the dedication of front-line healthcare workers in response to Cyclone Ditwah, the Director General of Health Services and WHO Representative to Sri Lanka present tokens of appreciation at the commemorative event in Badulla. (Credits - Ministry of Health & Mass Media)

Building Back Better and Safer

The field visits reinforced a shared commitment to a “Build Back Better” approach - going beyond restoration to ensure safer, more resilient health systems.

Image 5 – A hazard sign posted to warn visiting patients of risk of vulnerable building structure in a corridor of the Divisional Hospital – Lindula in the Nuwara Eliya District. (Credits - Dr Farrukh Qureshi / WHO)

Key priorities moving forward include:

• The relocation and reconstruction of damaged facilities in safer, less disaster-prone areas;
• Strengthening emergency preparedness and response capacities at all levels;
• Ensuring uninterrupted supply chains for medicines and essential services;
• Integrating mental health and psychosocial support into recovery efforts;
• Improving patient tracking and follow-up systems to address service disruptions.

Health facilities in Spring Valley, Lindula, Silmiyapura and Madakumbura North are actively advancing plans for safer rebuilding, reflecting a strong, risk-informed approach to recovery.

Image 6 – Repairs and reinforcement of structure ongoing at the Primary Medical Care Unit in Silmiyapura in the Nuwara Eliya District, which was moderately damaged during Cyclone Ditwah. (Credits – Ministry of Health & Mass Media, Sri Lanka)

Looking ahead: Strengthening preparedness and equity

Cyclone Ditwah has underscored the importance of resilient and people-centered health systems, particularly in vulnerable and underserved communities such as plantation sectors. Sri Lanka is now integrating lessons learned into strengthened preparedness planning at all levels.

The Director General of Health Services added, “We are committed to ensuring that all communities, including those in hard-to-reach and high-risk areas, are protected through stronger, more resilient health systems.”

From Uva to Central Province, the recovery journey reflects resilience, leadership, and collective action. Health workers have stood at the forefront, delivering care with dedication, courage, and compassion. 

As Sri Lanka moves forward, the focus remains clear: transforming recovery into long-term resilience, ensuring health for all, even in the face of future challenges. WHO Sri Lanka continues to support the Government of Sri Lanka in advancing recovery and preparedness, ensuring that health systems are not only restored but transformed.